Morphological Analysis of Papillary Retinal Vessels and Retinal Nerve Fiber Layer in Koreans

Hyun Sung Leem; Doo Jin Paik; Hyung Chan Kim

doi:10.3341/jkos.2007.48.10.1369-1378

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Leem, Paik, and Kim: Morphological Analysis of Papillary Retinal Vessels and Retinal Nerve Fiber Layer in Koreans

Original Article

J Korean Ophthalmol Soc 2007;48(10):1369-1378.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.10.1369-1378

Morphological Analysis of Papillary Retinal Vessels and Retinal Nerve Fiber Layer in Koreans

Hyun Sung Leem, M.D.¹, Doo Jin Paik, M.D.², Hyung Chan Kim, M.D.¹

¹Department of Ophthalmology, College of Medicine, Konkuk University, Seoul, Korea

²Department of anatomy and cell biology, College of Medicine, Hanyang University, Seoul, Korea

Address reprint request to Hyung Chan Kim, M.D,Department of Ophthalmology, School of Medicine, Konkuk University, #4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea, Tel: 82-2-2030-5270, Fax: 82-2-2030-5273, E-mail: eyekim@kuh.ac.kr

Received 8 December 2006 Accepted 27 June 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

The study present the central retina arterial supply, optic disc shape, RNFL (retinal nerve fiber layers) thickness and optic disc rim area.

Methods

To evaluate the relationship between central retina artery pattern, optic disk shape, and RNFL thickness was measured using optical coherence tomography (OCT3000) and pattern of the central retinal artery were investigated by TRC50IX. Healthy Koreans (107 males, 97 females) were enrolled in this study. The classification is made by dividing surface of the nerve head into ten sector.

Results

As a result of the shape of the optic disc divided into four group, vertically oval were 54%. The results showed the central retinal artery, in 252 eyes, had its origin in the center. None of the eyes had their origin on temporal side. RNFL thickness according to OCT parameter was superior, 127.68±16.16 ym; temporal quadrants, 79.60±16.05 ym; inferior quadrants.

Conclusions

In summary, this study indicates that in healthy Koreans the shape of the optic disc is vertically oval and the origin of their central retinal artery is at the center. The RFNL thickness of both the superior and inferior quadrants was 127 ym according to OCT.

Keywords: Morphology, Retinal vessels, OCT, Optic disk

References

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Figure 1.

Normal optic nerve head showing ten types of distribution of the central retinal artery (CRA) origin in the optic disc by Wood's classification. (A) 1. Nasal; 2. Nasal oblique; 3. Temporal oblique; 4. Temporal; 5. Nasal-temporal up; 6. Nasal-temporal down; 7. Temporal-nasal up; 8. Temporal-nasal down; 9. Symmetric; 10. Miscellaneous. (B) Topographic measurement of the central retinal artery (CRA) in the optic disc by fundus camera (TRC50XI).

Figure 2.

Distribution of the central retinal artery origin in the optic disc (A) 1. NC : Nasal center; 2. TC : Temporal center; 3. IN : Inferior nasal; 4. SN : Superior nasal; 5. ST : Superior temporal; 6. IT : Inferior nasal; 7. C : Center; (B) Topographic measurement of the central retinal artery in the optic disc by fundus camera (TRC50XI).

Figure 3.

The distribution of the central retinal artery branches in the optic disc. 1. Nasal; 2. Nasal oblique; 3. Temporal oblique; 4. Temporal; 5. Nasal-temporal up; 6. Nasal- temporal down; 7. Temporal-nasal up; 8. Temporal-nasal down; 9. Symmetric; 10. Miscellaneous.

Figure 4.

Distribution of the origin of the CRA in the optic disc.

Figure 5.

Distribution of RNFL thickness according to sexes.

Table 1.

Distribution of normal eyes in each age group

	20-29 years	40-49 years	Total
	202	204	406
Age
(mean±SD)	23.95±2.37	45.41±2.38	34.73± 11.00
(min-max)	(20-29)	(42-49)	(20-49)
Sex (Male/Female)	(58 / 43)	(49 / 53)	(107 / 96)
Refractive average (Diopter)	-3.08±2.57	-1.36±2.06	-2.21±2.48
(min-max)	(-9.50 - +5.50)	(-7.25 - + 1.00)	(- 9.50 - + 5.50)
Axial length (mm)
(mean±SD)	24.62±1.29	23.68±1.08	24.15± 1.28
(min-max)	(22.02-27.25)	(21.98-26.58)	(21.98-27.25)
IOP (mmHg)
(mean±SD)	15.61±2.32	15.17±2.88	15.38±2.62
(min-max)	(10-20)	(10-20)	(10-20)

Table 2.

Classification of optic disc types by TRC50IX

Optic disc type	20-29 years		40-49 years		Total (%)
Optic disc type	Male	Female	Male	Female	Male	Female
1. Vertical oval	71	52	50	49	121 (56)	101 (52)
2. Horizontal oval	3	0	6	1	9 (4)	1 (3)
3. Circular	38	29	37	51	75 (35)	80 (41)
4. Irregular	4	5	5	5	9 (5)	10 (4)
Total	116	86	98	106	214 (100)	192 (100)

Table 3.

Classification of the optic disc by the distribution of arterial branches

Classification	20-29 years		40-49 years		Total (%)
Classification	Male	Female	Male	Female	Male	Female
1. Nasal	43	25	31	26	74 (34)	51 (26)
2. Nasal oblique	0	0	0	4	0 (0)	4 (6)
3. Temporal oblique	1	0	0	0	1 (1)	0 (0)
4. Temporal	0	0	0	0	0 (0)	0 (0)
5. Nasal-temporal up	17	23	17	16	34 (16)	39 (19)
6. Nasal-temporaldown	8	12	2	11	10 (5)	23 (10)
7. Temporal-nasal up	2	0	2	4	4 (3)	4 (2)
8. Temporal-nasaldown	3	0	0	2	3 (1)	2 (1)
9. Symmetric	42	26	43	42	85 (39)	68 (36)
10. Miscellaneous	0	0	3	0	3 (1)	0 (0)
Total	116	86	98	106	214 (100)	192 (100)

Table 4.

Distribution of the CRA origin in the optic disc

^*CRA origin	20-29 years		40-49 years		Total (%)
^*CRA origin	Male	Female	Male	Female	Male	Female
1. Nasal-central	43	22	36	36	79 (37)	58 (29)
2. Temporal-central	0	0	0	0	0 (0)	0 (0)
3. Nasal down	3	8	2	0	5 (3)	8 (6)
4. Nasal up	2	2	0	0	2 (1)	2 (1)
5. Temporal up	0	0	0	0	0 (0)	0 (0)
6. Temporal down	0	0	0	0	0 (0)	0 (0)
7. Central	68	54	60	70	128 (59)	124 (64)
Total	116	86	98	106	214 (100)	196 (100)

^* CRA : Central retinal artery.

Table 5.

Classification of twigs by the distribution of retinal arterial branches

	Male	Female	Total
1 (min-max)	1.39±0.71 (1-3)	1.44±0.76 (0-3)	1.41±0.73 (0-3)
2 (min-max)	0.52±0.50 (1-1)	0.42±0.49 (0-1)	0.47±0.50 (0-1)
3 (min-max)	0.71±0.87 (1-3)	1.02±0.96 (0-3)	0.84±0.92 (0-3)
4 (min-max)	0.48±0.81 (0-3)	0.52±0.62 (0-2)	0.50±0.73 (0-3)
5 (min-max)	1.34±0.56 (1-2)	1.27±0.60 (1-2)	1.31±0.58 (0-2)
6 (min-max)	1.160.83 (0-2)	0.89±0.90 (0-2)	1.04±0.87 (0-2)

Table 6.

RNFL thickness for all parameter by OCT

Measurement ^*RNFL quadrants	20-29 years		40-49 years		Total
Measurement ^*RNFL quadrants	Male	Female	Male	Female	Male	Female
Superior (mean±SD)	148.93±14.66	149.06± 17.95	146.14± 15.81	147.67±14.50	147.66± 15.22	148.29±16.09
(min-max)	(121-193)	(100-208)	(123-186)	(120-182)	(121-193)	(100-208)
Temporal (mean±SD)	100.56±13.71	107.05± 17.97	100.71±12.35	100.49± 11.88	100.63 ±13.08	103.40±15.20
(min-max)	(76-170)	(85-172)	(80-148)	(80-137)	(76-170)	(80-172)
Inferior (mean±SD)	142.241±4.05	144.80±13.43	139.26±16.25	144.56±16.74	141.02 ±15.15	144.67±15.32
(min-max)	(77-176)	(115-188)	(100-176)	(111-193)	(77-176)	(111-193)
Nasal (mean±SD)	95.34± 13.28	98.84±18.34	93.91±11.99	97.06±14.12	94.69 ±12.70	97.85±16.11
(min-max)	(68-153)	(58-158)	(71-132)	(65-135)	(68-153)	(58-158)

^∗ RNFL: Retinal nerve fibers layer.

Table 7.

RNFL thickness for all parameter by OCT

	20-29 years		40-49 years		Total
	Male	Female	Male	Female	Male	Female
12 (superior)	150.67±22.67	149.83±27.47	149.40 ±20.59	150.47±3.74	150.00±22.59	150.19±25.39
(min-max)	(96-228)	(96-242)	(99-206)	(113-207)	(96-228)	(96-242)
11	161.6±22.10	162.01±19.96	154.40±20.59	154.00±21.37	158.35±21.68	157.55±21.08
(min-max)	(111-232)	(111-215)	(99-206)	(113-202)	(99-232)	(111-215)
10	121.69±21.49	128.08±23.60	113.09±22.77	115.17±19.55	117.80±22.44	120.89±22.33
(min-max)	(44-183)	(85-188)	(51-182)	(66-189)	(54-183)	(66-189)
9 (temporal)	84.87±21.06	88.39±25.26	89.67±30.00	85.18±18.57	87.05±25.55	86.60±21.79
(min-max)	(50-169)	(55-190)	(50-190)	(52-143)	(50-190)	(52-190)
8	107.40±18.45	105.95±25.49	101.17±20.70	112.94±23.27	104.58±19.70	109.84±24.47
(min-max)	(67-187)	(57-191)	(45-164)	(63-176)	(55-187)	(57-191)
7	141.69±21.49	148.08±23.60	151.17±20.70	162.75±22.94	145.99±21.61	156.24±24.30
(min-max)	(64-203)	(105-208)	(95-214)	(113-226)	(64-214)	(105-226)
6 (inferior)	155.83±22.44	151.90±31.93	152.92±24.62	151.74±22.76	154.51±23.44	151.81±27.14
(min-max)	(66-215)	(63-201)	(87-201)	(88-195)	(66-215)	(63-201)
5	134.79±20.05	133.12±25.89	112.33±23.28	115.17±19.55	124±24.27	123.13±24.23
(min-max)	(96-185)	(65-194)	(51-182)	(66-189)	(51-185)	(65-194)
4	92.43±15.40	97.12±21.86	94.56±5.99	93.24±19.77	93.40±20.84	94.96±20.76
(min-max)	(56-142)	(63-182)	(55-182)	(57-163)	(55-182)	(57-182)
3 (nasal)	80.30±11.49	87.52±16.90	85.65±26.89	83.18±18.57	82.72±20.11	85.10±17.93
(min-max)	(55-114)	(57-189)	(48-188)	(50-141)	(48-188)	(50-153)
2	115.00±19.17	113.02±23.72	113.71±23.29	115.17±19.55	114.42±21.09	114.22±21.47
(min-max)	(66-182)	(51-189)	(51-182)	(66-189)	(51-182)	(51-189)
1	145.00±19.17	143.02±23.72	131.94±24.12	135.35±21.57	139.09±22.47	138.75±22.81
(min-max)	(96-212)	(81-219)	(65-194)	(94-188)	(65-212)	(81-219)

Table 8.

Relations between AL and RNFL thickness for all parameters

	20-29 years		40-49 years		Total
	^*AL ≤ 25mm	^*AL〉 25mm	^∗AL ≤ 25mm	^∗AL〉 25mm	^∗AL ≤25mm	^∗AL〉 25mm
Superior	151.75±17.21	145.48±13.89	146.18± 15.15	151.40±14.30	148.37±16.20	146.97±14,17
(min-max)	(120-208)	(100-176)	(120-186)	(122-178)	(120-208)	(100-178)
Temporal	101.94±15.66	105.08±16.23	100.32±11.69	102.16±14.23	100.96±13.39	104.35±15.75
(min-max)	(79-172)	(76-172)	(80-137)	(80-137)	(79-172)	(76-172)
Inferior	144.26±15.12	142±11.93	142.49±17.15	139.60±13.62	143.19± 16.38	142.05±12.40
(min-max)	(77-188)	(119-170)	(100-193)	(111-162)	(77-193)	(111-170)
Nasal	97.45± 14.04	96.05±17.62	95.66±13.33	95.13±12.79	96.36±13.62	95.82± 16.49
(min-max)	(72-153)	(58-158)	(65-135)	(77-124)	(65-153)	(58-158)

^∗ AL : Axial length (mm).

RNFL: Retinal nerve fibers layer.

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