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Choi and Cho: Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography in Healthy Koreans
Original Article

J Korean Ophthalmol Soc 2018;59(6):537-542.

Published online: 25 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.6.537

Retinal Nerve Fiber Layer Thickness Measured by Spectral Domain Optical Coherence Tomography in Healthy Koreans

Youna Choi, MD, Byung Joo Cho, MD, PhD

Department of Ophthalmology, Konkuk University School of Medicine, Seoul, Korea

Address reprint requests to Byung Joo Cho, MD, PhD Department of Ophthalmology, Konkuk University Medical Center,#120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: 82-2-2030-8180, Fax: 82-2-2030-5273 E-mail: bjcho@kuh.ac.kr

Received 20 July 2017       Revised 31 March 2018       Accepted 28 May 2018

Copyright © 2018 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To determine normal retinal nerve fiber layer (RNFL) thickness by age and to investigate the relationships of the RNFL with clinical variables using spectral domain optical coherence tomography (SD-OCT) in healthy Koreans.

Methods

The peripapillary RNFL thicknesses were measured around the optic disc using consecutive circular B-scans with 3.5 mm diameter and automatically calculated using a SD-OCT.

Results

Three hundreds fifty-two eyes of 205 healthy subjects were included in the study and RNFL thickness were measured by SD-OCT. Overall average RNFL thickness was 100.2 ± 10.9 μ m, and significantly and negatively correlated with age (r = −0.164, p = 0.002). The overall average RNFL thickness decrease per decade was 0.8 μ m (95% confidence interval, −0.3 to −1.3, p = 0.019). Mean RNFL thickness of each quadrant was significantly correlated with axial length except in the superior quadrant.

Conclusions

This study describes the normal RNFL thickness values of Koreans as determined by SD-OCT. Furthermore, age was found to be correlated with normal RNFL thickness, however age-related changes were not uniform across every region. J Korean Ophthalmol Soc 2018;59(6):537–542

Keywords: Axial length, Cup-to-disc ratio, Korean, Retinal nerve fiber layer, Spectral domain optical coherence tomography

References

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Figure 1.
Associations between overall retinal nerve fiber layer (RNFL) thickness and age. Age significantly affected overall average RNFL thickness, and the rate of average RNFL thinning was approximately 0.8 μ m per decade. dots mean individual RNFL thickness for age, line mean RNFL thickness average.
jkos-59-537f1.tif
Figure 2.
The associations between retinal nerve fiber layer (RNFL) thickness and axial length (AXL). AXL significantly affected average RNFL thickness in four quadrants. RNFL thicknesses in superior, nasal, and inferior quadrants decreased and RNFL thickness in temporal quadrant increased as AXL increased. dots mean RNFL thickness for AXL, lines are pre-sented as mean RNFL thickness. T = temporal; S = superior; N = nasal; I = inferior.
jkos-59-537f2.tif
Table 1.
Characteristics of subjects
Variable Value
Age (years) (n = 352) 42.83 ± 22.42
BCVA (logMAR) (n = 350) 0.09 ± 0.20
SE (D) (n = 338) –0.87 ± 1.99
IOP (mmHg) (n = 298) 14.33 ± 2.78
c/d ratio (n = 352) 0.37 ± 0.13
AXL (mm) (n = 315) 23.60 ± 1.17

All data was presented as mean ± SD.

BCVA = best corrected visual acuity; SE = spherical equivalent; IOP = intraocular pressure; c/d ratio = cup-to-disc ratio; AXL = axial length; SD = standard deviation.

Table 2.
Mean retinal nerve fiber layer thicknesses of each segment by age
  1–9 10–19 20–29 30–39 40–49 50–59 60–69 70–79 80–89 Total p-value‡
N (%) 30 (8.5) 43 (12.2) 55 (15.6) 36 (10.2) 35 (9.9) 60 (17.0) 49 (13.9) 37 (10.5) 7 (2.0) 352  
                  (100.0)  
G 104.1 ± 100.9 ± 100.6 ± 101.4 ± 104.6 ± 98.9 ± 96.6 ± 96.3 ± 102.7 ± 100.2 ± 0.0054*
7.2 10.4 9.0 7.8 9.3 16.9 8.7 9.0 6.8 10.9  
T 79.7 ± 78.3 ± 88.9 ± 79.0 ± 79.9 ± 77.2 ± 75.9 ± 72.7 ± 80.6 ± 79.3 ± <0.0001*
13.7 11.5† 20.8† 13.1 12.6 12.7‡ 15.0† 9.7† 8.3 14.9  
S 131.5 ± 123.9 ± 122.3 ± 125.0 ± 130.1 ± 122.0 ± 115.5 ± 114.6 ± 106.6 ± 122.2 ± <0.0001*
13.6 14.9 19.1 13.1 17.8 17.7 14.6 17.0 23.6 17.3  
TS 144.7 ± 138.3 ± 138.9 ± 140.4 ± 145.1 ± 135.0 ± 129.2 ± 124.7 ± 116.3 ± 136.1 ± <0.0001*
14.2† 17.2† 18.5† 15.9† 23.3† 21.4 16.4† 19.1† 48.4 20.5  
NS 118.3 ± 109.6 ± 105.7 ± 109.5 ± 115.0 ± 108.9 ± 101.7 ± 104.6 ± 97.0 ± 108.3 ± 0.0223*
20.1† 19.9 27.3 17.7 22.2 23.1 19.9† 21.2 10.9† 22.1  
N 67.9 ± 69.9 ± 64.9 ± 69.1 ± 73.4 ± 72.1 ± 69.9 ± 68.2 ± 79.3 ± 69.6 ± 0.1308
13.7 15.6 22.1 14.0 12.6 12.6 12.6 14.7 10.9 15.3  
I 136.6 ± 131.3 ± 128.1 ± 131.7 ± 134.6 ± 131.2 ± 125.1 ± 129.5 ± 133.6 ± 130.6 ± 0.2879
16.5 20.1 15.6 15.6 12.8 31.2 12.9 16.2 14.4 19.4  
TS 144.7 ± 138.3 ± 138.9 ± 140.4 ± 145.1 ± 135.0 ± 129.2 ± 124.7 ± 116.3 ± 136.1 ± <0.0001*
14.2† 17.2† 18.5† 15.9† 23.3† 21.4 16.4† 19.1† 48.4 20.5  
TI 155.3 ± 153.0 ± 152.7 ± 152.5 ± 158.3 ± 152.3 ± 144.7 ± 147.2 ± 159.6 ± 151.9 ± 0.0832
22.9 19.7 18.3 17.8† 17.5 26.8† 15.9 18.5 11.7 20.3  
NI 117.9 ± 109.6 ± 103.5 ± 110.9 ± 110.9 ± 110.0 ± 105.6 ± 111.7 ± 107.6 ± 109.3 ± 0.4230
18.6 26.8 24.6 21.7 16.7 39.3 16.9 19.0 19.0 25.3  

Values are presented as mean ± SD or n (%) unless otherwise indicated.

G = general; T = temporal; S = superior; TS = temporosuperior; NS = nasosuperior; N = nasal; I = inferior; TI = temporoinferior; NI = nasoinferior.* Statically significant (p-value < 0.05)

† There are statistically significant differences (Dunneet T3 test are used for post hoc test, p < 0.05)

‡ One-way analysis of variance (ANOVA).

Table 3.
Correlation between RNFL thickness in each region and clinical variables
    Age logMAR SE IOP cd ratio AXL
No. of   352 350 338 298 352 315
subjects              
G Coefficient† –0.1640 –0.0787 –0.0223 0.0066 –0.1134 –0.0685
  p-value* 0.0020 0.1416 0.6826 0.9092 0.0334 0.2252
T Coefficient† –0.1774 –0.0883 –0.3100 0.0764 –0.0675 0.3340
  p-value* 0.0008 0.0990 <0.0001 0.1884 0.2063 <0.0001
S Coefficient† –0.2354 –0.1238 0.0265 0.0074 –0.1553 –0.0858
  p-value* <0.0001 0.0206 0.6270 0.8986 0.0035 0.1285
TS Coefficient† –0.2539 –0.1912 0.0015 –0.0073 –0.1426 –0.0100
  p-value* <0.0001 0.0003 0.9789 0.9002 0.0074 0.8601
NS Coefficient† –0.1325 –0.0163 0.0401 0.0185 –0.1104 –0.1282
  p-value* 0.0129 0.7618 0.4620 0.7507 0.0384 0.0229
N Coefficient† 0.0872 0.0130 0.1878 –0.0408 0.0482 –0.2937
  p-value* 0.1023 0.8085 0.0005 0.4830 0.3672 <0.0001
I Coefficient† –0.0732 –0.0461 0.0701 0.0138 –0.1371 –0.1632
  p-value* 0.1705 0.3899 0.1986 0.8126 0.0100 0.0037
TI Coefficient† –0.1045 –0.0867 –0.0688 0.0220 –0.1659 –0.0163
  p-value* 0.0502 0.1053 0.2074 0.7058 0.0018 0.7732
NI Coefficient† –0.0284 –0.0010 0.1633 0.0037 –0.0771 –0.2368
  p-value* 0.5949 0.9851 0.0026 0.9488 0.1489 <0.0001

RNFL = retinal nerve fiber layer; SE = spherical equivalent; IOP = intraocular pressure; cd ratio = cup-to-disc ratio; AXL = axial length; G = general; T = temporal; S = superior; TS = temporosuperior; NS = nasosuperior; N = nasal; I = inferior; TI = temporoinferior; NI = nasoinferior.

* One-way analysis of variance (ANOVA)

† Pearson correlation coefficient.

Table 4.
Multiple linear regression analysis for the relationship of age with RNFL thickness in each region
Segments RNFL thinning (μ m per decade of age m) 95% CI e p-value*
G –0.8 –1.3, −0.3 0.0019
T –0.7 –1.5, −0.0 0.0453
S –2.1 –2.9, −1.3 <0.0001
TS –2.4 –3.3, −1.5 <0.0001
NS –1.7 –2.7, −0.7 0.0011
N 0.4 –0.2, 1.1 0.3397
I –0.6 –1.6, −1.0 0.2070
TI –0.8 –1.7, 0.2 0.1076
NI –0.7 –1.9, 0.6 0.6253

RNFL = retinal nerve fiber layer; CI = confidence intervals; G = general; T = temporal; S = superior; TS = temporosuperior; NS = nasosuperior; N = nasal; I = inferior; TI = temporoinferior; NI = nasoinferior.

* Multivariate analysis regression.

Table 5.
Multiple linear regression analysis for the relationship of axial length with RNFL thickness in each region
Segments RNFL thinning (μ m per axial length m) 95% CI p-value*
G –0.9 –2.9, 1.0 0.3445
T 3.1 1.2, 4.9 0.0014
S –2.0 –3.7, −0.4 0.0018
TS –1.2 –3.4, 0.8 0.2459
NS –3.0 –5.0, −0.9 0.0045
N –3.5 –4.8, −2.1 <0.0001
I –2.7 –4.7, −0.8 0.0060
TI –0.4 –2.3, 1.6 0.7267
NI –5.6 –8.0, −3.1 <0.0001

RNFL = retinal nerve fiber layer; CI = confidence intervals; G = general; T = temporal; S = superior; TS = temporosuperior; NS = nasosuperior; N = nasal; I = inferior; TI = temporoinferior; NI = nasoinferior.

* Multivariate analysis regression.

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