Abstract
ObjectiveTo assess the prevalence of localized retinal nerve fiber layer defects (LRNFLD) and associated factors in adult Chinese.MethodsThe population-based Beijing Eye Study 2011 included 3468 individuals (mean age: 64.6±9.8 years (range: 50–93 years)). The study participants underwent a detailed ophthalmological examination including spectral-domain optical coherence tomography (SpectralisR-OCT) assisted measurement of the RNFL. A LRNFLD was defined as a sector in which the RNFL contour line dipped into the red zone for a length of <180°.ResultsReadable OCT images were available for 3242 (93.5%) subjects. LRNFLDs were detected in 640 eyes (9.9±0.4%) of 479 subjects (14.8±0.6%). In the age groups of 50–59 years, 60–69 years, 70–79 years, and 80+ years, the prevalence of LRNFLD per person increased from 9.9±0.9%, 11.6±1.0% and 20.6±1.4% to 33.0±3.2%, respectively. In multivariate analysis, prevalence of LRNFLDs was significantly associated with older age (P = 0.001; Odds Ratio (OR): 1.03; 95% Confidence Interval (CI): 1.01,1.05), myopic refractive error (P<0.001;OR:0.79;95%CI:0.74,0.85), larger beta zone of parapapillary atrophy (P<0.001; OR:1.34;95%CI:1.20,1.50), presence of glaucomatous optic neuropathy (P<0.001;OR:7.02;95%CI:3.87,12.7), presence of non-glaucomatous optic nerve damage (P = 0.001;OR:43.3;95%CI:8.24,227.1), and presence of diabetic retinopathy (P = 0.003;OR:2.79;95%CI:1.43,5.44).ConclusionsOCT-defined LRNFLDs were present in a prevalence of 14.8±0.6% in a population-based study sample of subjects aged 50+ years. Prevalence of LRNFLDs increased with higher age, myopic refractive error, and larger parapapillary beta zone. Major ocular diseases associated with LRNFLs were glaucoma, non-glaucomatous optic nerve damage and diabetic retinopathy. These data may be helpful for a semiautomatic assessment of the RNFL.
Highlights
The assessment of the retinal nerve fiber layer (RNFL) is of high importance for the diagnosis and follow-up of any optic nerve abnormality and disease since the optic nerve fibers are the continuation of the retinal nerve fibers to the lateral geniculate ganglion [1,2]
Prevalence of LRNFLDs was significantly associated with older age (P = 0.001; Odds Ratio (OR): 1.03; 95% Confidence Interval (CI): 1.01,1.05), myopic refractive error (P,0.001;OR:0.79;95%CI:0.74,0.85), larger beta zone of parapapillary atrophy (P,0.001; OR:1.34;95%CI:1.20,1.50), presence of glaucomatous optic neuropathy (P,0.001;OR:7.02;95%CI:3.87,12.7), presence of non-glaucomatous optic nerve damage (P = 0.001;OR:43.3;95%CI:8.24,227.1), and presence of diabetic retinopathy (P = 0.003;OR:2.79;95%CI:1.43,5.44)
Prevalence of LRNFLDs increased with higher age, myopic refractive error, and larger parapapillary beta zone
Summary
The assessment of the retinal nerve fiber layer (RNFL) is of high importance for the diagnosis and follow-up of any optic nerve abnormality and disease since the optic nerve fibers are the continuation of the retinal nerve fibers to the lateral geniculate ganglion [1,2]. After the clinical introduction of optical coherence tomography (OCT) by Huang and colleagues, the newly developed spectral-domain OCT technology has further improved the visualization of the RNFL and the detection of its defects [7,8,9,10,11,12,13]. Applying the spectral-domain OCT technology in a population-based study, we examined the RNFL in a cohort of more than 3000 study participants, assessed the prevalence of localized RNFLDs and searched for associations of localized RNFLDs with other ocular and systemic parameters. Knowledge about the prevalence of localized RNFLDs and the associated factors in a population is of clinical importance to assess sensitivity, specificity and diagnostic precision of the occurrence of localized RNFLDs for the detection of diseases such as glaucoma. Since the OCT examination is a non-invasive method, the results of our study could be helpful for a semi-automatic detection of diseases associated with localized RNFLDs
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