利用频域光学相干断层扫描分析年龄、性别和种族对正常视网膜神经纤维层厚度的影响。

Analysis of normal retinal nerve fiber layer thickness by age, sex, and race using spectral domain optical coherence tomography.

机构信息

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital and the Harvard Catalyst Program, Boston, MA, USA.

出版信息

J Glaucoma. 2013 Sep;22(7):532-41. doi: 10.1097/IJG.0b013e318255bb4a.

DOI:10.1097/IJG.0b013e318255bb4a

PMID:22549477

Abstract

PURPOSE

To determine the effects of age, sex, and race on the retinal nerve fiber layer (RNFL) in the normal human eye as measured by the spectral domain optical coherence tomography (SD-OCT) Spectralis machine (Heidelberg Engineering).

METHODS

Peripapillary SD-OCT RNFL thickness measurements were determined in normal subjects seen at a university-based clinic. One randomly selected eye per subject was used for analysis in this cross-sectional study. Multiple regression analysis was applied to assess the effects of age, sex, ethnicity, and mean refractive error on peripapillary RNFL thickness. Results are expressed as means±SD wherever applicable.

RESULTS

The study population consisted of 190 healthy participants from 9 to 86 years of age. Of the 190 participants, 62 (33%) were men, 125 (66%) Caucasians, 26 (14%) African Americans, 14 (7%) Hispanics, 16 (8%) Asians, and 9 (5%) other races. The mean RNFL thickness for the normal population studied was 97.3 ± 9.6 µm. Normal RNFL thickness values follow the ISNT rule with decreasing RNFL thickness values starting from the thickest quadrant inferiorly to the thinnest quadrant temporally: inferior quadrant (126 ± 15.8), superior quadrant (117.2±16.13), nasal quadrant (75 ± 13.9), and temporal quadrant (70.6 ± 10.8 µm). Thinner RNFL measurements were associated with older age (P<0.001); being Caucasian, versus being either Hispanic or Asian (P=0.02 and 0.009, respectively); or being more myopic (P<0.001). For every decade of increased age, mean RNFL thickness measured thinner by approximately 1.5 µm (95% confidence interval, 0.24-0.07). Comparisons between ethnic groups revealed that Caucasians had mean RNFL values (96 ± 9.2 µm) slightly thinner than those of Hispanics (102.9 ± 11 µm; P=0.02) or Asians (100.7 ± 8.5 µm; P=0.009). African Americans RNFL values (99.2 ± 10.2 µm) were not significantly different when compared with Caucasians. There was no relationship between RNFL thickness and sex.

CONCLUSIONS

The thickest RNFL measurements were found in the inferior quadrant, followed by the superior, nasal, and temporal quadrants (ISNT rule applied to the RNFL). Thinner RNFL measurements were associated with older age and increasing myopia. Caucasians tend to have thinner RNFL values when compared with Hispanics and Asians. SD-OCT analysis of the normal RNFL showed results similar to time domain OCT studies.

摘要

目的

使用海德堡光谱域光学相干断层扫描仪（SD-OCT）Spectralis 测量正常人眼的视网膜神经纤维层（RNFL），以确定年龄、性别和种族对其的影响。

方法

在大学诊所观察到的正常受试者中进行了视盘周围 SD-OCT RNFL 厚度测量。在这项横断面研究中，每例受试者随机选择一只眼进行分析。应用多元回归分析评估年龄、性别、种族和平均屈光不正对视盘周围 RNFL 厚度的影响。在适用的情况下，结果表示为平均值±标准差。

结果

该研究人群由 9 至 86 岁的 190 名健康参与者组成。在 190 名参与者中，62 名（33%）为男性，125 名（66%）为白种人，26 名（14%）为非裔美国人，14 名（7%）为西班牙裔，16 名（8%）为亚洲人，9 名（5%）为其他种族。研究人群的平均 RNFL 厚度为 97.3±9.6 µm。正常 RNFL 厚度值符合 ISNT 规则，即从最厚的下象限到最薄的颞象限，RNFL 厚度逐渐变薄：下象限（126±15.8）、上象限（117.2±16.13）、鼻象限（75±13.9）和颞象限（70.6±10.8 µm）。较薄的 RNFL 测量值与年龄较大有关（P<0.001）；与白种人相比，为西班牙裔或亚洲人（P=0.02 和 0.009）；或更近视（P<0.001）。每增加十年，平均 RNFL 厚度约变薄 1.5 µm（95%置信区间，0.24-0.07）。与种族群体的比较表明，白种人的平均 RNFL 值（96±9.2 µm）略低于西班牙裔（102.9±11 µm；P=0.02）或亚洲人（100.7±8.5 µm；P=0.009）。与白种人相比，非裔美国人的 RNFL 值（99.2±10.2 µm）无显著差异。RNFL 厚度与性别之间无相关性。