Factors Influencing Optic Disc and Retinal Nerve Fiber Layer Parameters Measured by Optical Coherence Tomography

Jung-Il Han; Han-Woong Lim; Yoo-Mi Song; Ki Bang Uhm

doi:10.3341/jkos.2007.48.8.1073-1081

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Han, Lim, Song, and Uhm: Factors Influencing Optic Disc and Retinal Nerve Fiber Layer Parameters Measured by Optical Coherence Tomography

Original Article

J Korean Ophthalmol Soc 2007;48(8):1073-1081.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.8.1073-1081

Factors Influencing Optic Disc and Retinal Nerve Fiber Layer Parameters Measured by Optical Coherence Tomography

Jung-Il Han, M.D.¹, Han-Woong Lim, M.D.², Yoo-Mi Song, M.D.², Ki Bang Uhm, M.D.^2,

Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea

Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea

Address reprint requests to Ki Bang Uhm, M.D., Department of Ophthalmology, College of Medicine, Hanyang University, #17 Haengdang-dong, Sungdong-gu, Seoul 133-792, Korea, Tel: 82-2-2290-8570, Fax: 82-2-2291-8517, E-mail: KBUhm@hanyang.ac.kr

Received 14 December 2006 Accepted 8 May 2007

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 the factors influence retinal nerve fiber layer (RNFL) and optic nerve head (ONH) parameters measured by Stratus optical coherence tomography (OCT).

Methods

Topographic RNFL thickness and optic disc parameters of 129 healthy Korean subjects of aged 14 to 87 were measured using the fast retinal nerve fiber layer thickness and fast optic disk algorithms of Stratus OCT. One eye of each subject was randomly selected for statistical analysis. Using multiple linear regression, the effect of optic disc area, age, refractive error, and zone beta on each parameter was analyzed.

Results

Large discs had large horizontal integrated rim width (HIRW), cup area, rim area, C/D area ratio, and vertical C/D ratio. The thickness of average, superior, inferior, and nasal quadrant RNFL increased significantly with an increase in optic disc area. Average and superior quadrant RNFL thickness, and HIRW decreased with age. Refractive error showed a correlation with the vertical integrated rim area, horizontal C/D ratio, and temporal quadrant RNFL thickness. Gender and zone beta had no statistically significant influence on ONH and RNFL parameters.

Conclusions

This study shows that optic disc size affects most RNFL thickness and ONH parameters. Because of the relationships revealed in this study, optic disc area in addition to age should be considered when the Stratus OCT RNFL thickness and ONH parameters are interpreted.

Keywords: Normal eye, Optic disc, Retinal Nerve Fiber Layer, Stratus optical coherence tomography

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Figure 1.

Simple linear regression (y=89.5+5.954xdisc area, R=0.298, R²=8.9%, P=0.001) between disc area and average retinal nerve fiber layer (RNFL) thickness.

Figure 2.

Simple linear regression (y=115.3-0.197xage, R=0.268, R²=7.2%, P=0.002) between age and average retinal nerve fiber layer (RNFL) thickness.

Table 1.

The influence of gender on optic disc and retinal nerve fiber layer parameters (mean value±standard deviation)

	Mean	Male	Female	P value
Number of eyes	129	63	66
Optic nerve head parameters
VIRA (mm³)	0.33±0.22	0.34±0.24	0.31±0.19	0.578
HIRW (mm²)	1.59±0.27	1.60±0.26	1.57±0.28	0.541
Disc area (mm²)	2.57±0.53	2.65±0.54	2.50±0.51	0.083
Cup area (mm²)	1.01±0.50	1.05±0.54	0.96±0.47	0.263
Rim area (mm²)	1.56±0.44	1.59±0.44	1.53±0.44	0.500
C/D area ratio	0.39±0.15	0.39±0.15	0.38±0.15	0.667
Horizontal C/D ratio	0.66±0.15	0.66±0.16	0.66±0.15	0.961
Vertical C/D ratio	0.56±0.13	0.56±0.13	0.55±0.12	0.613
RNFL thickness parameters
Average (pm)	104.8± 10.5	105.0±10.2	104.5±11.0	0.787
Superior quadrant (pm)	128.9±16.2	131.0± 14.8	126.9± 17.2	0.153
Temporal quadrant (pm)	75.1±15.9	74.9±12.8	75.3± 18.6	0.888
Inferior quadrant (pm)	134.9± 16.9	134.6±16.1	135.2±17.8	0.839
Nasal quadrant (pm)	80.4±17.5	80.1±18.7	80.6± 16.5	0.846
O'clock hour segment
12 (pm) (superior)	132.7±22.8	136.6±21.8	129.0±23.2	0.061
11 (pm)	135.7±22.5	134.6±21.5	136.8±23.5	0.588
10 (pm)	90.3±19.8	89.4±14.8	92.2±23.6	0.279
9 (pm) (temporal)	59.2± 12.4	59.5±11.4	58.9±13.4	0.775
8 (pm)	76.4±20.5	77.7± 17.3	75.3±23.3	0.518
7 (pm)	142.0±23.2	142.6±22.7	141.4±23.8	0.771
6 (pm) (inferior)	147.2±25.7	146.8±23.6	147.7±27.7	0.837
5 (pm)	115.4±21.2	114.2±22.3	116.5±20.2	0.525
4 (pm)	80.8±19.0	79.0±20.0	82.4± 18.0	0.311
3 (pm) (nasal)	66.2±17.9	65.5±17.7	66.9±18.1	0.661
^{2 (}p^m)	93.9±23.9	95.6±24.9	92.1±23.0	0.423
1 (pm)	118.4±20.9	121.7±20.5	115.3±20.9	0.080

VIRA=vertical integrated rim area, HIRW=horizontal integrated rim width, RNFL=retinal nerve fiber layer.

Table 2.

The influence of zone beta on optic disc and retinal nerve fiber layer parameters (mean value±standard deviation)

	Zone beta		P value
	Presence	Absence
Number of eyes	28	101
Optic nerve head parameters
VIRA (mm³)	0.32±0.22	0.32±0.21	0.997
HIRW (mm²)	1.58±0.33	1.59±0.25	0.818
Disc area (mm)	2.56±0.52	2.58±0.53	0.859
Cup area (mm²)	1.01±0.47	1.01±0.52	0.965
Rim area (mm²)	1.55±0.47	1.56±0.43	0.868
C/D area ratio	0.39±0.15	0.38±0.15	0.784
Horizontal C/D ratio	0.65±0.14	0.66±0.15	0.656
Vertical C/D ratio	0.57±0.12	0.55±0.13	0.434
RNFL thickness parameters
Average (pm)	103.3±10.8	105.2±10.5	0.405
Superior quadrant (pm)	121.9±18.4	130.8±15.0	0.009
Temporal quadrant (pm)	82.5±21.1	73.1±13.6	0.005
Inferior quadrant (pm)	134.0±19.3	135.2±16.3	0.744
Nasal quadrant (pm)	75.7±17.2	81.7±17.4	0.111

VIRA=vertical integrated rim area, HIRW=horizontal integrated rim width, RNFL=retinal nerve fiber layer.

Table 3.

Effect of optic disc area, age, and refractive error on optic disc and retinal nerve fiber layer parameters analyzed with simple linear regression

	Optic disc area		Age		Refractive error
	R² (%)	P value	R² (%)	P value	R² (%)	P value
Optic nerve head parameters
VIRA (mm³)	0.1	0.683	3.1	0.046	4.1	0.026
HIRW (mm²)	12.9	<0.001	10.6	<0.001	1.5	0.176
Cup area (mm²)	41.3	<0.001	0.00	0.827	6.1	0.006
Rim area (mm²)	21.6	<0.001	1.3	0.202	0.1	0.791
C/D area ratio	7.1	0.002	1.0	0.271	3.6	0.036
Horizontal C/D ratio	3.7	0.028	1.9	0.124	5.0	0.014
Vertical C/D ratio	5.8	0.006	1.4	0.186	3.7	0.035
RNFL thickness parameters
Average (pm)	8.9	0.001	7.2	0.002	1.1	0.258
Superior quadrant (pm)	6.2	0.004	5.8	0.006	0.6	0.390
Temporal quadrant (pm)	0.1	0.736	7.4	0.002	19.3	<0.001
Inferior quadrant (pm)	10.5	<0.001	2.4	0.082	1.5	0.175
Nasal quadrant (pm)	4.9	0.011	0.1	0.773	1.2	0.240

R²=determination coefficient, VIRA=vertical integrated rim area, HIRW=horizontal integrated rim width, RNFL=retinal nerve fiber layer.

Table 4.

Effect of optic disc area, age, and refraction on optic disc and retinal nerve fiber layer parameters analyzed with multiple linear regression model

	Explanatory variables	Partial R	P value
Optic nerve head parameters
VIRA (mm³)	refraction	-0.202	0.026
HIRW (mm²)	optic disc area	0.350	<0.001
	age	-0.324	<0.001
Cup area (mm²)	optic disc area	0.638	<0.001
Rim area (mm²)	optic disc area	0.462	<0.001
C/D area ratio	optic disc area	0.263	0.004
Horizontal C/D ratio	refraction	0.223	0.014
Vertical C/D ratio	optic disc area	0.242	0.007
RNFL thickness parameters
Average (pm)	optic disc area	0.279	0.001
	age	-0.233	0.007
Superior quadrant (pm)	age	-0.238	0.007
	optic disc area	0.237	0.007
Temporal quadrant (pm)	refraction	-0.439	<0.001
Inferior quadrant (pm)	optic disc area	0.331	<0.001
Nasal quadrant (pm)	optic disc area	0.207	0.023

R=correlation coefficient.

VIRA=vertical integrated rim area.

HIRW=horizontal integrated rim width.

RNFL=retinal nerve fiber layer.

Table 5.

Effect of optic disc area, age, and refraction on optic disc and retinal nerve fiber layer parameters analyzed with multiple linear regression model

	Equation	R	R²	P value
Optic nerve head parameters
VIRA (mm³)	y = 0.315-0.027×refractive error	0.202	0.041	0.026
HIRW (mm²)	y = 1.466+0.179×disc area-0.006×age	0.486	0.236	<0.001
Cup area (mm)	y =-0.562+0.614×disc area	0.638	0.407	<0.001
Rim area (mm²)	y = 0.564+0.386×disc area	0.462	0.214	<0.001
C/D area ratio	y = 0.196+0.074×disc area	0.263	0.069	0.004
Horizontal C/D ratio	y = 0.664+0.021×refractive error	0.223	0.050	0.014
Vertical C/D ratio	y = 0.409+0.059×disc area	0.242	0.059	0.007
RNFL thickness parameters
Average (μm)	y = 100.132+5.440×disc area-1.731×age	0.370	0.137	<0.001
Superior quadrant (μm)	y = 125.065-0.280×age+7.348×disc area	0.342	0.177	0.001
Temporal quadrant (μm)	y = 73.740-4.383×refractive error	0.439	0.193	<0.001
Inferior quadrant (μm)	y = 108.230+10.375×disc area	0.331	0.110	<0.001
Nasal quadrant (μm)	y = 63.155+6.787×disc area	0.207	0.043	0.023

R=correlation coefficient, R²=determination coefficient, VIRA=vertical integrated rim area, HIRW=horizontal integrated rim width, RNFL=retinal nerve fiber layer.

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