Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Ophthalmology. 2020 Aug;127(8):1064-1076. doi: 10.1016/j.ophtha.2020.01.055. Epub 2020 Feb 8.
To examine the normative profile and determinants of macular ganglion cell-inner plexiform layer (GCIPL) thickness based on spectral-domain OCT (SD-OCT) in a nonglaucoma, multi-ethnic Asian population.
Population-based, cross-sectional study.
Ethnic Chinese, Malay, and Indian adults aged ≥40 years recruited from the Singapore Epidemiology of Eye Diseases Study.
All participants underwent standardized examinations. The GCIPL thickness was measured using Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA). Participants with glaucoma or poor-quality scans were excluded. Eye-specific data were used. Associations of ocular and systemic factors with GCIPL thickness parameters were investigated using multivariable linear regression with generalized estimating equation models to account for correlation between both eyes.
GCIPL thickness.
A total of 4464 participants (7520 eyes) consisting of 1625 Chinese, 1212 Malay, and 1627 Indian adults contributed to this analysis. Average GCIPL thickness was 82.6±6.1 μm in Chinese, 81.5±6.8 μm in Malays, and 78.0±6.9 μm in Indians (P < 0.001 by analysis of variance). The 5th percentile limit of average GCIPL thickness was 72 μm in Chinese, 70 μm in Malays, and 67 μm in Indians. In multivariable analysis adjusting for age, gender, axial length, presence of cataract, OCT signal strength, disc area, hypertension, diabetes, and hyperlipidemia, eyes of Indians were observed to have 3.43 μm thinner GCIPL on average compared with Chinese (P < 0.001) and 3.36 μm thinner GCIPL compared with Malays (P < 0.001). In addition, older age (per decade; β = -2.51), female (β = -1.57), longer axial length (per mm; β = -1.54), and presence of chronic kidney disease (β = -1.49) were significantly associated with thinner average GCIPL (all P ≤ 0.008). Larger optic disc area (per mm; β = 0.78; P < 0.001) was associated with thicker GCIPL. These factors were consistently observed to be significant for superior and inferior hemisphere GCIPL thickness.
GCIPL thickness profiles were significantly thinner in Indians compared with Chinese and Malays. Our findings further highlight the need of a more refined, ethnic-specific normative database for GCIPL thickness, which in turn may improve the detection and diagnosis of glaucoma in Asians.
基于频域光相干断层扫描（SD-OCT），研究非青光眼、多民族亚洲人群中黄斑神经节细胞-内丛状层（GCIPL）厚度的正常分布和决定因素。
基于人群的横断面研究。
年龄≥40 岁的华裔、马来族和印度族成年人，均来自新加坡眼病流行病学研究。
所有参与者均接受了标准化检查。使用 Cirrus HD-OCT（Carl Zeiss Meditec，都柏林，加利福尼亚州）测量 GCIPL 厚度。排除青光眼或扫描质量差的患者。使用眼部特定数据，采用广义估计方程模型的多变量线性回归分析，以考虑双眼之间的相关性，研究眼部和全身因素与 GCIPL 厚度参数之间的关系。
GCIPL 厚度。
共有 4464 名参与者（7520 只眼），包括 1625 名华裔、1212 名马来族和 1627 名印度族成年人，参与了这项分析。华裔的平均 GCIPL 厚度为 82.6±6.1μm，马来族为 81.5±6.8μm，印度族为 78.0±6.9μm（方差分析，P<0.001）。华裔、马来族和印度族的平均 GCIPL 厚度第 5 百分位数下限分别为 72μm、70μm 和 67μm。在调整年龄、性别、眼轴长度、白内障存在、OCT 信号强度、视盘面积、高血压、糖尿病和高脂血症后，与华裔相比，印度族的 GCIPL 平均薄 3.43μm（P<0.001），与马来族相比，GCIPL 薄 3.36μm（P<0.001）。此外，年龄每增加 10 年（β=-2.51）、女性（β=-1.57）、眼轴长度每增加 1mm（β=-1.54）和慢性肾脏病（β=-1.49）与平均 GCIPL 变薄显著相关（均 P≤0.008）。视盘面积每增加 1mm（β=0.78；P<0.001）与 GCIPL 增厚相关。这些因素对上方和下方 GCIPL 厚度的影响始终具有统计学意义。
与华裔和马来族相比，印度族的 GCIPL 厚度明显变薄。我们的研究结果进一步强调了需要更精细的、特定于种族的 GCIPL 厚度正常参考值数据库，这反过来可能会提高亚洲人青光眼的检测和诊断水平。
