Comparison of Retinal Nerve Fiber Layers in Patients with Non-Neovascular Age-Related Macular Degeneration and Normal Controls

Jae Young Kim; Hyewon Chung; Hyung Chan Kim

doi:10.3341/jkos.2014.55.9.1334

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Kim, Chung, and Kim: Comparison of Retinal Nerve Fiber Layers in Patients with Non-Neovascular Age-Related Macular Degeneration and Normal Controls

Original Article

J Korean Ophthalmol Soc 2014;55(9):1334-1339.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.9.1334

Comparison of Retinal Nerve Fiber Layers in Patients with Non-Neovascular Age-Related Macular Degeneration and Normal Controls

Jae Young Kim, MD, Hyewon Chung, MD, PhD, Hyung Chan Kim, MD, PhD

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

Address reprint requests to Hyung Chan Kim, MD, PhD, Department of Ophthalmology, Konkuk University Medical Center, #120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea, Tel: 82-2-2030-8180, Fax: 82-2-2030-5273, E-mail: eyekim@kuh.ac.kr

Received 21 February 2014 Revised 7 May 2014 Accepted 20 August 2014

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

In neovascular age-related macular degeneration (AMD), it is reported that retinal nerve fiber layer (RNFL) thickness becomes gradually thinner due to degeneration of the outer retinal layer. To our knowledge, there is no previous report regarding RNFL thickness in patients with non-neovascular AMD. Therefore, in this study, we compared RNFL thickness in patients with non-neovascular AMD and normal controls.

Methods

Thirty-one eyes with AMD category 3a (AREDS research group), 11 eyes suffering foveal geographic atrophy AMD category 4a, and 31 age-matched normal eyes were evaluated. In every group, regional RNFL thickness (General, Temporal, Superotemporal, Superonasal, Superior, Nasal, Inferonasal, Inferotemporal, and Inferior) was measured using spectral domain optical coherence tomography (SD-OCT).

Results

There were no significant differences in age or intraocular pressure among the 3 groups. The mean best corrected visual acuity (BCVA) (log MAR) of the category 4a group was significantly decreased compared to those of the other 2 groups. The mean RNFL thickness in total area in the category 3a group, category 4a group, and normal control group was 99.5 ± 14.0 µm, 99.3 ± 9.4 µm, and 99.4 ± 9.6 µm, respectively. The difference was not statistically significant. No other regional mean values of RNFL thickness in the three groups were significantly different.

Conclusions

There was no significant difference in RNFL thickness between non-neovascular patients and the control group.

Keywords: Non-neovascular age-related macular degeneration, Retinal nerve fiber layer thickness, Spectral domain optical coherence tomography

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Figure 1.

Representative case of a 67-year old patient with non-neovascular age-related macular degeneration (AMD). (A) means retinal nerve fiber layer (RNFL) thickness of each region. (B) Fundus photography showed multiple large drusen. (C) Peripapillary RNFL thickness at 360 degree was within normal range in this patient. TS = temporosuperior; NS = nasosuperior; T = temporal; G = general; N = nasal; TI = temporoinferior; NI = nasoinferior; TMP = temporal; SUP = superior; NAS = nasal; INF = inferior.

Figure 2.

Representative case of a 62-year old patient with non-neovascular age-related macular degeneration (AMD) with foveal geographic atrophy. (A) means retinal nerve fiber layer (RNFL) thickness of each region. (B) Fundus photography showed foveal geographic atrophy. (C) Peripapillary RNFL thickness at 360 degree was within normal range in this patient although there were local regions having slightly decreased thickness.

Table 1.

Baseline characteristics in each group

	Normal	Category 3a	Category 4a	p-value
Eyes (n)	31	31	11	0.488
Age (years)	69.7 ± 8.2	68.0 ± 6.4	69.6 ± 8.8
Sex^* (M/F)	13 (41.9%)/18 (58.1%)	9 (29.0%)/22 (71.0%)	9 (81.8%)/2 (18.26%)	0.009
BCVA (log MAR)	0.122 ± 0.152	0.081 ± 0.113	1.295 ± 1.090	<0.001
IOP (mm Hg)	13.4 ± 3.1	14.9 ± 2.4	14.6 ± 2.6	0.185

Values are presented as mean ± SD unless otherwise indicated; Kruskal Wallis test, p-value < 0.05.

BCVA = best corrected visual acuity; IOP = intraocular pressure.

^* Chi-square test, p-value < 0.05.

Table 2.

Retinal nerve fiber layer (RNFL) thickness at various location (μm)

	G	T	TS	NS	S	N	NI	TI	I
Category 3a	99.5 ± 14.0	73.8 ± 12.9	146.7 ± 62.2	108.1 ± 22.7	113.8 ± 34.0	71.8 ± 13.5	113.5 ± 27.9	145.7 ± 24.8	141.5 ± 36.3
Category 4a	99.3 ± 9.4	75.6 ± 16.5	135.6 ± 25.1	102.6 ± 20.4	112.2 ± 36.1	73.3 ± 12.3	104.1 ± 12.7	153.5 ± 17.9	138.5 ± 23.6
Normal	99.4 ± 9.6	75.4 ± 15.7	130.7 ± 20.5	101.8 ± 17.5	112.4 ± 34.7	70.0 ± 13.2	115.7 ± 18.1	155.0 ± 15.5	149.5 ± 35.2
p-value	0.987	0.850	0.407	0.499	0.842	0.950	0.297	0.226	0.480

Values are presented as mean ± SD; Kruskal Wallis test, p-value < 0.05.

G = general; T = temporal; TS = temporosuperior; NS = nasosuperior; S = superior; N = nasal; NI = nasoinferior; TI = temporoinferior; I = inferior.

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