关于眼部和全身参数的视乳头周围视网膜神经纤维层厚度的决定因素——MIPH眼与健康研究
Determinants of peripapillary retinal nerve fiber layer thickness regarding ocular and systemic parameters - the MIPH Eye&Health Study.
作者信息
Schuster Alexander Karl-Georg, Fischer Joachim Ernst, Vossmerbaeumer Christine, Vossmerbaeumer Urs
机构信息
Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Private practice, Charlottenstrasse, Stuttgart, Germany.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2016 Oct;254(10):2011-2016. doi: 10.1007/s00417-016-3422-y. Epub 2016 Jul 29.
BACKGROUND
Optical coherence tomography (OCT) allows quantitative image analysis of retinal tissue in vivo. Peripapillary retinal nerve fiber layer (pRNFL) thickness is widely used for evaluation of retinal nerve fiber rarefaction in several optic neuropathies. This study evaluates associations of pRNFL thickness in healthy adult subjects in order to evaluate influencing factors.
METHODS
A cross-sectional study was performed in a working-age population. Only eyes without detectable ocular pathologies were included in the analysis. Among analyzed systemic cardiovascular parameters were age, gender, body-mass index, mean arterial blood pressure, HbA1c, high- and low-density-lipoproteins, and triglycerides. A comprehensive ophthalmological examination including refraction, tonometry, keratometry, and central corneal thickness measurmentwas performed. In addition, pRNFL thickness was imaged by spectral-domain OCT. Univariable and multivariable associations of pRNFL thickness in all four quadrants and on average with systemic and ocular parameters were calculated using a generalized estimating equation model.
RESULTS
Three hundred and six subjects were included. pRNFL thickness measurements showed a significant association with spherical equivalent: pRNFL thickness decreased with increasing myopia in all quadrants (multivariable regression coefficients Beta: superior: 1.16, 95 % CI [0.62;1.71], p < 0.001; temporal: 0.87, [0.33;1.41], p = 0.001; inferior: 1.80, [1.18;2.42], p < 0.001; nasal: 2.60, [2.01;3.20], p < 0.001) and on average (1.51, [1.20;1.82], p < 0.001). A thicker central cornea thickness was related to lower pRNFL in the superior (-0.05, [-0.10; -0.01], p = 0.01), the inferior quadrant (-0.05, [-0.10;0.00], p = 0.03) and on average (-0.04, [-0.07; -0.01], p = 0.02). All other parameters were not associated.
CONCLUSION
Our findings highlight the importance of refraction when evaluating pRNFL thickness and its independence from other systemic parameters.
背景
光学相干断层扫描（OCT）可对活体视网膜组织进行定量图像分析。视乳头周围视网膜神经纤维层（pRNFL）厚度被广泛用于评估多种视神经病变中的视网膜神经纤维稀疏情况。本研究评估健康成年受试者pRNFL厚度的相关性，以评估影响因素。
方法
对工作年龄人群进行横断面研究。分析中仅纳入未检测出眼部病变的眼睛。分析的全身心血管参数包括年龄、性别、体重指数、平均动脉血压、糖化血红蛋白、高密度脂蛋白和低密度脂蛋白以及甘油三酯。进行了包括验光、眼压测量、角膜曲率测量和中央角膜厚度测量在内的全面眼科检查。此外，通过光谱域OCT对pRNFL厚度进行成像。使用广义估计方程模型计算所有四个象限以及平均pRNFL厚度与全身和眼部参数的单变量和多变量相关性。
结果
纳入306名受试者。pRNFL厚度测量显示与等效球镜有显著相关性：所有象限中pRNFL厚度均随近视增加而降低（多变量回归系数β：上方：1.16，95%可信区间[0.62；1.71]，p＜0.001；颞侧：0.87，[0.33；1.41]，p = 0.001；下方：1.80，[1.18；2.42]，p＜0.001；鼻侧：2.60，[2.01；3.20]，p＜0.001），平均情况也是如此（1.51，[1.20；1.82]，p＜0.001）。较厚的中央角膜厚度与上方（-0.05，[-0.10；-0.01]，p = 0.01）、下方象限（-0.05，[-0.10；0.00]，p = 0.03）以及平均（-0.04，[-0.07；-0.01]，p = 0.02）的较低pRNFL相关。所有其他参数均无关联。
结论
我们的研究结果突出了在评估pRNFL厚度时验光的重要性及其与其他全身参数的独立性。
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