Jonas Rahul Arvo, Wang Ya Xing, Yang Hua, Li Jian Jun, Xu Liang, Panda-Jonas Songhomitra, Jonas Jost Bruno
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China; Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany.
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.
PLoS One. 2015 Sep 21;10(9):e0138701. doi: 10.1371/journal.pone.0138701. eCollection 2015.
To measure the distance between the optic disc center and the fovea (DFD) and to assess its associations.
The population-based cross-sectional Beijing Eye Study 2011 included 3468 individuals aged 50+ years. The DFD was measured on fundus photographs.
Readable fundus photographs were available for 2836 (81.8%) individuals. Mean DFD was 4.76 ± 0.34 mm (median: 4.74 mm; range: 3.76-6.53 mm). In multivariate analysis, longer DFD was associated with longer axial length (P<0.001; standardized correlation coefficient beta: 0.62), higher prevalence of axially high myopia (P<0.001; beta:0.06), shallower anterior chamber depth (P<0.001; beta:-0.18), thinner lens thickness (P = 0.004; beta: -0.06), smaller optic disc-fovea angle (P = 0.02; beta: -0.04), larger parapapillary alpha zone (P = 0.008; beta: 0.05), larger parapapillary beta/gamma zone (P<0.001; beta: 0.11), larger optic disc area (P<0.001; beta: 0.08), lower degree of cortical cataract (P = 0.002; beta: -0.08), and lower prevalence of age-related macular degeneration (P = 0.001; beta: -0.06). Bruch´s membrane opening-fovea distance (DFD minus disc radius minus parapapillary beta/gamma zone width) in non-glaucomatous eyes was not significantly (P = 0.60) related with axial length in emmetropic or axially myopic eyes (axial length ≥23.5 mm), while it increased significantly (P<0.001; r: 0.32) with longer axial length in eyes with an axial length of <23.5 mm. Ratio of mean DFD to disc diameter was 2.65 ± 0.30. If the ratio of disc-fovea distance to disc diameter was considered constant and if the individual disc diameter was calculated as the individual disc-fovea distance divided by the constant factor of 2.65, the resulting calculated disc diameter differed from the directly measured disc diameter by 0.16 ±0.13 mm (median: 0.13 mm, range: 0.00-0.89 mm) or 8.9 ± 7.3% (median: 7.4%; range: 0.00-70%) of the measured disc diameter.
DFD (mean: 4.76 mm) increases with longer axial length, larger parapapillary alpha zone and parapapillary beta/gamma zone, and larger disc area. The axial elongation associated increase in DFD was due to an enlargement of parapapillary beta/gamma zone while the Bruch's membrane opening-fovea distance did not enlarge with longer axial length. This finding may be of interest for the process of emmetropization and myopization. Due to its variability, the disc-fovea distance has only limited clinical value as a relative size unit for structures at the posterior pole.
测量视盘中心与黄斑中心凹之间的距离（DFD）并评估其相关性。
基于人群的横断面2011年北京眼病研究纳入了3468名年龄在50岁及以上的个体。在眼底照片上测量DFD。
2836名（81.8%）个体有可读的眼底照片。平均DFD为4.76±0.34mm（中位数：4.74mm；范围：3.76 - 6.53mm）。在多变量分析中，DFD较长与眼轴长度较长相关（P<0.001；标准化相关系数β：0.62）、轴性高度近视患病率较高（P<0.001；β：0.06）、前房深度较浅（P<0.001；β： - 0.18）、晶状体厚度较薄（P = 0.004；β： - 0.06）、视盘 - 黄斑中心凹角度较小（P = 0.02；β： - 0.04）、视盘旁α区较大（P = 0.008；β：0.05）、视盘旁β/γ区较大（P<0.001；β：0.11）、视盘面积较大（P<0.001；β：0.08）、皮质性白内障程度较低（P = 0.002；β： - 0.08）以及年龄相关性黄斑变性患病率较低（P = 0.001；β： - 0.06）。在正视眼或轴性近视眼（眼轴长度≥23.5mm）的非青光眼眼中，Bruch膜开口 - 黄斑中心凹距离（DFD减去视盘半径减去视盘旁β/γ区宽度）与眼轴长度无显著（P = 0.60）相关性，而在眼轴长度<23.5mm的眼中，其随眼轴长度增加而显著增加（P<0.001；r：0.32）。平均DFD与视盘直径的比值为2.65±0.30。如果将视盘 - 黄斑中心凹距离与视盘直径的比值视为恒定，并且将个体视盘直径计算为个体视盘 - 黄斑中心凹距离除以2.65的常数因子，则所得计算出的视盘直径与直接测量的视盘直径相差0.16±0.13mm（中位数：0.13mm，范围：0.00 - 0.89mm）或测量视盘直径的8.9±7.3%（中位数：7.4%；范围：0.00 - 70%）。
DFD（平均值：4.76mm）随眼轴长度较长、视盘旁α区和视盘旁β/γ区较大以及视盘面积较大而增加。与眼轴伸长相关的DFD增加是由于视盘旁β/γ区增大，而Bruch膜开口 - 黄斑中心凹距离并未随眼轴长度增加而增大。这一发现可能对视轴正常化和近视化过程具有意义。由于其变异性，视盘 - 黄斑中心凹距离作为后极部结构的相对大小单位，其临床价值有限。
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