Majithia Shivani, Tham Yih-Chung, Chong Crystal Chun Yuen, Yu Marco, Cheung Carol Y, Bikbov Mukharram M, Kazakbaeva Gyulli M, Wang Ningli, Hao Jie, Cao Kai, Wang Ya Xing, Sasaki Mariko, Ito Yoshikazu, Wong Ian Y, Cheuk-Hung Chan Jonathan, Khanna Rohit C, Marmamula Srinivas, Nakano Eri, Mori Yuki, Aung Tin, Wong Tien Yin, Jonas Jost B, Miyake Masahiro, Cheng Ching-Yu
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore.
Ophthalmology. 2022 May;129(5):552-561. doi: 10.1016/j.ophtha.2021.11.022. Epub 2021 Nov 29.
To evaluate ethnic variations, ocular and systemic determinants of retinal nerve fiber layer (RNFL) thickness, and neuroretinal rim area among Asians using a large consortium of population-based eye studies.
Cross-sectional pooled analysis.
Twenty-two thousand four hundred thirty-six participants (22 436 eyes) from 10 population-based studies (in China, Hong Kong, India, Japan, Russia, and Singapore) of the Asian Eye Epidemiology Consortium.
Participants 40 years of age or older without glaucoma were included. All participants underwent spectral-domain OCT imaging and systemic and ocular examinations. Data were pooled from each study. Multivariable regression was performed to evaluate interethnic differences, intermachine variations, and ocular and systemic factors associated with RNFL thickness and rim area, adjusting for age, gender, diabetes, intraocular pressure (IOP), spherical equivalent (SE), ethnicity, OCT model, and study group. When evaluating body mass index, smoking, and hypertension as exposures, these factors were additionally adjusted for in the model.
Average RNFL thickness (in micrometers) and rim area (in square millimeters).
Indian and Japanese eyes have thinner RNFLs than those of other Asian ethnicities (β values range, 7.31-12.76 μm; P < 0.001 for all pairwise comparisons). Compared with measurements by Cirrus HD-OCT (Carl Zeiss Meditec, Inc), RNFL on average was 7.29 μm thicker when measured by Spectralis (Heidelberg Engineering), 12.85 μm thicker when measured by RS-3000 (NIDEK Co, Ltd), and 17.48 μm thicker when measured by iVue/RTVue (Optovue, Inc) devices (all P < 0.001). Additionally, older age (per decade, β = -2.70), diabetes (β = -0.72), higher IOP (per 1 mmHg, β = -0.07), more myopic SE (per diopter, β = -1.13), cardiovascular disease (β = -0.94), and hypertension (β = -0.68) were associated with thinner RNFL (all P ≤ 0.003). Similarly, older age (β = -0.019), higher IOP (β = -0.010), and more myopic SE (β = -0.025) were associated with smaller rim area (all P < 0.001).
In this large pooled analysis of Asian population studies, Indian and Japanese eyes were observed to have thinner RNFL profiles. These findings suggest the need for an ethnic-specific normative database to improve glaucoma detection.
利用大量基于人群的眼部研究联盟评估亚洲人中视网膜神经纤维层（RNFL）厚度、神经视网膜边缘面积的种族差异、眼部和全身决定因素。
横断面汇总分析。
来自亚洲眼流行病学联盟10项基于人群研究（在中国、中国香港、印度、日本、俄罗斯和新加坡）的22436名参与者（22436只眼）。
纳入40岁及以上无青光眼的参与者。所有参与者均接受了光谱域光学相干断层扫描（OCT）成像以及全身和眼部检查。数据来自每项研究并进行汇总。进行多变量回归以评估种族间差异、不同机器间差异以及与RNFL厚度和边缘面积相关的眼部和全身因素，并对年龄、性别、糖尿病、眼压（IOP）、等效球镜度（SE）、种族、OCT型号和研究组进行校正。在评估体重指数、吸烟和高血压作为暴露因素时，这些因素在模型中进行了额外校正。
平均RNFL厚度（以微米为单位）和边缘面积（以平方毫米为单位）。
印度人和日本人的RNFL比其他亚洲种族薄（β值范围为7.31 - 12.76μm；所有两两比较P < 0.001）。与Cirrus HD - OCT（卡尔·蔡司医疗技术公司）测量结果相比，Spectralis（海德堡工程公司）测量的RNFL平均厚7.29μm，RS - 3000（尼德克公司）测量的厚12.85μm，iVue/RTVue（奥普托视公司）设备测量的厚17.48μm（所有P < 0.001）。此外，年龄较大（每十年，β = -2.70）、糖尿病（β = -0.72）、眼压较高（每1mmHg，β = -0.07）、近视程度较高的等效球镜度（每屈光度，β = -1.13）、心血管疾病（β = -0.94）和高血压（β = -0.68）与较薄的RNFL相关（所有P≤0.003）。同样，年龄较大（β = -0.019）、眼压较高（β = -0.010）和近视程度较高的等效球镜度（β = -0.025）与较小的边缘面积相关（所有P < 0.001）。
在这项对亚洲人群研究的大型汇总分析中，观察到印度人和日本人的RNFL较薄。这些发现表明需要一个针对特定种族的规范数据库来改善青光眼检测。
