Almidani Louay, Sabharwal Jasdeep, Shahidzadeh Anoush, Martinez Ana Collazo, Ting Shu Jie, Vaidya Brinda, Jiang Xuejuan, Kowalczyk Tim, Beiser Alexa, Sobrin Lucia, Seshadri Sudha, Ramulu Pradeep, Kashani Amir H
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Ophthalmol Sci. 2024 May 6;4(6):100549. doi: 10.1016/j.xops.2024.100549. eCollection 2024 Nov-Dec.
To explore participant-level biological attributes and scan-level methodological attributes associated with retinal nerve fiber layer (RNFL) thickness variability in a population-based sample of elderly United States adults.
Cross-sectional analysis using data from the Framingham Heart Study.
One thousand three hundred forty-seven eyes from 825 participants with ≥1 OCT scan and axial length data were included.
Three or more successive RNFL scans of each eye of each participant were obtained in a single session. Multivariable linear mixed models were employed to explore the associations between average RNFL thickness with participant-level biological attributes (age, gender, race, ethnicity, and axial length) and scan-level attributes (signal strength [SS]) as independent variables in the whole population as well as a subsample of adults with no self-reported history of glaucoma. Similar analyses were designed to assess methodological variability with average within-eye standard deviation (SD) for repeated scans as the dependent variable.
(1) Biological variability: average RNFL thickness, and (2) methodological variability: average within-participant SD across repeated scans.
Age (β = 0.19 microns/year, [95% confidence interval {CI}: 0.29, 0.09]), female gender (β = +1.48 microns vs. male, [95% CI: 0.09, 2.86]), axial length (β = 1.24 microns/mm of greater length, [95% CI: 1.80, 0.67]), and SS (β = +1.62 microns/1 unit greater SS, [95% CI: 1.16, 2.09]) were significantly associated with RNFL thickness, while race and ethnicity were not ( > 0.05). In analyses designed to assess methodological variability, higher RNFL thickness (β = +0.02 per micron increase, [95% CI: 0.01, 0.03]), and lower SS (β = +0.19 per 1 unit lower SS, [95% CI: 0.10, 0.27]) were significantly associated with greater RNFL variability. In adults with no self-reported history of glaucoma (n of eyes = 1165, n of participants = 712), female gender was not associated with RNFL, while African American race was associated with thicker RNFL (β = +4.65 microns vs. Whites, [95% CI: 1.28, 8.03]).
Retinal nerve fiber layer thickness is lower with older age, male gender, greater axial length, lower SS, and Whites (as compared with African Americans) without self-reported glaucoma. Measurement variability (SD) is higher with greater RNFL thickness and lower SS. Understanding these biological and methodological variations is important to aid in OCT interpretation.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
在以美国老年成年人为基础的样本中，探究与视网膜神经纤维层（RNFL）厚度变异性相关的参与者层面的生物学属性和扫描层面的方法学属性。
使用弗雷明汉心脏研究的数据进行横断面分析。
纳入了825名参与者的1347只眼睛，这些参与者有≥1次光学相干断层扫描（OCT）和眼轴长度数据。
在单次检查中获取每位参与者每只眼睛的三次或更多连续RNFL扫描。采用多变量线性混合模型，以参与者层面的生物学属性（年龄、性别、种族、族裔和眼轴长度）和扫描层面的属性（信号强度[SS]）作为自变量，在整个人群以及无青光眼自我报告病史的成年子样本中，探究平均RNFL厚度之间的关联。设计类似分析以评估方法学变异性，将重复扫描的眼内平均标准差（SD）作为因变量。
（1）生物学变异性：平均RNFL厚度，以及（2）方法学变异性：重复扫描中参与者内的平均SD。
年龄（β = 0.19微米/年，[95%置信区间{CI}：0.29，0.09]）、女性性别（β = +1.48微米 vs 男性，[95%CI：0.09，2.86]）、眼轴长度（β = 1.24微米/每增加1毫米长度，[95%CI：1.80，0.67]）和SS（β = +1.62微米/每增加1个单位SS，[95%CI：1.16，2.09]）与RNFL厚度显著相关，而种族和族裔则无相关性（P > 0.05）。在旨在评估方法学变异性的分析中，较高的RNFL厚度（β = +0.02/每增加1微米，[95%CI：0.01，0.03]）和较低的SS（β = +0.19/每降低1个单位SS，[95%CI：0.10，0.27]）与更大的RNFL变异性显著相关。在无青光眼自我报告病史的成年人中（眼睛n = 1165，参与者n = 712），女性性别与RNFL无关，而非洲裔美国人种族与更厚的RNFL相关（β = +4.65微米 vs 白人，[95%CI：1.28，8.03]）。
在无青光眼自我报告病史的情况下，年龄较大、男性、眼轴长度较长、SS较低以及白人（与非洲裔美国人相比）者的视网膜神经纤维层厚度较低。测量变异性（SD）随着RNFL厚度增加和SS降低而更高。了解这些生物学和方法学变异对于辅助OCT解读很重要。
在本文末尾的脚注和披露中可能会发现专有或商业披露信息。
