Changes of Peripapillary Retinal Nerve Fiber Layer Thickness Profile According to Aging in Myopic Eyes

Jin Bae Eun; Cheol Yoo Young

doi:10.3341/jkos.2013.54.7.1066

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Eun and Young: Changes of Peripapillary Retinal Nerve Fiber Layer Thickness Profile According to Aging in Myopic Eyes

Original Article

J Korean Ophthalmol Soc 2013;54(7):1066-1073.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.7.1066

Changes of Peripapillary Retinal Nerve Fiber Layer Thickness Profile According to Aging in Myopic Eyes

Jin Bae Eun, MD, Cheol Yoo Young, MD

¹Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Address reprint requests to Young Cheol Yoo, MD Department of Ophthalmology, Kangdong Sacred Heart Hospital, #150 Seongan-ro, Gangdong-gu, Seoul 134-701, Korea Tel: 82-2-2224-2274, Fax: 82-2-470-2088 E-mail: demian7435@gmail.com

Received 22 September 201215 January 2013 Accepted 10 April 2013

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 evaluate the effects of age on the distributional variability of peripapillary retinal nerve fiber layer (RFNL) thickness measured by optical coherence tomography (OCT) in myopia.

Methods

Only the right eye of 64 myopic patients with long axial length (≥24.5 mm) was included in the present study. The patients were divided into 2 age groups, 20 to 39 years of age and 40 to 59 years of age. Eventually, 42 subjects were selected and matched based on the difference of axial length not exceeding 0.5 mm between subjects in each group. The RFNL thickness was measured using Stratus OCT and average thickness, angular locations of double humps, and false-positive rate were compared.

Results

In both groups, the distribution of RNFL thickness in a double hump pattern was observed, which had a deviation to the temporal side only in the younger myopic eye group, but not in the middle-aged group. The middle-aged group had significantly thinner RNFL in 1, 7, and 8 clock-hour sectors compared to the younger myopic eyes ( p ≤ 0.02). Probability of abnormal OCT parameters at the 5% level of the 2 groups with the built-in RNFL normative database was not sig-nificantly different.

Conclusions

The variability of RFNL thickness distribution related to axial length was less observed in the middle-aged group than the younger-aged group. These results should be considered in glaucoma diagnosis when using OCT.

Keywords: Aging, Glaucoma, Myopia, Retinal nerve fiber layer (RNFL), Stratus OCT

References

1. Katz J, Tielsch JM, Sommer A. Prevalence and risk factors for re-fractive errors in an adult inner city population. Invest Ophthalmol Vis Sci. 1997; 38:334–40.

2. Wang Q, Klein BE, Klein R, Moss SE. Refractive status in the bea-ver dam eye study. Invest Ophthalmol Vis Sci. 1994; 35:4344–7.

3. Lin LL, Shih YF, Hsiao CK, et al. Epidemiologic study of the prev-alence and severity of myopia among schoolchildren in taiwan in 2000. J Formos Med Assoc. 2001; 100:684–91.

4. Wong TY, Foster PJ, Hee J, et al. Prevalence and risk factors for re-fractive errors in adult chinese in singapore. Invest Ophthalmol Vis Sci. 2000; 41:2486–94.

5. Tay MT, Au Eong KG, Ng CY, Lim MK. Myopia and educational attainment in 421,116 young Singaporean males. Ann Acad Med Singapore. 1992; 21:785–91.

6. Au Eong KG, Tay TH, Lim MK. Race, culture and myopia in 110,236 young Singaporean males. Singapore Med J. 1993; 34:29–32.

7. Kang SH, Kim PS, Choi DG. Prevalence of myopia in 19-year-old Korean males: The relationship between the prevalence and educa-tion or urbanization. J Korean Ophthalmol Soc. 2004; 45:2082–7.

8. Daubs JG, Crick RP. Effect of refractive error on the risk of ocular hypertension and open angle glaucoma. Trans Ophthalmol Soc U K. 1981; 101:121–6.

9. Phelps CD. Effect of myopia on prognosis in treated primary open-angle glaucoma. Am J Ophthalmol. 1982; 93:622–8.

10. Podos SM, Becker B, Morton WR. High myopia and primary open-angle glaucoma. Am J Ophthalmol. 1966; 62:1038–43.

11. Perkins ES, Phelps CD. Open angle glaucoma, ocular hyper-tension, low-tension glaucoma, and refraction. Arch Ophthalmol. 1982; 100:1464–7.

12. Wilson MR, Hertzmark E, Walker AM, et al. A case-control study of risk factors in open angle glaucoma. Arch Ophthalmol. 1987; 105:1066–71.

13. Mitchell P, Hourihan F, Sandbach J, Wang JJ. The relationship be-tween glaucoma and myopia: The blue mountains eye study. Ophthalmology. 1999; 106:2010–5.

14. Fong DS, Epstein DL, Allingham RR. Glaucoma and myopia: are they related? Int Ophthalmol Clin. 1990; 30:215–8.

15. Seddon JM, Schwartz B, Flowerdew G. Case-control study of ocu-lar hypertension. Arch Ophthalmol. 1983; 101:891–4.

16. Ko YC, Liu CJ, Chou JC, et al. Comparisons of risk factors and vis-ual field changes between juvenile-onset and late-onset primary open-angle glaucoma. Ophthalmologica. 2002; 216:27–32.

17. Tay E, Seah SK, Chan SP, et al. Optic disk ovality as an index of tilt and its relationship to myopia and perimetry. Am J Ophthalmol. 2005; 139:247–52.

18. Jonas JB, Gusek GC, Naumann GO. Optic disk morphometry in high myopia. Graefes Arch Clin Exp Ophthalmol. 1988; 226:587–90.

19. Schuman JS, Pedut-Kloizman T, Hertzmark E, et al. Reproducibility of nerve fiber layer thickness measurements using optical coher-ence tomography. Ophthalmology. 1996; 103:1889–98.

20. Blumenthal EZ, Williams JM, Weinreb RN, et al. Reproducibility of nerve fiber layer thickness measurements by use of optical co-herence tomography. Ophthalmology. 2000; 107:2278–82.

21. Hoh ST, Greenfield DS, Mistlberger A, et al. Optical coherence to-mography and scanning laser polarimetry in normal, ocular hyper-tensive, and glaucomatous eyes. Am J Ophthalmol. 2000; 129:129–35.

22. Wollstein G, Schuman JS, Price LL, et al. Optical coherence to-mography (OCT) macular and peripapillary retinal nerve fiber lay-er measurements and automated visual fields. Am J Ophthalmol. 2004; 138:218–25.

23. Mohammad Salih PA. Evaluation of peripapillary retinal nerve fi-ber layer thickness in myopic eyes by spectral-domain optical co-herence tomography. J Glaucoma. 2012; 21:41–4.

24. Qiu KL, Zhang MZ, Leung CK, et al. Diagnostic classification of retinal nerve fiber layer measurement in myopic eyes: A compar-ison between time-domain and spectral-domain optical coherence tomography. Am J Ophthalmol. 2011; 152:646–53.e2.

25. Rauscher FM, Sekhon N, Feuer WJ, Budenz DL. Myopia affects retinal nerve fiber layer measurements as determined by optical co-herence tomography. J Glaucoma. 2009; 18:501–5.

26. Schweitzer KD, Ehmann D, Garcia R. Nerve fibre layer changes in highly myopic eyes by optical coherence tomography. Can J Ophthalmol. 2009; 44:e13–6.

27. Yoo YC, Lee CM, Park JH. Changes in peripapillary retinal nerve fi-ber layer distribution by axial length. Optom Vis Sci. 2012; 89:4–11.

28. Song TG, Yoo YC, Lee HB. Quantitative analysis of retinal nerve fiber layer thickness profile in myopic eyes. J Korean Ophthalmol Soc. 2009; 50:1840–46.

29. Leung CK, Mohamed S, Leung KS, et al. Retinal nerve fiber layer measurements in myopia: An optical coherence tomography study. Invest Ophthalmol Vis Sci. 2006; 47:5171–6.

30. Choi SW, Lee SJ. Thickness changes in the fovea and peripapillary retinal nerve fiber layer depend on the degree of myopia. Korean J Ophthalmol. 2006; 20:215–9.

31. Hougaard JL, Ostenfeld C, Heijl A, Bengtsson B. Modelling the normal retinal nerve fibre layer thickness as measured by stratus optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2006; 244:1607–14.

32. Wollstein G, Schuman JS, Price LL, et al. Optical coherence to-mography (OCT) macular and peripapillary retinal nerve fiber lay-er measurements and automated visual fields. Am J Ophthalmol. 2004; 138:218–25.

33. Iliev ME, Meyenberg A, Garweg JG. Morphometric assessment of normal, suspect and glaucomatous optic discs with stratus OCT and HRT II. Eye (Lond). 2006; 20:1288–99.

34. Bayraktar S, Bayraktar Z, Yilmaz OF. Influence of scan radius cor-rection for ocular magnification and relationship between scan ra-dius with retinal nerve fiber layer thickness measured by optical coherence tomography. J Glaucoma. 2001; 10:163–9.

35. Kang SH, Hong SW, Im SK, et al. Effect of myopia on the thick-ness of the retinal nerve fiber layer measured by cirrus HD optical coherence tomography. Invest Ophthalmol Vis Sci. 2010; 51:4075–83.

36. Jonas JB, Schmidt AM, Muller-Bergh JA, et al. Human optic nerve fiber count and optic disc size. Invest Ophthalmol Vis Sci. 1992; 33:2012–8.

37. Alamouti B, Funk J. Retinal thickness decreases with age: An OCT study. Br J Ophthalmol. 2003; 87:899–901.

38. Bowd C, Zangwill LM, Blumenthal EZ, et al. Imaging of the optic disc and retinal nerve fiber layer: The effects of age, optic disc area, refractive error, and gender. J Opt Soc Am A Opt Image Sci Vis. 2002; 19:197–207.

39. Hougaard JL, Kessel L, Sander B, et al. Evaluation of heredity as a determinant of retinal nerve fiber layer thickness as measured by optical coherence tomography. Invest Ophthalmol Vis Sci. 2003; 44:3011–6.

40. Kanamori A, Escano MF, Eno A, et al. Evaluation of the effect of aging on retinal nerve fiber layer thickness measured by optical co-herence tomography. Ophthalmologica. 2003; 217:273–8.

41. Yamada H, Yamakawa Y, Chiba M, Wakakura M. Evaluation of the effect of aging on retinal nerve fiber thickness of normal japanese measured by optical coherence tomography. Nihon Ganka Gakkai Zasshi. 2006; 110:165–70.

42. Budenz DL, Anderson DR, Varma R, et al. Determinants of normal retinal nerve fiber layer thickness measured by stratus OCT. Ophthalmology. 2007; 114:1046–52.

Figure 1.

Comparison of retinal nerve fiber layer thickness profile between 2 groups. ◆(black diamond) = Group A, aged 20 to 39 years; ■(gray square) = Group B, aged 40 to 59 years. The standard deviation of each group was expressed with dotted (Group A) and straight lines (Group B). A sig-nificant difference of retinal nerve fiber layer thickness be-tween the young and old patients was revealed at 1 hour ( p = 0.020), 7 ( p = 0.001), and 8 ( p = 0.005) clock-hour sectors.

Table 1.

Comparison of the characteristics between the 2 groups

	Group A^* (n = 21)	Group B^† (n = 21)	p-value^‡
Age (years)	26.10 ± 1.30	50.70 ± 1.10	<0.001
Axial length (mm)	25.71 ± 0.17	25.54 ± 0.19	0.491
Spherical equivalent (diopter)	-4.88 ± 0.47	-3.69 ± 0.58	0.096
Intraocular pressure (mm Hg)	14.86 ± 0.78	14.33 ± 0.56	0.588

Values are presented as mean ± SD.

^* Aged 20 to 39 years

^† Aged 40 to 59 years

^‡ Independent t-test.

Table 2.

Comparison of the angular location with peak thickness in 2 major retinal nerve fiber layer humps between the 2 groups

	Group A^* (n = 21)	Group B^† (n = 21)	p-value^‡
Angle α (°)	59.51 ± 12.68	65.90 ± 9.51	0.071
Angle β (°)	64.37 ± 5.19	69.30 ± 8.52	0.028

Values are presented as mean ± SD.

^* Aged 20 to 39 years

^† Aged 40 to 59 years

^‡ Independent t-test.

Table 3.

Bivariate correlation analysis between axial length and angular locations of 2 nerve fiber layer humps

	Group A^* (n = 21)		Group B^† (n = 21)
	R	p-value	R	p-value
Angle α (°)	-0.609	0.003	-0.177	0.442
Angle β (°)	-0.561	0.008	-0.240	0.296

^* Aged 20 to 39 years

^† Aged 40 to 59 years.

Table 4.

Comparison of the retinal nerve fiber layer thickness between the 2 groups

	Group A^*	Group B^†	p-value^‡
Whole scan	104.09 ± 8.73	98.36 ± 10.95	0.068
Superior quadrant	119.48 ± 15.75	109.57 ± 18.35	0.129
Inferior quadrant	132.67 ± 15.46	127.57 ± 18.82	0.068
Temporal quadrant	99.00 ± 23.48	84.86 ± 15.97	0.028
Nasal quadrant	64.19 ± 16.30	71.29 ± 13.19	0.343
1-o’clock hour	113.81 ± 24.62	93.14 ± 30.25	0.020
2-o’clock hour	77.62 ± 25.21	83.90 ± 19.91	0.375
3-o’clock hour	52.61 ± 12.60	59.76 ± 17.50	0.137
4-o’clock hour	62.29 ± 16.20	66.67 ± 14.46	0.361
5-o’clock hour	93.05 ± 21.73	99.81 ± 18.51	0.284
6-o’clock hour	136.76 ± 24.22	133.05 ± 38.41	0.710
7-o’clock hour	168.52 ± 22.59	142.57 ± 22.88	0.001
8 -o’clock hour	108.04 ± 31.01	85.38 ± 16.2	0.005
9-o’clock hour	78.62 ± 25.09	67.86 ± 14.48	0.096
10-o’clock hour	110.29 ± 20.39	97.95 ± 22.67	0.071
11-o’clock hour	134.00 ± 20.11	126.76 ± 17.75	0.224
12 -o’clock hour	112.29 ± 17.23	107.0 ± 27.30	0.457

Values are presented as mean ± SD.

^* Aged 20 to 39 years

^† Aged 40 to 59 years

^‡ Independent t-test.

Table 5.

Comparison of the proba normative database ability of abnormal OCT paramete ers at the 5% level between the 2 groups using the built-in RNFL

	Group A^* (%)	Group B^† (%)	p-value^‡
Whole scan	0.0	0.0	NA
Superior quadrant	7.1	14.3	0.454
Inferior quadrant	2.4	2.4	1.000
Temporal quadrant	0.0	0.0	NA
Nasal quadrant	7.1	2.4	0.606
1-o’clock hour	4.8	14.3	0.238
2-o’clock hour	21.4	2.4	0.009
3-o’clock hour	9.5	0.0	0.107
4-o’clock hour	11.9	2.4	0.184
5-o’clock hour	7.1	4.8	1.000
6-o’clock hour	4.8	2.4	1.000
7-o’clock hour	0.0	2.4	1.000
8 -o’clock hour	0.0	0.0	NA
9-o’clock hour	0.0	0.0	NA
10-o’clock hour	0.0	0.0	NA
11-o’clock hour	2.4	0.0	1.000
12 -o’clock hour	2.4	4.8	1.000

OCT = optical coherence tomograp

^* Aged 20 to 39 years

^† Aged 40 to phy; RNFL = retinal nerve fiber lay 59 years

^‡ Fisher‘s exact test. yer; NA = not available.

Table 6.

Comparison of the number of clock-hour sectors below normal value at the 5% probability level and the proportion of eyes with abnormally thin clock-hour sectors at the 5% probability level between the 2 groups

	Group A^*	Group B^†	p-value^‡
Number of abnormal clock-hour sectors	1.19 ± 0.82	0.67 ± 0.68	0.308^‡
Proportion of eyes with abnormal clock-hour sectors (%)
One or more clock	10/21 (47.6)	6/21 (28.6)	0.063^§
Two or more clock-hours	5/21 (23.8)	3/21 (14.3)	1.000^§
Three or more clock-hours	3/21 (14.3)	2/21 (9.5)	1.000^§

Values are presented as mean ± SD.

^* Aged 20 to 39 years

^† Aged 40 to 59 years

^‡ Independent t-test

^§ Fisher’s exact test.

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