Abstract
Purpose We aimed to evaluate the distribution and determinants of peripapillary retinal nerve fiber layer (pRNFL) thickness and its associations with general sleep quality in Chinese school students. Methods 1063 grade 7 students aged 13 to 14 years with pRNFL thickness data from a school-based study on grade 7 students in Southwestern China participated in the study. The pRNFL thickness was measured on the optical coherence tomography images of a circular scan centered on the optic disc. Refractive error was measured after cycloplegia using an autorefractor and biometric parameters including axial length (AL) were measured by an IOLMaster. Participants' sleep quality was measured by the Children's Sleep Habits Questionnaire (CSHQ). Results The mean pRNFL thickness was 106.8 ± 10.7 μm among the 1063 participants. There was an increasing trend of spherical equivalent and a decreasing trend of AL with RNFL thickness. In multivariate analysis, each diopter of spherical equivalent increase was associated with 0.64 μm increase in pRNFL thickness. Girls had an increased mean pRNFL thickness compared with boys with a mean difference of 1.65 μm. Per 10 μm increase in pRNFL thickness was significantly associated with a 0.5 reduction in CSHQ score (better sleep quality). Conclusions More myopic refractive error was the major ocular determinant of decreased pRNFL thickness. In addition, students with thinner pRNFL tended to have a worse sleep quality.
Highlights
The peripapillary retinal nerve fiber layer thickness is an important ocular parameter in the diagnosis and monitoring of glaucoma [1], which is a leading cause of irreversible vision loss and blindness [2]
Our study reported that the mean peripapillary retinal nerve fiber layer (pRNFL) thickness as measured by SD-OCT was about 106.8 μm in grade 7 Chinese students, which was greater than the estimates reported in other studies on Chinese students of similar ages [27]
E population-based estimate of mean pRNFL thickness in this study could be compared with the measurements reported in other studies, especially in younger generations
Summary
The peripapillary retinal nerve fiber layer (pRNFL) thickness is an important ocular parameter in the diagnosis and monitoring of glaucoma [1], which is a leading cause of irreversible vision loss and blindness [2]. PRNFL thickness plays a role to aid the diagnosis of systemic nerve diseases such as dementia [3], stroke [4], and multiple sclerosis [5]. Us, understanding the normative distribution of pRNFL thickness and its predictors in general population is crucial in the clinical management of these ocular and systemic nerve diseases. By using SD-OCT, several epidemiologic studies have reported the distribution and determinants of pRNFL thickness in middle-aged to elderly adults [7,8,9,10,11,12]. The assessment of pRNFL thickness has important implications in the diagnosis of several pediatric nerve disorders such as congenital glaucoma [16] and Marfan syndrome [17]
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