December 2013
Volume 54, Issue 13
Free
Clinical and Epidemiologic Research  |   December 2013
Retinal Nerve Fiber Layer Thickness in Normal Chinese Students Aged 6 to 17 Years
Author Affiliations & Notes
  • Li Chen
    Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
  • Jiannan Huang
    Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
  • Haidong Zou
    Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
    Department of Preventive Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
  • Wenwen Xue
    Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
  • Yingyan Ma
    Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
  • Xiangui He
    Department of Preventive Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
  • Lina Lu
    Department of Preventive Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
  • Jianfeng Zhu
    Department of Preventive Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
  • Correspondence: Haidong Zou, Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Department of Preventive Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center, No. 100 Haining Road, Shanghai, China 200080; zouhaidong@hotmail.com
Investigative Ophthalmology & Visual Science December 2013, Vol.54, 7990-7997. doi:10.1167/iovs.12-11252
  • Views
  • PDF
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Li Chen, Jiannan Huang, Haidong Zou, Wenwen Xue, Yingyan Ma, Xiangui He, Lina Lu, Jianfeng Zhu; Retinal Nerve Fiber Layer Thickness in Normal Chinese Students Aged 6 to 17 Years. Invest. Ophthalmol. Vis. Sci. 2013;54(13):7990-7997. doi: 10.1167/iovs.12-11252.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose.: We obtained retinal nerve fiber layer (RNFL) thickness measurements in normal Chinese students aged 6 to 17 years, and investigated the relationship between RNFL thickness and sex, eye laterality, age, axial length, and refractive error.

Methods.: A total of 4648 eyes in 2324 normal, randomly-selected Chinese students aged 6 to 17 years was examined in this study. The RNFL thickness was measured by optical coherence tomography. The effects of sex, eye laterality (left or right), age, refractive error, and axial length on RNFL thickness were assessed.

Results.: The average age of the subjects was 12.82 ± 3.11 years. The global average RNFL thickness (±SD) was 106.89 ± 12.84 μm. The thickest RNFL measurements were found at the superior (133.22 ± 19.48 μm) and inferior (129.23 ± 20.30 μm) quadrants of the retina, followed by the temporal (93.58 ± 29.15 μm) and nasal (77.10 ± 14.89 μm) quadrants. In the 1529 participants aged 12 to 17, there were no significant differences in RNFL thickness values between the right and left eyes (P > 0.05); significant differences in RNFL were found only in the inferior and temporal quadrants of the retina in different sex groups (P < 0.05). Linear regression analysis revealed that the RNFL thickness values were correlated independently with axial length and refractive error (P < 0.05).

Conclusions.: For clinical assessment of RNFL thickness, the influence of refractive error and axial length should be taken into account.

Introduction
Glaucoma is a syndrome with manifestations of high intraocular tension, damaged visual function and damage to the optic nerve, leading to blindness. 1 According to a recent epidemiologic study, the prevalence of glaucoma in China is approximately 0.21% to 1.64%. 2 Early diagnosis and prevention of glaucoma is important, because damage to the visual field is irreversible. Studies confirm that before the occurrence of clinical visual field defects in glaucoma patients, approximately 40% to 50% of the retinal nerve fibers already have been lost. 3 Therefore, recognition of changes in retinal nerve fibers is extremely important in the early diagnosis and follow-up control of glaucoma. 
Optical coherence tomography (OCT) is a technology that uses near-infrared light to create high-resolution images. It is noninvasive, rapid, and easy to perform, and does not involve contact. The OCT has been used widely for the observation and follow-up of changes in retinal nerve fibers, with good repeatability and high reliability. Early diagnosis and precise monitoring of retinal nerve fiber layer (RNFL) thickness alterations is possible only if an accurate database of living healthy human RNFL thickness is available. Several studies have obtained data for RNFL thickness using OCT in Chinese children. 47 Nevertheless, none of these studies involved more than 200 healthy children, and few of them reported retinal thickness in different age or sex groups. Thus, data for Chinese teenagers under 18 years of age are lacking. Such data would be useful in the auxiliary diagnosis of early glaucoma and to follow suspected glaucoma patients longitudinally; such data also would provide information on whether RNFL thickness increases or decreases in normal eyes during childhood. In our study, we reported in vivo measurement of RNFL thickness in 4648 healthy eyes of 2324 healthy Chinese teenagers aged 6 to 17 years using OCT, and explore factors related to our observations. 
Methods
We first randomly selected the Luwan, Huangpu, and Jiading districts from 18 Shanghai administrative districts. These three districts represent the city, rural-urban fringe, and countryside. Five primary schools and seven middle schools in these three districts were selected randomly as survey sites, and the students with odd student code numbers were chosen for participation. The inclusion criteria were: Chinese nationality; age between 6 and 17 years; best-corrected visual acuity of 12/20 or better; no history of eye disorders, such as cataract or glaucoma, and no abnormal findings in examinations. Those who could not cooperate with the examination and those who did not sign the informed consent form were excluded from the study. This study was conducted according to the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board at the Shanghai First People's Hospital, Shanghai Jiao Tong University. 
Field investigations took place from October 2011 to June 2013. The investigative team included three trained ophthalmologists who conducted OCT examinations and seven experienced doctors who assisted with the investigations. The three ophthalmologists received training in the study methodology and conducted pilot OCT examinations on volunteers 1 month before the investigations. 
Before field examination, the purpose and methods of this study were explained to the participants' parents, and written informed consent was obtained. We collected data, including age, sex, best-corrected visual acuity, refraction, and axial length (AL). An autorefractor (model KR-8800; Topcon, Tokyo, Japan) provided a median value of three reliable measurements of refractive status if individual measurements varied by no more than 0.5 diopters (D). An IOL-Master (Carl Zeiss Meditec, Oberkochen, Germany) provided a median value of five reliable measurements of AL if individual measurements varied by no more than 0.02 mm. OCT (OCT-iVue100, version 1.5; Optovue, Inc., Fremont, CA) was performed without pupillary dilation. The position of the aiming circle was adjusted by the operator to match the optic nerve head so that the nerve head scan, covering a set diameter (3.45 mm) around the center of the optic disc, would acquire an OCT image that was equidistant from the disc margins in all directions. The operator was to ensure the centration of the measurement circle before OCT image acquisition. The RNFL thickness was evaluated as a global average in various quadrants and at 45° intervals, and 13 RNFL parameters representing the average RNFL thickness of 13 different locations were displayed by means of a color-coded map. The locations and abbreviation terms corresponding to these 13 parameters are presented in Table 1. Any questions raised during the study were discussed by the staff and resolved in a timely fashion. An engineer from Optovue, Inc. (Shanghai, China) frequently helped us ensure that the OCT-iVue100 device (Optovue, Inc.) was working properly. 
Table 1
 
Parameter Locations and Abbreviations Used in the Analysis
Table 1
 
Parameter Locations and Abbreviations Used in the Analysis
Location Abbreviation Term Used in Analysis Right Eye Left Eye
Superior nasal SN 00:00–01:30 10:30–00:00
Nasal upper NU 01:30–03:00 09:00–10:30
Nasal lower NL 03:00–04:30 07:30–09:00
Inferior nasal IN 04:30–06:00 06:00–07:30
Inferior temporal IT 06:00–07:30 04:30–06:00
Temporal lower TL 07:30–09:00 03:00–04:30
Temporal upper TU 09:00–10:30 01:30–03:00
Superior temporal ST 10:30–00:00 00:00–01:30
Superior S 10:30–12:00–01:30 10:30–12:00–01:30
Nasal N 01:30–03:00–04:30 07:30–09:00–10:30
Inferior I 04:30–06:00–07:30 04:30–06:00–07:30
Temporal T 07:30–09:00–10:30 01:30–03:00–04:30
Total quadrants Avg 00:00–06:00–12:00 00:00–06:00–12:00
The data were recorded on Excel spreadsheets by two persons independently. The spherical equivalent was calculated as the spherical degree plus half of the cylindrical degree. Statistical analyses were performed using an SPSS software program (SPSS16.0; SPSS Institute, Inc., Chicago, IL). Normalcy of distribution of the 13 RNFL thickness parameter values was evaluated using the 1-sample Kolmogorov-Smirnov Z test. If the values did not follow a Gaussian distribution, the Wilcoxon signed-rank or Mann-Whitney U nonparameter test was used to determine significant difference. A 2-tailed Pearson bivariate correlation analysis was used to determine the interaction between RNFL thickness and age, refractive error, and axial length. Multiple linear regression analysis was used to determine the effects of sex, eye laterality, age, and refractive error on RNFL measurements. P values <0.05 were considered statistically significant. 
Results
There were 2469 participants enrolled at baseline, and 2421 children who met the inclusion criteria were examined by OCT. Data for only one eye were obtained for 97 of the 2421 healthy participants, because they could not cooperate fully with the OCT examination. To minimize possible bias from poor cooperation, the data on 4648 eyes of 2324 participants who underwent examination in both eyes were used for RNFL thickness distribution analysis in different sex, eye side, or age. Participants under 12 years of age were not given cycloplegia. Therefore, the group comparisons and regression analysis between RNFL thickness and sex, eye laterality, age, and refractive error were conducted using only the data from the 1529 participants aged 12 to 17, because their refractive error data could be included in the analysis. Of the 1529 participants in this age group, IOL-Master examinations were well-conducted in 549 subjects, and the data obtained from these 549 subjects were used to evaluate the relationship statistically between RNFL thickness and AL. The participation flowchart for assessment used in the study is shown in the Figure
Figure
 
Participation flowchart for assessing RNFL thickness distribution and related factors in our study.
Figure
 
Participation flowchart for assessing RNFL thickness distribution and related factors in our study.
The demographic characteristics of the 2324 participants are shown in Table 2. The mean (SD) age of the participants was 12.82 (3.11) years. A significant correlation was found between spherical equivalent and age, regardless of eye laterality (2-tailed Pearson bivariate correlation coefficients of 0.35 and 0.34, both P < 0.01). 
Table 2
 
Demographic Characteristics of 2324 Normal Chinese Students Aged 6 to 17 Years
Table 2
 
Demographic Characteristics of 2324 Normal Chinese Students Aged 6 to 17 Years
Age, y Total N Male N Female N Spherical Equivalent Mean (SD)
Right Eye Left Eye
6 92 55 37 NA NA
7 89 41 48 NA NA
8 86 43 43 NA NA
9 94 59 35 NA NA
10 118 61 57 NA NA
11 316 148 168 NA NA
12 242 135 107 −1.61 (2.88) −1.66 (2.63)
13 218 120 98 −2.11 (2.81) −2.13 (2.75)
14 232 125 107 −2.52 (4.09) −2.59 (2.52)
15 258 137 121 −2.74 (3.86) −2.84 (3.55)
16 275 129 146 −3.44 (4.76) −3.37 (4.55)
17 304 144 160 −3.67 (5.19) −3.61 (5.10)
Total 2324 1197 1127 NA NA
The 13 RNFL thickness parameter values of the participants' right and left eyes are shown in Table 3. Considering the correlation between the two eyes, we used data of the 2324 right eyes to evaluate RNFL thickness distribution in different age and sex groups. For these eyes, the mean (SD) RNFL thickness of the superior, inferior, temporal, nasal, and total quadrants was 133.22 (19.48), 129.23 (20.30), 93.58 (29.15), 77.10 (14.89), and 106.89 (12.84) μm, respectively. The detailed distributions of the 13 RNFL thickness parameter values in different age groups are shown in Tables 4 and 5. In almost all age groups, the thickest RNFL was located in the superior quadrant, with the inferior quadrant following. The temporal quadrant was thinner, and the nasal quadrant was thinnest. The distributions of the 13 RNFL thickness parameter values in the two sex groups are shown in Table 6
Table 3
 
RNFL Thickness Measurement Results in Different Eye Side Groups of Normal Chinese Students
Table 3
 
RNFL Thickness Measurement Results in Different Eye Side Groups of Normal Chinese Students
Total 2324 Participants Aged 6–17 1529 Participants Aged 12–17
Right Eye Left Eye Right Eye Left Eye Z* P
SN
 Range 65–241 43–276 74–209 57–208 1.95 0.05
 Mean ± SD 122.85 ± 25.23 121.66 ± 22.94 122.72 ± 26.84 117.58 ± 21.24
NU
 Range 33–243 33–248 33–168 33–248 3.80 <0.01
 Mean ± SD 83.63 ± 16.64 87.16 ± 32.37 80.94 ± 14.58 90.57 ± 37.28
NL
 Range 23–251 21–246 23–146 21–246 1.10 0.27
 Mean ± SD 70.55 ± 14.83 72.60 ± 24.49 68.00 ± 11.93 73.28 ± 27.45
IN
 Range 53–231 57–267 58–224 57–220 1.63 0.10
 Mean ± SD 108.95 ± 25.47 110.20 ± 27.96 105.45 ± 24.46 108.95 ± 29.72
IT
 Range 57–248 73–260 57–226 73–246 1.56 0.19
 Mean ± SD 149.48 ± 23.73 147.93 ± 25.88 148.45 ± 24.46 144.37 ± 26.25
TL
 Range 42–254 45–210 54–254 45–159 1.62 0.11
 Mean ± SD 92.12 ± 33.58 83.97 ± 15.80 97.65 ± 39.28 96.93 ± 16.53
TU
 Range 35–204 37–185 46–203 37–166 1.77 0.08
 Mean ± SD 95.03 ± 28.57 89.53 ± 17.39 99.35 ± 32.62 99.05 ± 17.96
ST
 Range 73–260 72–249 78–220 72–239 1.12 0.26
 Mean ± SD 143.56 ± 19.99 143.01 ± 21.38 142.04 ± 19.84 141.20 ± 21.41
S
 Range 72–251 69–257 79–205 69–216 1.09 0.28
 Mean ± SD 133.22 ± 19.48 132.31 ± 19.12 132.38 ± 19.97 129.39 ± 18.58
N
 Range 28–247 31–203 28–151 33–203 3.38 <0.01
 Mean ± SD 77.10 ± 14.89 79.89 ± 24.43 74.47 ± 12.37 81.92 ± 30.13
I
 Range 67–234 71–249 67–189 71–210 0.03 0.90
 Mean ± SD 129.23 ± 20.30 129.10 ± 20.07 127.03 ± 20.47 126.66 ± 19.69
T
 Range 45–220 48–197 56–220 48–163 0.77 0.40
 Mean ± SD 93.58 ± 29.15 86.76 ± 14.63 98.50 ± 33.87 97.99 ± 15.36
Avg
 Range 70–167 67–222 72–151 72–153 1.96 0.05
 Mean ± SD 108.28 ± 13.97 107.01 ± 11.41 108.09 ± 15.13 108.99 ± 11.17
Table 4
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 6 to 11 Years
Table 4
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 6 to 11 Years
Age 6 Age 7 Age 8 Age 9 Age 10 Age 11
SN
 Range 80–171 80–229 84–188 65–191 75–239 71–241
 Mean ± SD 123.00 ± 20.88 121.34 ± 25.02 120.86 ± 18.18 121.83 ± 20.86 124.09 ± 23.36 124.22 ± 22.58
NU
 Range 46–122 36–230 66–234 43–222 38–243 42–223
 Mean ± SD 87.17 ± 14.70 87.90 ± 19.76 91.02 ± 21.90 86.99 ± 22.68 90.64 ± 26.17 88.80 ± 17.33
NL
 Range 44–111 44–177 50–210 39–205 46–251 40–238
 Mean ± SD 74.45 ± 12.44 74.27 ± 15.35 77.78 ± 21.48 72.26 ± 20.90 76.54 ± 24.98 76.00 ± 18.18
IN
 Range 53–174 73–164 78–224 74–231 75–190 66–225
 Mean ± SD 116.42 ± 22.70 114.30 ± 22.10 121.26 ± 27.66 115.76 ± 26.17 113.81 ± 23.47 114.28 ± 24.59
IT
 Range 79–225 77–204 110–205 92–198 97–239 71–248
 Mean ± SD 152.33 ± 23.46 152.80 ± 21.90 153.21 ± 19.47 149.63 ± 20.93 153.16 ± 22.64 150.26 ± 22.71
TL
 Range 56–116 60–140 56–109 54–116 42–146 54–135
 Mean ± SD 81.15 ± 11.18 84.17 ± 14.70 79.27 ± 10.96 80.17 ± 11.30 84.00 ± 13.62 80.91 ± 12.53
TU
 Range 54–146 59–182 58–116 35–123 59–146 56–204
 Mean ± SD 85.27 ± 15.05 89.00 ± 16.90 85.29 ± 12.45 84.09 ± 15.13 87.05 ± 14.34 87.57 ± 16.04
ST
 Range 86–207 84–184 105–217 73–184 83–194 97–260
 Mean ± SD 144.14 ± 19.32 147.03 ± 19.22 147.30 ± 20.40 145.05 ± 20.00 147.13 ± 19.95 146.98 ± 20.33
S
 Range 85–188 93–203 104–189 72–185 92–216 93–251
 Mean ± SD 133.61 ± 18.18 134.19 ± 19.07 134.14 ± 16.11 133.49 ± 17.89 135.64 ± 18.61 135.66 ± 18.99
N
 Range 53–108 51–204 58–222 45–117 47–247 46–212
 Mean ± SD 80.82 ± 12.05 81.06 ± 16.78 84.47 ± 21.19 79.70 ± 10.99 85.58 ± 24.69 82.46 ± 16.94
I
 Range 81–185 82–175 97–184 83–207 93–213 83–234
 Mean ± SD 134.42 ± 18.96 133.54 ± 18.07 137.23 ± 18.89 132.70 ± 20.28 133.49 ± 18.75 132.29 ± 19.69
T
 Range 60–131 62–151 66–111 45–113 53–127 64–169
 Mean ± SD 83.24 ± 10.84 86.54 ± 13.99 82.30 ± 9.73 82.20 ± 11.05 85.50 ± 12.07 84.26 ± 12.34
Avg
 Range 79–131 84–150 87–154 70–149 81–159 82–167
 Mean ± SD 108.02 ± 10.35 108.83 ± 10.65 109.53 ± 11.06 107.02 ± 11.20 109.55 ± 12.15 108.69 ± 11.84
Table 5
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 12 to 17 Years
Table 5
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 12 to 17 Years
Age 12 Age 13 Age 14 Age 15 Age 16 Age 17 CC P
SN
 Range 78–188 80–187 85–187 78–209 74–205 74–191 −0.25 <0.01
 Mean ± SD 125.11 ± 23.88 127.33 ± 28.06 123.88 ± 30.20 121.49 ± 26.50 111.99 ± 20.18 112.11 ± 19.35
NU
 Range 43–130 42–142 52–120 42–155 34–168 33–159 −0.12 <0.01
 Mean ± SD 85.29 ± 13.68 83.21 ± 14.13 78.01 ± 13.28 80.49 ± 14.17 79.95 ± 15.60 79.37 ± 15.07
NL
 Range 46–218 28–208 42–206 33–246 35–227 23–241 −0.17 <0.01
 Mean ± SD 72.15 ± 20.90 69.59 ± 20.30 67.74 ± 20.25 67.19 ± 22.23 66.08 ± 22.11 66.16 ± 23.60
IN
 Range 68–224 62–197 62–176 59–183 62–168 58–210 −0.19 <0.01
 Mean ± SD 112.12 ± 24.02 108.94 ± 26.86 110.06 ± 28.89 106.05 ± 23.33 99.66 ± 20.93 99.63 ± 25.13
IT
 Range 57–225 60–215 67–221 68–218 77–214 62–226 −0.13 <0.01
 Mean ± SD 152.52 ± 23.79 149.10 ± 23.35 153.50 ± 28.72 149.50 ± 21.89 144.80 ± 22.46 143.28 ± 24.73
TL
 Range 56–230 55–254 56–245 54–194 55–193 56–192 −0.18 <0.01
 Mean ± SD 92.44 ± 34.98 100.97 ± 34.25 97.05 ± 24.67 95.76 ± 34.47 82.49 ± 15.94 84.65 ± 16.83
TU
 Range 60–187 54–197 56–203 57–198 46–187 47–175 −0.12 <0.01
 Mean ± SD 95.06 ± 28.65 98.68 ± 34.52 105.21 ± 47.90 101.03 ± 31.72 90.62 ± 17.75 89.96 ± 16.91
ST
 Range 86–217 78–208 94–213 92–217 88–206 84–220 −0.12 <0.01
 Mean ± SD 145.78 ± 19.31 144.11 ± 18.86 143.33 ± 19.03 142.08 ± 20.59 138.49 ± 19.05 139.78 ± 20.93
S
 Range 85–191 79–188 92–195 87–197 85–187 84–205 −0.23 <0.01
 Mean ± SD 135.44 ± 17.84 135.72 ± 19.76 133.61 ± 19.79 131.78 ± 20.38 125.24 ± 17.91 125.95 ± 18.36
N
 Range 45–124 37–125 47–101 38–151 36–148 28–138 −0.15 <0.01
 Mean ± SD 78.72 ± 11.35 76.40 ± 11.30 72.88 ± 10.67 73.84 ± 12.37 73.01 ± 13.12 72.77 ± 13.45
I
 Range 77–185 76–184 71–183 74–175 72–176 67–189 −0.19 <0.01
 Mean ± SD 132.32 ± 18.68 129.02 ± 20.40 131.78 ± 21.45 127.77 ± 19.26 122.23 ± 18.91 121.45 ± 21.29
T
 Range 66–208 63–220 66–212 62–193 65–190 56–183 −0.17 <0.01
 Mean ± SD 93.75 ± 29.83 99.82 ± 37.11 101.13 ± 48.35 98.39 ± 31.07 86.56 ± 14.56 87.31 ± 14.39
Avg
 Range 79–149 77–150 82–151 79–145 72–142 74–144 −0.18 <0.01
 Mean ± SD 110.06 ± 13.14 110.24 ± 14.99 109.85 ± 18.04 107.95 ± 14.37 101.76 ± 11.10 101.87 ± 11.56
Table 6
 
RNFL Thickness Measurement Results for the Right Eye in Different Sex Groups of Normal Chinese Students
Table 6
 
RNFL Thickness Measurement Results for the Right Eye in Different Sex Groups of Normal Chinese Students
Total 2324 Participants Aged 6–17 1529 Participants Aged 12–17
Male Female Male Female Z* P
SN
 Range 65–241 74–239 74–205 74–209 −0.80 0.43
 Mean ± SD 122.74 ± 24.90 122.96 ± 25.78 121.99 ± 26.29 123.49 ± 27.40
NU
 Range 34–243 33–223 34–159 33–168 −1.74 0.08
 Mean ± SD 84.25 ± 17.33 82.98 ± 15.85 81.49 ± 13.95 80.36 ± 15.20
NL
 Range 28–251 23–200 28–116 23–146 −1.05 0.29
 Mean ± SD 70.83 ± 15.50 70.24 ± 14.08 68.20 ± 11.39 67.78 ± 12.48
IN
 Range 58–224 53–231 58–183 59–224 −1.12 0.26
 Mean ± SD 107.96 ± 24.73 110.00 ± 26.20 104.71 ± 24.61 106.54 ± 26.00
IT
 Range 60–248 57–242 60–225 57–226 −7.09 <0.01
 Mean ± SD 146.55 ± 22.81 152.59 ± 24.30 144.31 ± 23.08 152.77 ± 25.12
TL
 Range 42–254 54–233 54–254 56–233 −3.87 <0.01
 Mean ± SD 90.46 ± 32.84 93.89 ± 34.27 94.98 ± 38.17 100.43 ± 40.24
TU
 Range 35–204 56–198 46–203 56–198 −6.19 <0.01
 Mean ± SD 92.91 ± 28.50 97.28 ± 28.49 96.04 ± 32.08 102.79 ± 32.85
ST
 Range 73–260 84–222 78–220 84–217 −0.59 0.56
 Mean ± SD 143.22 ± 19.58 143.93 ± 20.43 141.63 ± 19.43 142.27 ± 20.27
S
 Range 72–251 84–216 79–205 84–197 −1.05 0.29
 Mean ± SD 132.98 ± 18.95 133.47 ± 20.03 131.81 ± 19.60 132.98 ± 20.35
N
 Range 36–247 28–212 36–138 28–151 −1.59 0.11
 Mean ± SD 77.55 ± 15.67 76.63 ± 14.01 74.85 ± 11.83 74.07 ± 12.90
I
 Range 68–213 67–234 68–185 67–189 −4.90 <0.01
 Mean ± SD 127.30 ± 19.89 131.28 ± 20.54 123.51 ± 20.09 129.66 ± 20.55
T
 Range 45–220 58–210 56–220 58–210 −5.72 <0.01
 Mean ± SD 91.69 ± 28.78 95.59 ± 29.42 95.51 ± 33.15 101.61 ± 34.35
Avg
 Range 70–163 75–167 72–151 75–151 −4.52 <0.01
 Mean ± SD 104.67 ± 11.04 109.24 ± 14.13 106.67 ± 14.86 109.58 ± 15.28
Among the 1529 participants who were at least 12 years of age, none of the 13 RNFL thickness parameter values, and neither the right nor the left eye spherical equivalent followed a Gaussian distribution (1-sample Kolmogorov Smirnov Z ranged from 1.347–9.177, all P < 0.05). The mean spherical equivalent of the 1529 right eyes was −2.74 (SD 2.07), a value that was not statistically significantly different from that of the 1529 left eyes (mean −2.76, SD 2.02, Wilcoxon signed rank test Z = 1.91, P = 0.06). The Wilcoxon signed rank test was used to compare RFNL thickness in the right and left eyes of the 1529 subjects. Significant differences were found in only 2 of the 13 parameters, the nasal upper quadrant and the nasal part (Table 3). Therefore, we considered that there were no significant differences in RNFL thickness parameter values between the right and left eyes. Between male and female sex groups, no statistically significant difference was found in spherical equivalent, regardless of eye laterality (Wilcoxon signed rank test Z = 1.00 or 1.44, P = 0.32 or 0.15), while significant differences in RNFL thickness were found in the inferior and temporal parts in the two sex groups (Table 6). 
Of the 1529 subjects older than 11 years, almost all of the 13 parameters decreased significantly with age (Table 5). Significant correlation was found between spherical equivalent and all of the 13 parameters, regardless of eye laterality (2-tailed Pearson bivariate correlation coefficient between 0.10 and 0.44, all P < 0.05). Linear regression analyses were performed in the 1529 subjects, keeping the RNFL thickness parameters as the dependent variables, and designating age, sex, and spherical equivalent as the independent variables. For 5 of the 13 RNFL thickness parameters, spherical equivalent was found to be the only independent relative factor in linear regression analysis. For the remaining eight parameters, which included temporal, inferior, and nasal parts, spherical equivalent and age were the independent relative factors, as shown in Table 7
Table 7
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 1529 Chinese Students Aged 12 to 17
Table 7
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 1529 Chinese Students Aged 12 to 17
Dependent Variable Independent Variables Included in Equation Accumulative Adjusted R 2 Standardized β Coefficients P
SN Spherical equivalent 0.10 0.25 <0.01
Age 0.12 0.17 <0.01
NU Spherical equivalent 0.11 0.33 <0.01
NL Spherical equivalent 0.18 0.42 <0.01
IN Spherical equivalent 0.20 0.44 <0.01
IT Spherical equivalent 0.06 0.25 <0.01
Age 0.09 0.18 <0.01
TL Spherical equivalent 0.03 0.19 <0.01
Age 0.04 0.08 <0.01
TU Spherical equivalent 0.02 0.13 <0.01
Age 0.03 0.11 <0.01
ST Spherical equivalent 0.06 0.24 <0.01
S Spherical equivalent 0.11 0.28 <0.01
Age 0.12 0.13 <0.01
N Spherical equivalent 0.16 0.39 <0.01
I Spherical equivalent 0.18 0.42 <0.01
Age 0.19 0.13 <0.01
T Spherical equivalent 0.03 0.17 <0.01
Age 0.04 0.10 <0.01
Avg Spherical equivalent 0.15 0.34 <0.01
Age 0.17 0.15 <0.01
Using IOL-Master, AL measurement results were acquired in 267 boys and 282 girls, including 138 subjects aged 12, 113 subjects aged 13, 170 subjects aged 14, 51 subjects aged 15, 36 subjects aged 16, and 41 subjects aged 17 years. Significant correlation was found between AL and all of the 13 parameters, regardless of eye laterality (2-tailed Pearson bivariate correlation coefficient between 0.09 and 0.49, all P < 0.05). Linear regression analyses then were performed in the 549 subjects, keeping the RNFL thickness parameters as the dependent variables, and designating age, sex, spherical equivalent, and AL as the independent variables. The AL and spherical equivalent were found as the independent relative factors of almost all of the 13 RNFL thickness parameters in linear regression analysis, as shown in Table 8
Table 8
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 549 Chinese Students Aged 12 to 17
Table 8
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 549 Chinese Students Aged 12 to 17
Dependent Variable Independent Variables Included in Equation Accumulative Adjusted R 2 Standardized
β Coefficients
P
SN Spherical equivalent 0.02 0.30 <0.01
Axial length 0.06 0.28 <0.01
Age 0.07 0.09 <0.01
NU Axial length 0.22 0.47 <0.01
NL Spherical equivalent 0.20 0.30 <0.01
Axial length 0.25 0.26 <0.01
IN Axial length 0.18 0.34 <0.01
Spherical equivalent 0.20 0.16 <0.01
IT Axial length 0.03 0.18 <0.01
Spherical equivalent 0.04 0.09 <0.01
TL Axial length 0.08 0.42 <0.01
Spherical equivalent 0.12 0.24 <0.01
TU Axial length 0.04 0.30 <0.01
Spherical equivalent 0.06 0.16 <0.01
ST Spherical equivalent 0.02 0.14 <0.01
Axial length 0.03 0.09 <0.01
S Spherical equivalent 0.03 0.28 <0.01
Axial length 0.05 0.18 <0.01
N Axial length 0.24 0.39 <0.01
Spherical equivalent 0.27 0.19 <0.01
I Axial length 0.12 0.25 <0.01
Spherical equivalent 0.13 0.16 <0.01
T Axial length 0.07 0.39 <0.01
Spherical equivalent 0.10 0.22 <0.01
Avg Spherical equivalent 0.04 0.30 <0.01
Axial length 0.06 0.18 <0.01
Discussion
Reliable visual field results are difficult to obtain in children, making the use of conventional methods for diagnosis and management of childhood glaucoma difficult. 8 In contrast, OCT is suitable for children due to its quick and easy methodology. In this study of RNFL thickness in Shanghai children and teenagers, we found that RNFL thickness showed a “double hump” curve, as was reported in some previous studies 9,10 : the RNFL is thickest in its superior and inferior parts, followed by the temporal part, and it is thinnest in the nasal part. The average RNFL thickness measured in 2324 subjects in our study was similar to the measurements obtained in two small-sample Asian studies: 107.3 ± 10.2 μm in 18 nonglaucomatous individuals aged <18 years 5 and 112.36 ± 9.21 μm in 199 healthy individuals aged 5 to 18 years. 4  
The average measured RNFL thickness in the right and left eyes of children differed in previous studies. Qian et al. 4 found that the RNFL was thicker in the left eye. However, Mwanza et al. 11 considered that the superior quadrant RNFL was thicker in the left eye, while the RNFL in the other three quadrants was thicker in the right eye. Data from Huynh et al. 12 showed no statistically significant differences between right and left eyes. We considered that differences in refractive error may bias comparison of RNFL thickness. In the 1529 participants aged over 11 in our study, we found no significant differences in RNFL thickness in the symmetric parts between the two eyes, which were almost equal to each other in refractive error. 
Several previous reports suggest that sex is not a relevant factor affecting RNFL thickness. 5,6,13 In our study, most of the RNFL thickness parameter values did not differ between the two sex groups; however, the RNFL thickness in the inferior and temporal quadrants was greater in girls than in boys, in agreement with results reported in two previous studies. 4,13 However, Huynh et al. 14 found the opposite result in a population of 6-year-old children in which the inferior quadrant RNFL was thicker in the eyes of boys than girls. We considered that differences in study design may have led to these different conclusions. 
Bivariate tests revealed a negative correlation between all RNFL thickness parameter values and age, and further regression analysis indicated that age was an independent variable associated with several parameter values. Nevertheless, we considered age to have less influence on RNFL than refractive error or AL, as shown in Tables 7 and 8. A strong influence of refractive error and AL on RNFL thickness also has been found in other studies, 1416 and is plausible based on the viewpoint expressed by Lam et al. 17 : in Asian children, refractive status always changes from hypermetropia to myopia and AL gradually increases with age, 18,19 resulting in expansion of the ocular wall and the creation of more space in the retina. 
Some inherent weaknesses of our study should not be neglected. First, the applicability of our results to non-Chinese racial groups or to adults is not known. Second, because the Institutional Review Board did not approve the use of cycloplegia in this large-scale population-based study, the refractive error data of participants under 12 years of age was not taken into consideration. Future studies may shed further light on the relationship of refractive error status and RNFL thickness in young children. 
Acknowledgments
Supported by Three-Year Action Program of Shanghai Municipality for Strengthening the Construction of the Public Health System (2011–2013, Grant 2011-15), Key Scientific Research Project of Shanghai Municipal Health Bureau (Grant 20114007), Research Funding for Young Medical Staff from Shanghai Municipal Health Bureau (Grant 2010Y113), and Shanghai Public Health Excellent Youth Training Program (Grant 08GWQ036). The authors alone are responsible for the content and writing of the paper. 
Disclosure: L. Chen, None; J. Huang, None; H. Zou, None; W. Xue, None; Y. Ma, None; X. He, None; L. Lu, None; J. Zhu, None 
References
Yang Z Du S. Measurement of human retinal thickness at posterior pole with retinal thickness analyzer in normal and glaucomatous eyes. Zhonghua Yan Ke Za Zhi . 2000; 36: 124–128. [PubMed]
Li M. Glaucoma. 1st ed. Beijing, China: People's Medical Publishing House; 2004: 166–181.
Quigley HA Addicks EM Green WR. Optic nerve damage in human glaucomas. Arch Ophthalmol . 1982; 100: 135–146. [CrossRef] [PubMed]
Qian J Wang W Zhang X Optical coherence tomography measurements of retinal nerve fiber layer thickness in Chinese children and teenagers. J Glaucoma . 2011; 20: 509–513. [PubMed]
Peng P Lin H. Retinal nerve fiber layer thickness measured by optical coherence tomography in nonglaucomatous Taiwanese. J Formos Med Assoc . 2008; 107: 627–634. [CrossRef] [PubMed]
Chen W Fu P Yang Q Evaluation of factors associated with variability in retinal nerve fiber layer thickness in myopic juveniles aged 7–18 years. Zhonghua Yan Ke Za Zhi . 2010; 46: 1011–1015. [PubMed]
Mabel MPL Ronnie YCH Andrew KCL. Retinal nerve fiber layer thickness in normal Hong Kong Chinese children measured with optical coherence tomography. J Glaucoma . 2010; 19: 95–99. [PubMed]
Hess DB Asrani SG Bhide MG Macular and retinal nerve fiber layer analysis of normal and glaucomatous eyes in children using optical coherence tomography. Am J Ophthalmol . 2005; 139: 509–517. [CrossRef] [PubMed]
Dichtl A Jonas JB Naumann GO. Retinal nerve fiber layer thickness in human eyes. Graefes Arch Clin Exp Ophthalmol . 1999; 237: 474–479. [CrossRef] [PubMed]
Varma R Skaf M Barron E. Retinal nerve fiber layer thickness in normal human eyes. Ophthalmology . 1996; 103: 2114–2119. [CrossRef] [PubMed]
Mwanza JC Durbin MK Budenz DL Interocular symmetry in peripapillary retinal nerve fiber layer thickness measured with the Cirrus HD-OCT in healthy eyes. Am J Ophthalmol . 2011; 151: 514–521. [CrossRef] [PubMed]
Huynh SC Wang XY Burlutsky G Mitchell P. Symmetry of optical coherence tomography retinal measurements in young children. Am J Ophthalmol . 2007; 143: 518–520. [CrossRef] [PubMed]
Varma R Bazzaz S Lai M. Optical tomography-measured retinal nerve fiber layer thickness in normal Latinos. Invest Ophthalmol Vis Sci . 2003; 44: 3369–3373. [CrossRef] [PubMed]
Huynh SC Wang XY Rochtchina E Peripapillary retinal nerve fiber layer thickness in a population of 6-year-old children: findings by optical coherence tomography. Ophthalmology . 2006; 113: 1583–1592. [CrossRef] [PubMed]
Jun JH Lee SY. The effects of optic disc factors on retinal nerve fiber layer thickness measurement in children. Korean J Ophthalmol . 2008; 22: 115–122. [CrossRef] [PubMed]
Mays AE Sanjay GA Laura BE Optical coherence tomograph in the eyes of normal children. Arch Ophthalmol . 2009; 127: 50–58. [CrossRef] [PubMed]
Lam DS Leung KS Mohamed S et a1. Regional variations in the relationship between macular thickness measurements and myopia. Invest Ophthalmol Vis Sci . 2007; 48: 376–382. [CrossRef] [PubMed]
Zhao J Pan X Sui R Sergio RM Robert DS Leon BE. Refractive error study in children results from Shunyi District, China. Am J Ophthalmol . 2000; 129: 427–435. [CrossRef] [PubMed]
Dandona R Dandona L Srinivas M Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci . 2002; 43: 615–622. [PubMed]
Footnotes
 LC and JH contributed equally to the work presented here and should therefore be regarded as equivalent authors.
Figure
 
Participation flowchart for assessing RNFL thickness distribution and related factors in our study.
Figure
 
Participation flowchart for assessing RNFL thickness distribution and related factors in our study.
Table 1
 
Parameter Locations and Abbreviations Used in the Analysis
Table 1
 
Parameter Locations and Abbreviations Used in the Analysis
Location Abbreviation Term Used in Analysis Right Eye Left Eye
Superior nasal SN 00:00–01:30 10:30–00:00
Nasal upper NU 01:30–03:00 09:00–10:30
Nasal lower NL 03:00–04:30 07:30–09:00
Inferior nasal IN 04:30–06:00 06:00–07:30
Inferior temporal IT 06:00–07:30 04:30–06:00
Temporal lower TL 07:30–09:00 03:00–04:30
Temporal upper TU 09:00–10:30 01:30–03:00
Superior temporal ST 10:30–00:00 00:00–01:30
Superior S 10:30–12:00–01:30 10:30–12:00–01:30
Nasal N 01:30–03:00–04:30 07:30–09:00–10:30
Inferior I 04:30–06:00–07:30 04:30–06:00–07:30
Temporal T 07:30–09:00–10:30 01:30–03:00–04:30
Total quadrants Avg 00:00–06:00–12:00 00:00–06:00–12:00
Table 2
 
Demographic Characteristics of 2324 Normal Chinese Students Aged 6 to 17 Years
Table 2
 
Demographic Characteristics of 2324 Normal Chinese Students Aged 6 to 17 Years
Age, y Total N Male N Female N Spherical Equivalent Mean (SD)
Right Eye Left Eye
6 92 55 37 NA NA
7 89 41 48 NA NA
8 86 43 43 NA NA
9 94 59 35 NA NA
10 118 61 57 NA NA
11 316 148 168 NA NA
12 242 135 107 −1.61 (2.88) −1.66 (2.63)
13 218 120 98 −2.11 (2.81) −2.13 (2.75)
14 232 125 107 −2.52 (4.09) −2.59 (2.52)
15 258 137 121 −2.74 (3.86) −2.84 (3.55)
16 275 129 146 −3.44 (4.76) −3.37 (4.55)
17 304 144 160 −3.67 (5.19) −3.61 (5.10)
Total 2324 1197 1127 NA NA
Table 3
 
RNFL Thickness Measurement Results in Different Eye Side Groups of Normal Chinese Students
Table 3
 
RNFL Thickness Measurement Results in Different Eye Side Groups of Normal Chinese Students
Total 2324 Participants Aged 6–17 1529 Participants Aged 12–17
Right Eye Left Eye Right Eye Left Eye Z* P
SN
 Range 65–241 43–276 74–209 57–208 1.95 0.05
 Mean ± SD 122.85 ± 25.23 121.66 ± 22.94 122.72 ± 26.84 117.58 ± 21.24
NU
 Range 33–243 33–248 33–168 33–248 3.80 <0.01
 Mean ± SD 83.63 ± 16.64 87.16 ± 32.37 80.94 ± 14.58 90.57 ± 37.28
NL
 Range 23–251 21–246 23–146 21–246 1.10 0.27
 Mean ± SD 70.55 ± 14.83 72.60 ± 24.49 68.00 ± 11.93 73.28 ± 27.45
IN
 Range 53–231 57–267 58–224 57–220 1.63 0.10
 Mean ± SD 108.95 ± 25.47 110.20 ± 27.96 105.45 ± 24.46 108.95 ± 29.72
IT
 Range 57–248 73–260 57–226 73–246 1.56 0.19
 Mean ± SD 149.48 ± 23.73 147.93 ± 25.88 148.45 ± 24.46 144.37 ± 26.25
TL
 Range 42–254 45–210 54–254 45–159 1.62 0.11
 Mean ± SD 92.12 ± 33.58 83.97 ± 15.80 97.65 ± 39.28 96.93 ± 16.53
TU
 Range 35–204 37–185 46–203 37–166 1.77 0.08
 Mean ± SD 95.03 ± 28.57 89.53 ± 17.39 99.35 ± 32.62 99.05 ± 17.96
ST
 Range 73–260 72–249 78–220 72–239 1.12 0.26
 Mean ± SD 143.56 ± 19.99 143.01 ± 21.38 142.04 ± 19.84 141.20 ± 21.41
S
 Range 72–251 69–257 79–205 69–216 1.09 0.28
 Mean ± SD 133.22 ± 19.48 132.31 ± 19.12 132.38 ± 19.97 129.39 ± 18.58
N
 Range 28–247 31–203 28–151 33–203 3.38 <0.01
 Mean ± SD 77.10 ± 14.89 79.89 ± 24.43 74.47 ± 12.37 81.92 ± 30.13
I
 Range 67–234 71–249 67–189 71–210 0.03 0.90
 Mean ± SD 129.23 ± 20.30 129.10 ± 20.07 127.03 ± 20.47 126.66 ± 19.69
T
 Range 45–220 48–197 56–220 48–163 0.77 0.40
 Mean ± SD 93.58 ± 29.15 86.76 ± 14.63 98.50 ± 33.87 97.99 ± 15.36
Avg
 Range 70–167 67–222 72–151 72–153 1.96 0.05
 Mean ± SD 108.28 ± 13.97 107.01 ± 11.41 108.09 ± 15.13 108.99 ± 11.17
Table 4
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 6 to 11 Years
Table 4
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 6 to 11 Years
Age 6 Age 7 Age 8 Age 9 Age 10 Age 11
SN
 Range 80–171 80–229 84–188 65–191 75–239 71–241
 Mean ± SD 123.00 ± 20.88 121.34 ± 25.02 120.86 ± 18.18 121.83 ± 20.86 124.09 ± 23.36 124.22 ± 22.58
NU
 Range 46–122 36–230 66–234 43–222 38–243 42–223
 Mean ± SD 87.17 ± 14.70 87.90 ± 19.76 91.02 ± 21.90 86.99 ± 22.68 90.64 ± 26.17 88.80 ± 17.33
NL
 Range 44–111 44–177 50–210 39–205 46–251 40–238
 Mean ± SD 74.45 ± 12.44 74.27 ± 15.35 77.78 ± 21.48 72.26 ± 20.90 76.54 ± 24.98 76.00 ± 18.18
IN
 Range 53–174 73–164 78–224 74–231 75–190 66–225
 Mean ± SD 116.42 ± 22.70 114.30 ± 22.10 121.26 ± 27.66 115.76 ± 26.17 113.81 ± 23.47 114.28 ± 24.59
IT
 Range 79–225 77–204 110–205 92–198 97–239 71–248
 Mean ± SD 152.33 ± 23.46 152.80 ± 21.90 153.21 ± 19.47 149.63 ± 20.93 153.16 ± 22.64 150.26 ± 22.71
TL
 Range 56–116 60–140 56–109 54–116 42–146 54–135
 Mean ± SD 81.15 ± 11.18 84.17 ± 14.70 79.27 ± 10.96 80.17 ± 11.30 84.00 ± 13.62 80.91 ± 12.53
TU
 Range 54–146 59–182 58–116 35–123 59–146 56–204
 Mean ± SD 85.27 ± 15.05 89.00 ± 16.90 85.29 ± 12.45 84.09 ± 15.13 87.05 ± 14.34 87.57 ± 16.04
ST
 Range 86–207 84–184 105–217 73–184 83–194 97–260
 Mean ± SD 144.14 ± 19.32 147.03 ± 19.22 147.30 ± 20.40 145.05 ± 20.00 147.13 ± 19.95 146.98 ± 20.33
S
 Range 85–188 93–203 104–189 72–185 92–216 93–251
 Mean ± SD 133.61 ± 18.18 134.19 ± 19.07 134.14 ± 16.11 133.49 ± 17.89 135.64 ± 18.61 135.66 ± 18.99
N
 Range 53–108 51–204 58–222 45–117 47–247 46–212
 Mean ± SD 80.82 ± 12.05 81.06 ± 16.78 84.47 ± 21.19 79.70 ± 10.99 85.58 ± 24.69 82.46 ± 16.94
I
 Range 81–185 82–175 97–184 83–207 93–213 83–234
 Mean ± SD 134.42 ± 18.96 133.54 ± 18.07 137.23 ± 18.89 132.70 ± 20.28 133.49 ± 18.75 132.29 ± 19.69
T
 Range 60–131 62–151 66–111 45–113 53–127 64–169
 Mean ± SD 83.24 ± 10.84 86.54 ± 13.99 82.30 ± 9.73 82.20 ± 11.05 85.50 ± 12.07 84.26 ± 12.34
Avg
 Range 79–131 84–150 87–154 70–149 81–159 82–167
 Mean ± SD 108.02 ± 10.35 108.83 ± 10.65 109.53 ± 11.06 107.02 ± 11.20 109.55 ± 12.15 108.69 ± 11.84
Table 5
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 12 to 17 Years
Table 5
 
RNFL Thickness Measurement Results for the Right Eye in Normal Chinese Students Aged 12 to 17 Years
Age 12 Age 13 Age 14 Age 15 Age 16 Age 17 CC P
SN
 Range 78–188 80–187 85–187 78–209 74–205 74–191 −0.25 <0.01
 Mean ± SD 125.11 ± 23.88 127.33 ± 28.06 123.88 ± 30.20 121.49 ± 26.50 111.99 ± 20.18 112.11 ± 19.35
NU
 Range 43–130 42–142 52–120 42–155 34–168 33–159 −0.12 <0.01
 Mean ± SD 85.29 ± 13.68 83.21 ± 14.13 78.01 ± 13.28 80.49 ± 14.17 79.95 ± 15.60 79.37 ± 15.07
NL
 Range 46–218 28–208 42–206 33–246 35–227 23–241 −0.17 <0.01
 Mean ± SD 72.15 ± 20.90 69.59 ± 20.30 67.74 ± 20.25 67.19 ± 22.23 66.08 ± 22.11 66.16 ± 23.60
IN
 Range 68–224 62–197 62–176 59–183 62–168 58–210 −0.19 <0.01
 Mean ± SD 112.12 ± 24.02 108.94 ± 26.86 110.06 ± 28.89 106.05 ± 23.33 99.66 ± 20.93 99.63 ± 25.13
IT
 Range 57–225 60–215 67–221 68–218 77–214 62–226 −0.13 <0.01
 Mean ± SD 152.52 ± 23.79 149.10 ± 23.35 153.50 ± 28.72 149.50 ± 21.89 144.80 ± 22.46 143.28 ± 24.73
TL
 Range 56–230 55–254 56–245 54–194 55–193 56–192 −0.18 <0.01
 Mean ± SD 92.44 ± 34.98 100.97 ± 34.25 97.05 ± 24.67 95.76 ± 34.47 82.49 ± 15.94 84.65 ± 16.83
TU
 Range 60–187 54–197 56–203 57–198 46–187 47–175 −0.12 <0.01
 Mean ± SD 95.06 ± 28.65 98.68 ± 34.52 105.21 ± 47.90 101.03 ± 31.72 90.62 ± 17.75 89.96 ± 16.91
ST
 Range 86–217 78–208 94–213 92–217 88–206 84–220 −0.12 <0.01
 Mean ± SD 145.78 ± 19.31 144.11 ± 18.86 143.33 ± 19.03 142.08 ± 20.59 138.49 ± 19.05 139.78 ± 20.93
S
 Range 85–191 79–188 92–195 87–197 85–187 84–205 −0.23 <0.01
 Mean ± SD 135.44 ± 17.84 135.72 ± 19.76 133.61 ± 19.79 131.78 ± 20.38 125.24 ± 17.91 125.95 ± 18.36
N
 Range 45–124 37–125 47–101 38–151 36–148 28–138 −0.15 <0.01
 Mean ± SD 78.72 ± 11.35 76.40 ± 11.30 72.88 ± 10.67 73.84 ± 12.37 73.01 ± 13.12 72.77 ± 13.45
I
 Range 77–185 76–184 71–183 74–175 72–176 67–189 −0.19 <0.01
 Mean ± SD 132.32 ± 18.68 129.02 ± 20.40 131.78 ± 21.45 127.77 ± 19.26 122.23 ± 18.91 121.45 ± 21.29
T
 Range 66–208 63–220 66–212 62–193 65–190 56–183 −0.17 <0.01
 Mean ± SD 93.75 ± 29.83 99.82 ± 37.11 101.13 ± 48.35 98.39 ± 31.07 86.56 ± 14.56 87.31 ± 14.39
Avg
 Range 79–149 77–150 82–151 79–145 72–142 74–144 −0.18 <0.01
 Mean ± SD 110.06 ± 13.14 110.24 ± 14.99 109.85 ± 18.04 107.95 ± 14.37 101.76 ± 11.10 101.87 ± 11.56
Table 6
 
RNFL Thickness Measurement Results for the Right Eye in Different Sex Groups of Normal Chinese Students
Table 6
 
RNFL Thickness Measurement Results for the Right Eye in Different Sex Groups of Normal Chinese Students
Total 2324 Participants Aged 6–17 1529 Participants Aged 12–17
Male Female Male Female Z* P
SN
 Range 65–241 74–239 74–205 74–209 −0.80 0.43
 Mean ± SD 122.74 ± 24.90 122.96 ± 25.78 121.99 ± 26.29 123.49 ± 27.40
NU
 Range 34–243 33–223 34–159 33–168 −1.74 0.08
 Mean ± SD 84.25 ± 17.33 82.98 ± 15.85 81.49 ± 13.95 80.36 ± 15.20
NL
 Range 28–251 23–200 28–116 23–146 −1.05 0.29
 Mean ± SD 70.83 ± 15.50 70.24 ± 14.08 68.20 ± 11.39 67.78 ± 12.48
IN
 Range 58–224 53–231 58–183 59–224 −1.12 0.26
 Mean ± SD 107.96 ± 24.73 110.00 ± 26.20 104.71 ± 24.61 106.54 ± 26.00
IT
 Range 60–248 57–242 60–225 57–226 −7.09 <0.01
 Mean ± SD 146.55 ± 22.81 152.59 ± 24.30 144.31 ± 23.08 152.77 ± 25.12
TL
 Range 42–254 54–233 54–254 56–233 −3.87 <0.01
 Mean ± SD 90.46 ± 32.84 93.89 ± 34.27 94.98 ± 38.17 100.43 ± 40.24
TU
 Range 35–204 56–198 46–203 56–198 −6.19 <0.01
 Mean ± SD 92.91 ± 28.50 97.28 ± 28.49 96.04 ± 32.08 102.79 ± 32.85
ST
 Range 73–260 84–222 78–220 84–217 −0.59 0.56
 Mean ± SD 143.22 ± 19.58 143.93 ± 20.43 141.63 ± 19.43 142.27 ± 20.27
S
 Range 72–251 84–216 79–205 84–197 −1.05 0.29
 Mean ± SD 132.98 ± 18.95 133.47 ± 20.03 131.81 ± 19.60 132.98 ± 20.35
N
 Range 36–247 28–212 36–138 28–151 −1.59 0.11
 Mean ± SD 77.55 ± 15.67 76.63 ± 14.01 74.85 ± 11.83 74.07 ± 12.90
I
 Range 68–213 67–234 68–185 67–189 −4.90 <0.01
 Mean ± SD 127.30 ± 19.89 131.28 ± 20.54 123.51 ± 20.09 129.66 ± 20.55
T
 Range 45–220 58–210 56–220 58–210 −5.72 <0.01
 Mean ± SD 91.69 ± 28.78 95.59 ± 29.42 95.51 ± 33.15 101.61 ± 34.35
Avg
 Range 70–163 75–167 72–151 75–151 −4.52 <0.01
 Mean ± SD 104.67 ± 11.04 109.24 ± 14.13 106.67 ± 14.86 109.58 ± 15.28
Table 7
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 1529 Chinese Students Aged 12 to 17
Table 7
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 1529 Chinese Students Aged 12 to 17
Dependent Variable Independent Variables Included in Equation Accumulative Adjusted R 2 Standardized β Coefficients P
SN Spherical equivalent 0.10 0.25 <0.01
Age 0.12 0.17 <0.01
NU Spherical equivalent 0.11 0.33 <0.01
NL Spherical equivalent 0.18 0.42 <0.01
IN Spherical equivalent 0.20 0.44 <0.01
IT Spherical equivalent 0.06 0.25 <0.01
Age 0.09 0.18 <0.01
TL Spherical equivalent 0.03 0.19 <0.01
Age 0.04 0.08 <0.01
TU Spherical equivalent 0.02 0.13 <0.01
Age 0.03 0.11 <0.01
ST Spherical equivalent 0.06 0.24 <0.01
S Spherical equivalent 0.11 0.28 <0.01
Age 0.12 0.13 <0.01
N Spherical equivalent 0.16 0.39 <0.01
I Spherical equivalent 0.18 0.42 <0.01
Age 0.19 0.13 <0.01
T Spherical equivalent 0.03 0.17 <0.01
Age 0.04 0.10 <0.01
Avg Spherical equivalent 0.15 0.34 <0.01
Age 0.17 0.15 <0.01
Table 8
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 549 Chinese Students Aged 12 to 17
Table 8
 
Multiple Linear Regression Analysis of the Relationship of RNFL Thickness Parameters to Independent Variables in 549 Chinese Students Aged 12 to 17
Dependent Variable Independent Variables Included in Equation Accumulative Adjusted R 2 Standardized
β Coefficients
P
SN Spherical equivalent 0.02 0.30 <0.01
Axial length 0.06 0.28 <0.01
Age 0.07 0.09 <0.01
NU Axial length 0.22 0.47 <0.01
NL Spherical equivalent 0.20 0.30 <0.01
Axial length 0.25 0.26 <0.01
IN Axial length 0.18 0.34 <0.01
Spherical equivalent 0.20 0.16 <0.01
IT Axial length 0.03 0.18 <0.01
Spherical equivalent 0.04 0.09 <0.01
TL Axial length 0.08 0.42 <0.01
Spherical equivalent 0.12 0.24 <0.01
TU Axial length 0.04 0.30 <0.01
Spherical equivalent 0.06 0.16 <0.01
ST Spherical equivalent 0.02 0.14 <0.01
Axial length 0.03 0.09 <0.01
S Spherical equivalent 0.03 0.28 <0.01
Axial length 0.05 0.18 <0.01
N Axial length 0.24 0.39 <0.01
Spherical equivalent 0.27 0.19 <0.01
I Axial length 0.12 0.25 <0.01
Spherical equivalent 0.13 0.16 <0.01
T Axial length 0.07 0.39 <0.01
Spherical equivalent 0.10 0.22 <0.01
Avg Spherical equivalent 0.04 0.30 <0.01
Axial length 0.06 0.18 <0.01
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×