Zhang Xiu-Juan, Lau Yi-Han, Wang Yu-Meng, Chan Hei-Nga, Chan Poemen P, Kam Ka-Wai, Ip Patrick, Zhang Wei, Young Alvin L, Tham Clement C, Pang Chi-Pui, Chen Li-Jia, Yam Jason C
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
Division of Pediatric Ophthalmology and Strabismus, Tianjin Eye Hospital, Tianjin 300020, China.
Diagnostics (Basel). 2022 Feb 15;12(2):500. doi: 10.3390/diagnostics12020500.
This study aims to investigate the effect of age on the peripapillary retinal nerve fiber layer (p-RNFL) thickness among schoolchildren. A total of 4034 children aged 6-8 years old received comprehensive ophthalmological examinations. p-RNFL thickness was measured from a circular scan (⌀ = 3.4 mm) captured using spectral-domain optical coherence tomography (SD-OCT). Associations between p-RNFL thickness with ocular and systemic factors were determined by multivariate linear regression after adjusting potential confounders using generalized estimating equations (GEE). The mean global p-RNFL thickness was 106.60 ± 9.41 μm (range: 72 to 171 μm) in the right eyes, 105.99 ± 9.30 μm (range: 76 to 163 μm) in the left eyes, and 106.29 ± 9.36 μm (range: 72 to 171 μm) across both eyes. Age was positively correlated with p-RNFL after adjusting for axial length (AL) and confounding factors (β = 0.509; = 0.001). Upon multivariable analysis, AL was positively associated with temporal p-RNFL thickness (β = 3.186, < 0.001) but negatively with non-temporal p-RNFL thickness (β = (10.003, -2.294), < 0.001). Sectoral p-RNFL was the thickest in the inferior temporal region (155.12 ± 19.42 μm, range 68 to 271 μm), followed by the superior temporal region (154.67 ± 19.99 μm, range 32 to 177 μm). To conclude, p-RNFL increased significantly with older age among children 6 to 8 years old in a converse trend compared to adults. Our results provide a reference for interpreting OCT information in children and suggest that stable p-RNFL thickness may not indicate a stable disease status in pediatric patients due to the age effects.
本研究旨在调查年龄对学龄儿童视乳头周围视网膜神经纤维层（p-RNFL）厚度的影响。共有4034名6至8岁的儿童接受了全面的眼科检查。使用光谱域光学相干断层扫描（SD-OCT）进行圆形扫描（⌀ = 3.4 mm），测量p-RNFL厚度。在使用广义估计方程（GEE）调整潜在混杂因素后，通过多变量线性回归确定p-RNFL厚度与眼部和全身因素之间的关联。右眼的平均整体p-RNFL厚度为106.60±9.41μm（范围：72至171μm），左眼为105.99±9.30μm（范围：76至163μm），双眼为106.29±9.36μm（范围：72至171μm）。在调整眼轴长度（AL）和混杂因素后，年龄与p-RNFL呈正相关（β = 0.509；P = 0.001）。多变量分析显示，AL与颞侧p-RNFL厚度呈正相关（β = 3.186，P < 0.001），但与非颞侧p-RNFL厚度呈负相关（β =（10.003，-2.294），P < 0.001）。扇形p-RNFL在下颞区最厚（155.12±19.42μm，范围68至271μm），其次是上颞区（154.67±19.99μm，范围32至177μm）。总之, 6至8岁儿童的p-RNFL随年龄增长显著增加，这与成年人的趋势相反。我们的结果为解释儿童光学相干断层扫描（OCT）信息提供了参考，并表明由于年龄影响，稳定的p-RNFL厚度可能并不表明儿科患者的疾病状态稳定。
