Wagner Felix Mathias, Hoffmann Esther Maria, Nickels Stefan, Fiess Achim, Münzel Thomas, Wild Philipp S, Beutel Manfred E, Schmidtmann Irene, Lackner Karl J, Pfeiffer Norbert, Schuster Alexander Karl-Georg
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Transl Vis Sci Technol. 2020 Aug 21;9(9):35. doi: 10.1167/tvst.9.9.35. eCollection 2020 Aug.
To investigate the retinal nerve fiber layer profile measured by optical coherence tomography and its relation to refractive error and axial length.
The Gutenberg Health Study is a population-based study in Mainz, Germany. At the five-year follow-up examination, participants underwent optical coherence tomography, objective refraction and biometry. Peripapillary retinal nerve fiber layer (pRNFL) was segmented using proprietary software. The pRNFL profiles were compared between different refraction groups and the angle between the maxima, i.e., the peaks of pRNFL thickness in the upper and lower hemisphere (angle between the maxima of pRNFL thickness [AMR]) was computed. Multivariable linear regression analysis was carried out to determine associations of pRNFL profile (AMR) including age, sex, optic disc size, and axial length in model 1 and spherical equivalent in model 2.
A total of 5387 participants were included. AMR was 145.3° ± 23.4° in right eyes and 151.8° ± 26.7° in left eyes and the pRNFL profile was significant different in the upper hemisphere. The AMR decreased with increasing axial length by -5.86°/mm (95% confidence interval [CI]: [-6.44; -5.29], < 0.001), female sex (-7.61°; 95% CI: [-8.71; -6.51], < 0.001) and increased with higher age (0.08°/year; 95% CI: [0.03; 0.14], = 0.002) and larger optic disc size (2.29°/mm; 95% CI: [1.18; 3.41], < 0.001). In phakic eyes, AMR increased with hyperopic refractive error by 2.60°/diopters (dpt) (95% CI: [2.33; 2.88], < 0.001).
The pRNFL profiles are related to individual ocular and systemic parameters.
Biometric parameters should be considered when pRNFL profiles are interpreted in diagnostics, i.e., in glaucoma.
研究通过光学相干断层扫描测量的视网膜神经纤维层轮廓及其与屈光不正和眼轴长度的关系。
古登堡健康研究是一项在德国美因茨进行的基于人群的研究。在五年随访检查中，参与者接受了光学相干断层扫描、客观验光和生物测量。使用专用软件对视乳头周围视网膜神经纤维层（pRNFL）进行分割。比较不同屈光组之间的pRNFL轮廓，并计算上下半球pRNFL厚度最大值之间的夹角，即pRNFL厚度最大值之间的夹角（AMR）。进行多变量线性回归分析，以确定模型1中包括年龄、性别、视盘大小和眼轴长度以及模型2中球镜等效度在内的pRNFL轮廓（AMR）的关联。
共纳入5387名参与者。右眼的AMR为145.3°±23.4°，左眼为151.8°±26.7°，上半球的pRNFL轮廓有显著差异。AMR随着眼轴长度增加而降低，斜率为-5.86°/mm（95%置信区间[CI]：[-6.44；-5.29]，P<0.001），女性降低幅度更大（-7.61°；95%CI：[-8.71；-6.51]，P<0.001），且随着年龄增长而增加（0.08°/年；95%CI：[0.03；0.14]，P=0.002），视盘越大增加幅度越大（2.29°/mm；95%CI：[1.18；3.41]，P<0.001）。在有晶状体眼中，AMR随着远视性屈光不正增加，斜率为2.60°/屈光度（dpt）（95%CI：[2.33；2.88]，P<0.001）。
pRNFL轮廓与个体眼部和全身参数相关。
在诊断（即青光眼诊断）中解释pRNFL轮廓时应考虑生物测量参数。
