Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, P. R. China.
Ophthalmology. 2012 Apr;119(4):731-7. doi: 10.1016/j.ophtha.2011.10.010. Epub 2012 Jan 20.
To investigate age-related changes of the retinal nerve fiber layer (RNFL) imaged by a spectral-domain optical coherence tomography (OCT).
Prospective, cross-sectional, and longitudinal studies.
One hundred normal individuals were recruited for cross-sectional analysis, 35 of whom were randomly selected for longitudinal analysis.
The circumpapillary average and quadrant RNFL thicknesses were measured by the Cirrus HD-OCT. In the longitudinal study, participants were followed at 4-month intervals for a mean of 30 months (range, 24-41 months) for RNFL and visual field measurements. Cross-sectional RNFL data were analyzed with multiple linear regression models with adjustment of spherical error, optic disc area, and signal strength. Longitudinal RNFL measurements were analyzed with linear mixed models with fixed coefficients on follow-up duration, baseline RNFL thickness, spherical error, optic disc area, and signal strength. Factors influencing the rate of change of RNFL measurements were analyzed in the interaction terms with "duration" in the linear mixed models.
Rates of change of average and quadrant RNFL thicknesses.
In the cross-sectional analysis, significant negative correlations were found between age and average (-0.33 μm/year; P = 0.011), inferior (-0.45 μm/year; P = 0.037), and temporal (-0.31 μm/year; P = 0.046) RNFL thicknesses. In the longitudinal analysis, the mean rates of change of average, superior, and inferior RNFL thicknesses were -0.52 (95% confidence interval [CI], -0.86 to -0.17), -1.35 (95% CI, -2.05 to -0.65) and -1.25 μm/year (95% CI, -1.78 to -0.71), respectively, after adjusting for baseline RNFL thickness, spherical error, disc area, and signal strength. There was no detectable RNFL reduction in the nasal and temporal quadrants. The only significant factor influencing the rates of change of RNFL measurements was the baseline RNFL thickness. A greater baseline RNFL thickness was associated with a faster rate of change.
Progressive, age-related decline of RNFL thickness can be detected with longitudinal OCT imaging. Rate estimates derived from trend analysis for detection of glaucomatous RNFL progression should be interpreted with reference to the normal ranges of age-related reduction, particularly when the baseline RNFL measurement is large.
利用频域光相干断层扫描（OCT）研究视网膜神经纤维层（RNFL）的年龄相关性变化。
前瞻性、横断面和纵向研究。
对 100 名正常个体进行横断面分析，其中 35 名随机选择进行纵向分析。
采用 Cirrus HD-OCT 测量周边平均和象限 RNFL 厚度。在纵向研究中，参与者平均随访 30 个月（24-41 个月），每 4 个月进行一次 RNFL 和视野测量。用多元线性回归模型对横断面 RNFL 数据进行分析，调整球差、视盘面积和信号强度。用线性混合模型对纵向 RNFL 测量值进行分析，固定随访时间、基线 RNFL 厚度、球差、视盘面积和信号强度等因素。用线性混合模型的交互项分析影响 RNFL 测量值变化率的因素。
平均和象限 RNFL 厚度的变化率。
在横断面分析中，年龄与平均（-0.33μm/年；P=0.011）、下侧（-0.45μm/年；P=0.037）和颞侧（-0.31μm/年；P=0.046）RNFL 厚度呈显著负相关。在纵向分析中，平均、上侧和下侧 RNFL 厚度的平均变化率分别为-0.52μm/年（95%置信区间[CI]：-0.86 至-0.17）、-1.35μm/年（95%CI：-2.05 至-0.65）和-1.25μm/年（95%CI：-1.78 至-0.71），调整基线 RNFL 厚度、球差、视盘面积和信号强度后。鼻侧和颞侧象限未发现可检测到的 RNFL 减少。唯一显著影响 RNFL 测量值变化率的因素是基线 RNFL 厚度。更大的基线 RNFL 厚度与更快的变化率相关。
通过纵向 OCT 成像可以检测到与年龄相关的 RNFL 厚度进行性下降。在进行青光眼 RNFL 进展的趋势分析时，应参考与年龄相关的正常下降范围来解释估计的变化率，特别是当基线 RNFL 测量值较大时。
