1 Aier School of Ophthalmology, Central South University, Changsha Aier Eye Hospital, Changsha 410000, China
2 Shenzhen Aier Eye Hospital, Shenzhen 518000, China
3 Chinese University of Hong Kong, Hong Kong 999077, China
4 Shenzhen People's Hospital, Shenzhen 518000, China
Abstract:Objective: To investigate the correlation between the thickness of the retinal nerve fiber layer (RNFL) and axial length (AL), as well as age in normal people from the perspective of spatial distribution characteristics by utilizing the two-dimensional thickness matrix data of RNFL thickness. Methods: This was a serial case research project. The examination results of a total of 123 normal people (213 eyes) who underwent physical examinations in the outpatient clinic of Changsha Aier Eye Hospital from October 2015 to July 2020 were recruited. A data set of mean circumpapillary retinal never fiber layer (cpRNFL) thickness and a cross-sectional database of the RNFL thickness map based on a two-dimensional matrix of normal eyes (including refractive errors) spanning different age groups (18-69 year-old) and different ALs (22.07-30.00 mm) was established. Age, AL and RNFL thickness at each pixel position were substituted into the calculation library based on the mixed linear model for matrix calculation by using a custom-made computing program based on the Python language. The effective slope maps based on age and AL factors were generated. RNFL thickness/AL change (μm/mm) indicated the rate of change of RNFL thickness with the growth of AL. A mixed linear model and stacked maps were used to analyze the correlation between each factor and RNFL thickness and its spatial distribution characteristics. Results: The mean thickness of cpRNFL was negatively correlated with age and AL (r=-0.146, P=0.023; r=-1.012, P=0.026). However, in terms of spatial distribution, there were positive and negative correlations between the RNFL thickness and AL in the retinal inferotemporal region. As the AL grew, the thickness of the RNFL in the superior and inferior temporal quadrants became thinner. The fastest change was in the location close to the inferior temporal direction of the optic disc (-8.186 μm/mm), and the slowest change was in the location far from the optic disc (-0.155 μm/mm). In the inferior temporal area near the temporal side, there was a positive correlation with an increase in AL. The fastest rate of change was at the proximal temporal position near the optic disc, with a rate of change of 6.292 μm/mm. The RNFL thickness stack map of the longest axis indicated that the area positively correlated with the axis of the eye overlaps with the angle shift of the RNFL bundle in the case of the long axis. Conclusions: The thickness of RNFL is correlated with AL and age. The correlation and rate of change are different in spatial distribution. As the AL grows, the angle shift of the temporal RNFL bundle may cause a change in correlation.
李青蒨, 常征, 郭亚文, 等. 基于矩阵数据的视网膜神经纤维层厚度与眼轴长度及年龄的相关性[J]. 中华眼视光学与视觉科学杂志, 2021, 23(11): 805-812.
Qingqian Li,Zheng Chang,Yawen Guo,et al. Analysis of the Correlation between Retinal Nerve Fiber Layer Thickness and Axial Length and Age Based on Matrix Data. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(11): 805-812. DOI: 10.3760/cma.j.cn115909-20210406-00134
Tai EL, Ling JL, Gan EH, et al. Comparison of peripapillary retinal nerve fiber layer thickness between myopia severity groups and controls. Int J Ophthalmol, 2018, 11(2): 274-278. DOI: 10.18240/ijo.2018.02.16.
Jeong D, Sung KR, Jo YH, et al. Age-related physiologic thinning rate of the retinal nerve fiber layer in different levels of myopia. Int J Ophthalmol, 2020, e1873581. DOI: 10.1155/2020/1873581.
[6]
Chen CY, Huang EJ, Kuo CN, et al. The relationship between age, axial length and retinal nerve fiber layer thickness in the normal elderly population in Taiwan: The Chiayi eye study in Taiwan. PLoS One, 2018, 13(3): e0194116. DOI: 10.1371/ journal.pone.0194116.
[7]
Alasil T, Wang K, Keane PA, et al. Analysis of normal retinal nerve fiber layer thickness by age, sex, and race using spectral domain optical coherence tomography. J Glaucoma, 2013, 22(7): 532-541. DOI: 10.1097/IJG.0b013e318255bb4a.
[8]
Thapa M, Khanal S, Shrestha GB, et al. Retinal nerve f iber layer thickness in a healthy Nepalese population by spectral domain optical coherence tomography. Nepal J Ophthalmol, 2014, 6(2): 131-139. DOI: 10.3126/nepjoph.v6i2.11709.
[9]
Leung CK, Yu M, Weinreb RN, et al. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: interpreting the RNFL maps in healthy myopic eyes. Invest Ophthalmol Vis Sci, 2012, 53(11): 7194-7200. DOI: 10.1167/ iovs.12-9726.
[10]
Peng PH, Hsu SY, Wang WS, et al. Age and axial length on peripapillary retinal nerve fiber layer thickness measured by optical coherence tomography in nonglaucomatous Taiwanese participants. Plos One, 2017, 12(6): e0179320. DOI: 10.1371/ journal.pone.0179320.
[11]
Chauhan BC, Vianna JR, Sharpe GP, et al. Differential effects of aging in the macular retinal layers, neuroretinal rim, and peripapillary retinal nerve fiber layer. Ophthalmology, 2020, 127(2): 177-185. DOI: 10.1016/j.ophtha.2019.09.013.
Porwal S, Nithyanandam S, Joseph M, et al. Correlation of axial length and peripapillary retinal nerve fiber layer thickness measured by Cirrus HD optical coherence tomography in myopes. Indian J Ophthalmol, 2020, 68(8): 1584-1586. DOI: 10.4103/ijo.IJO_1778_19.
[14]
Lee MW, Kim JM, Shin YI, et al. Longitudinal changes in peripapillary retinal nerve fiber layer thickness in high myopia: A prospective, observational study. Ophthalmology, 2019, 126(4): 522-528. DOI: 10.1016/j.ophtha.2018.07.007.
Hirasawa H, Tomidokoro A, Araie M, et al. Peripapillary retinal nerve fiber layer thickness determined by spectral-domain optical coherence tomography in ophthalmologically normal eyes. Arch Ophthalmol, 2010, 128(11): 1420-1426. DOI: 10.1001/archophthalmol.2010.244.
[17]
Ikuno Y, Tano Y. Retinal and choroidal biometry in highly myopic eyes with spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci, 2009, 50(8): 3876- 3880. DOI: 10.1167/iovs.08-3325.
Gopinath B, Wang JJ, Kifley A, et al. The association between ocular biometry and retinal vascular caliber is comparable from early childhood to adolescence. Invest Ophthalmol Vis Sci, 2013, 54(2): 1501-1508. DOI: 10.1167/iovs.12-11036.
[20]
Benavente-Pérez A, Hosking SL, Logan NS, et al. Ocular blood flow measurements in healthy human myopic eyes. Graefes Arch Clin Exp Ophthalmol, 2010, 248(11): 1587-1594. DOI: 10.1007/s00417-010-1407-9.