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Roh, Kwon, Han, Wee, Lee, and Park: Comparison of the Detection Rate, Location and Amount of Retinal Nerve Fiber Layer Defect
Original Article

J Korean Ophthalmol Soc 2011;52(2):210-215.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.2.210

Comparison of the Detection Rate, Location and Amount of Retinal Nerve Fiber Layer Defect

Young Rae Roh, MD1, Ji Won Kwon, MD, PhD1, 2, Young Keun Han, MD, PhD1, 3, Won Ryang Wee, MD, PhD1, 2, Jin Hak Lee, MD, PhD1, 2, 4, Ki Ho Park, MD, PhD1, 2

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

2Department of Ophthalmology, Seoul National University College of Medicine, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea

3Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, Korea

4Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea

Address reprint requests to Ji Won Kwon, MD, PhD Department of Ophthalmology, Seoul National University Hospital #28 Yeongeon-dong, Jhongno-gu, Seoul 110-744, Korea Tel: 82-2-2072-2438, Fax: 82-2-741-3187, E-mail: eyeminerva@yahoo.co.kr

Received 29 June 20107 October 2010       Accepted 25 November 2010

Copyright © 2011 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 compare the detection rate of the patients with retinal nerve fiber layer (RNFL) defect and the amount of RNFL defect according to the patients’ age.

Methods

Retrospective chart reviews of 22,811 subjects, who visited the health care center from January 2009 to December 2009 were performed. The detection rate, location and average amount of RNFL defect and the proportions of the patients who were diagnosed with glaucoma through Humphrey visual field (HVF) test or determined as a glaucomatous optic disc were compared according to the patients’ age.

Results

The proportions of the patients whose RNFL defect were detected was highest in the patients 60 years old or older (2.3%) and was statistically significant (p = 0.012). However, there was no significant difference among the other age groups (under 40 years: 1.7%, 40 thru 49 years: 1.5%, 50 thru 59 years: 2.0%). The proportions of the patients who were determined as glaucoma through the HVF test or glaucomatous optic disc were also highest in the patients 60 years old or older (1.4%), however, there was no statistically significant difference (p = 0.070) among the age groups (under 40 years: 1.1%, 40 thru 49 years: 0.9%, 50 thru 59 years: 1.2%).

Conclusions

The RNFL defect is likely to be detected in subjects less than 40 years of age and the detection rate is similar to subjects in their 40's and 50's. The use of fundus photography to detect RNFL defect in a health care center is recom-mended in subjects under 40 years of age.

Keywords: Glaucoma, Retinal nerve fiber layer (RNFL) defect, Routine health check-up

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Table 1.
The numbers of the patients and eyes of each age group
Age (yr) Male Female Total patients Total eyes
Under 40 2,000 1,942 3,942 7,884
40∼49 4,263 3,371 7,634 15,268
50∼59 4,396 3,191 7,587 15,174
Over 60 2,172 1,476 3,648 7,296
Total 12,831 9,980 22,811 45,622
Table 2.
The numbers of patients whose RNFL∗ defects were found and who were diagnosed as glaucoma by HVF† and an optic disc shape or not
Age group Total number RNFL∗ defect The numbers of patients who were diagnosed as glaucoma
 RNFL∗ defect only
Glaucomatous HVF† † Both Glaucomatous disc Total
Under 40 3,942 66 (1.7%) 17 (0.4%) 13 (0.3%) 26 (0.7%) 43 (1.1%) 23 (0.6%)
40∼49 7,634 113 (1.5%) 35 (0.5%) 17 (0.2%) 33 (0.4%) 68 (0.9%) 45 (0.6%)
50∼59‡ 7,587 151 (2.0%) 49 (0.6%) 26 (0.3%) 41 (0.5%) 90 (1.2%) 60 (0.8%)
Over 60 3,648 83 (2.3%) 38 (1.0%) 22 (0.6%) 14 (0.4%) 52 (1.4%) 31 (0.8%)
Total 22,811 413 (1.8%) 139 (0.6%) 78 (0.3%) 114 (0.5%) 253 (1.1%) 159 (0.7%)

∗ RNFL = retinal nerve fiber layer;

† HVF = Humphrey visual field;

‡ Only one eye of superior segmental optic hypoplasia was found in the age group 50∼59.

Table 3.
The comparison of the location of RNFL∗ defect according to the age group
Age group Superotemporal (%) Inferotemporal (%) T Both (%) Total numbers of the eyes of RNFL∗ defect (%) Total number
Under 40 30 (0.4) 32 (0.4) 18 (0.2) 80 (1.0) 7,884
40∼49 46 (0.3) 70 (0.5) 34 (0.2) 150 (1.0) 15,268
50∼59 92 (0.6) 78 (0.5) 25 (0.2) 195 (1.3) 15,174
Over 60 49 (0.7) 38 (0.5) 20 (0.3) 107 (1.5) 7,296
Total 217 (0.5) 218 (0.5) 97 (0.2) 532 (1.2) 45,622

∗ RNFL = retinal nerve fiber layer.

Table 4.
The comparison among the amount of RNFL∗ defect according to the method of diagnosis of glaucoma
Age group Diagnosed by HVF† Diagnosed by disc shape RNFL∗ defect only Total
Under 40 31.0 ± 28.3° 22.7 ± 10.6° 14.3 ± 8.4° 22.4 ± 18.2°
40∼49 21.5 ± 10.3° 21.0 ± 11.2° 12.3 ± 5.7° 17.9 ± 10.1°
50∼59 20.6 ± 9.6° 18.7 ± 10.4° 11.5 ± 5.0° 16.9 ± 10.7°
Over 60 20.0 ± 10.2° 25.4 ± 18.6° 13.9 ± 7.4° 18.8 ± 12.0°
Total 22.0 ± 14.0° 21.1 ± 12.1° 12.6 ± 6.3° 18.2 ± 11.9°

All of the values were shown as ‘Mean ± standard deviation’.

∗ RNFL = retinal nerve fiber layer;

† HVF = Humphrey visual field.

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