Associations Between Supportive Leadership Behavior and the Costs of Absenteeism and Presenteeism: An Epidemiological and Economic Approach.

OBJECTIVE: This study investigates associations between supportive leadership behavior (SLB) and presenteeism/absenteeism, and estimates related costs. METHODS: Cross-sectional data from a German industrial sample (n = 17,060) assessing SLB and presenteeism/absenteeism were used. Adjusted interval regressions were performed. The study population was split into tertiles with respect to SLB, and minimum and maximum costs for each tertile were estimated on the basis of national industry averages. RESULTS: Low SLB was associated with higher presenteeism [-0.31, 95% confidence interval (95% CI) -0.33 to -0.28)] and absenteeism (-0.36, 95% CI -0.40 to -0.32). Compared with high SLB, the costs of low SLB for absenteeism are between 534.54 and 1675.16 Euro higher per person and year. For presenteeism, this difference ranges between 63.76 and 433.7 Euro. CONCLUSIONS: SLB has the potential to reduce absenteeism, presenteeism, and associated costs. To contribute to workforce health, productivity, and efficiency, SLB merits being fostered by corporate policy.

Determinants of peripapillary retinal nerve fiber layer thickness regarding ocular and systemic parameters - the MIPH Eye&Health Study.

BACKGROUND: Optical coherence tomography (OCT) allows quantitative image analysis of retinal tissue in vivo. Peripapillary retinal nerve fiber layer (pRNFL) thickness is widely used for evaluation of retinal nerve fiber rarefaction in several optic neuropathies. This study evaluates associations of pRNFL thickness in healthy adult subjects in order to evaluate influencing factors. METHODS: A cross-sectional study was performed in a working-age population. Only eyes without detectable ocular pathologies were included in the analysis. Among analyzed systemic cardiovascular parameters were age, gender, body-mass index, mean arterial blood pressure, HbA1c, high- and low-density-lipoproteins, and triglycerides. A comprehensive ophthalmological examination including refraction, tonometry, keratometry, and central corneal thickness measurmentwas performed. In addition, pRNFL thickness was imaged by spectral-domain OCT. Univariable and multivariable associations of pRNFL thickness in all four quadrants and on average with systemic and ocular parameters were calculated using a generalized estimating equation model. RESULTS: Three hundred and six subjects were included. pRNFL thickness measurements showed a significant association with spherical equivalent: pRNFL thickness decreased with increasing myopia in all quadrants (multivariable regression coefficients Beta: superior: 1.16, 95 % CI [0.62;1.71], p < 0.001; temporal: 0.87, [0.33;1.41], p = 0.001; inferior: 1.80, [1.18;2.42], p < 0.001; nasal: 2.60, [2.01;3.20], p < 0.001) and on average (1.51, [1.20;1.82], p < 0.001). A thicker central cornea thickness was related to lower pRNFL in the superior (-0.05, [-0.10; -0.01], p = 0.01), the inferior quadrant (-0.05, [-0.10;0.00], p = 0.03) and on average (-0.04, [-0.07; -0.01], p = 0.02). All other parameters were not  associated. CONCLUSION: Our findings highlight the importance of refraction when evaluating pRNFL thickness and its independence from other systemic parameters.

Central Corneal Thickness in Spectral-Domain OCT and Associations with Ocular and Systemic Parameters.

Background. Optical coherence tomography (OCT) allows quantitative analysis of the anterior segment of the eye with a noncontact examination. The aim of this study is to analyze associations of central corneal thickness (CCT) as measured by OCT with ocular and systemic cardiovascular parameters. Methods. A cross-sectional study of 734 persons was performed in a working age population. Only healthy eyes were included. A comprehensive ophthalmological examination including refraction, noncontact tonometry, and imaging of the anterior segment by SD-OCT was performed. In parallel, a broad range of systemic cardiovascular parameters were measured. Associations were analyzed using a generalized estimating equations' model. Results. CCT measurements showed a significant association with corneal curvature and intraocular pressure: a thinner CCT was associated with a flatter cornea and with lower intraocular pressure (p < 0.001). Age was positively associated with CCT (p < 0.001); all other cardiovascular parameters were not associated. Conclusion. A thinner cornea is associated with a flatter surface and with lower intraocular pressure readings, while there are no independent associations with refraction and systemic cardiovascular parameters. Our findings highlight the value of SD-OCT CCT measurements as a standard tool in anterior segment analysis.

Associations of macular thickness in spectral-domain OCT with ocular and systemic cardiovascular parameters - the MIPH Eye & Health Study.

PURPOSE: Beyond in-vivo histological analysis of retinal tissue, optical coherence tomography (OCT) allows quantitative image analysis. This study evaluates associations of macular retinal thickness measured with spectral-domain OCT (SD-OCT) and ocular and systemic cardiovascular parameters in adult subjects. METHODS: An epidemiological cross-sectional study was performed in the staff of a European high-tech company. Examination of known cardiovascular risk factors including biochemical blood analysis was performed, and ocular parameters such as refraction, tonometry, SD-OCT imaging of the macula and cornea, and fundus photography were evaluated. Retinal thickness measurements were evaluated according to the ETDRS grid. Associations of macular retinal thickness and systemic cardiovascular and ocular parameters were calculated by multivariate analysis using SPSS software. RESULTS: Four hundred and twenty-four probands were included. Macular thickness measurement were significantly associated with gender and refraction. Female persons had thinner retinal thickness in all zones. Macular thickness decreased with increasing myopia in all perifoveal measurements. Outer perifoveal measurements were associated with keratometry; a flatter corneal radius was linked to a thinner retina. Tonometry and systemic cardiovascular risk factors were not associated with macular retinal thickness in multivariate analysis (p > 0.05). CONCLUSIONS: Macular retinal thickness is associated with refraction and gender; cardiovascular risk factors or tonometry do not influence macular retinal thickness measurements. Keratometry might influence outer zone measurements. Our findings provide a dataset for quantitative evaluation of SD-OCT, and evaluate influencing factors.

A retinal snap shot may indicate individual risk for cardiovascular disease - the MIPH Eye&Health Study.

BACKGROUND: Examination of retinal vasculature can be used to non-invasively quantify changes within the microvasculature of the human body and might be a predictor of cardiovascular disease. This study evaluates associations of the structure of the retinal vasculature with established risk factors for cardiovascular disease. METHODS: A cross-sectional study was performed in a working age population. Several systemic cardiovascular parameters were analyzed and PROCAM- and SCORE-risk estimates were calculated. A quantitative ophthalmological examination including digital fundus imaging has taken place. Central retinal arterial/venous equivalents (CRAE/CRVE) and arterio-venous ratio (AVR) were analyzed using validated software. Associations of retinal vessel parameters and systemic cardiovascular and ocular parameters were calculated by multivariate analysis using SPSS software. A p-value of <0.05 with Bonferroni correction was accepted as significant. RESULTS: 338 probands were included. A smaller CRAE was independently associated with increased mean arterial blood pressure, higher age and higher body-mass index. Regarding CRVE age was inversely associated. Other cardiovascular risk parameters were not associated to the examined retinal vessel equivalents. AVR showed a significant association to mean arterial blood pressure and body-mass-index. PROCAM- and SCORE-risk estimates were negatively associated with CRAE and AVR, but not associated to CRVE. CONCLUSIONS: Arterial retinal vessel analysis and AV-ratio showed associations to established cardiovascular parameters in the study population. PROCAM- and SCORE-risk estimates as indicators of cardiovascular risk were associated with the CRAE and the AV-ratio. This suggests that a single snap shot of the retinal vessels may indicate the individual relative risk for cardiovascular events.

Optical coherence tomography-based retinal vessel analysis for the evaluation of hypertensive vasculopathy.

PURPOSE: Evaluation of retinal vessels in cardiovascular disease traditionally relies upon funduscopy, but more recently digital photo analysis has expanded the spectrum. As spectral domain optical coherence tomography (OCT) allows an in-vivo assessment of retinal tissue and its vessels on a histological scale, our study aimed at using this tool for the analysis of the retinal vasculature. METHODS: Circumferential peripapillary OCT scans (3DOCT-2000; Topcon Inc., Tokyo, Japan), with centration on the optic nerve head, were taken from 20 eyes (20 participants) with normal blood pressure and 20 eyes (20 participants) with arterial hypertension above 120 mmHg (mean blood pressure). The diameter of all vessels intersecting the scan line was measured in the OCT and used to calculate central vessel equivalents, and the A/V ratios were calculated. Bland-Altman analysis was performed to evaluate reliability. Correlation coefficients were determined for reliability of the method as well as with the individual mean arterial blood pressures. RESULTS: Forty eyes (40 participants) were included in the study. Mean arterial blood pressure was 96±4 mmHg in the control group and 132±7 mmHg in the hypertonic group. Mean A/V ratio as determined from OCT scans was 0.82±0.13 (normotonic) versus 0.62±0.11 (hypertonic). A Pearson's correlation coefficient of 0.67 (p<0.001) was determined between A/V ratio and blood pressure. CONCLUSIONS: Our results highlight the feasibility of retinal vessel measurements in spectral domain OCT. A relation between mean arterial blood pressure and OCT-based A/V ratio was established. Further research will elucidate influencing factors and provide a broader basis for therapeutic approaches.

Semi-automated retinal vessel analysis in nonmydriatic fundus photography.

PURPOSE: Funduscopic assessment of the retinal vessels may be used to assess the health status of microcirculation and as a component in the evaluation of cardiovascular risk factors. Typically, the evaluation is restricted to morphological appreciation without strict quantification. Our purpose was to develop and validate a software tool for semi-automated quantitative analysis of retinal vasculature in nonmydriatic fundus photography. METHODS: matlab software was used to develop a semi-automated image recognition and analysis tool for the determination of the arterial-venous (A/V) ratio in the central vessel equivalent on 45° digital fundus photographs. Validity and reproducibility of the results were ascertained using nonmydriatic photographs of 50 eyes from 25 subjects recorded from a 3DOCT device (Topcon Corp.). Two hundred and thirty-three eyes of 121 healthy subjects were evaluated to define normative values. RESULTS: A software tool was developed using image thresholds for vessel recognition and vessel width calculation in a semi-automated three-step procedure: vessel recognition on the photograph and artery/vein designation, width measurement and calculation of central retinal vessel equivalents. Mean vessel recognition rate was 78%, vessel class designation rate 75% and reproducibility between 0.78 and 0.91. Mean A/V ratio was 0.84. Application on a healthy norm cohort showed high congruence with prior published manual methods. Processing time per image was one minute. CONCLUSIONS: Quantitative geometrical assessment of the retinal vasculature may be performed in a semi-automated manner using dedicated software tools. Yielding reproducible numerical data within a short time leap, this may contribute additional value to mere morphological estimates in the clinical evaluation of fundus photographs.