Peripapillary retinal nerve fiber layer profile in relation to refractive error and axial length: results from the Gutenberg Health Study

Abstract

Purpose : To investigate the retinal nerve fiber layer profile measured by optical coherence tomography and its relation to refractive error and axial length.

Methods : The Gutenberg Health Study is a population-based cohort study in Mainz, Germany including. Study participants underwent a comprehensive ophthalmologic examination including refraction, biometry, and optical coherence tomography at the first 5-year follow-up examination (in the year 2012-2017). Automated segmentation of the peripapillary retinal nerve fiber layer (pRNFL) was performed and its thickness measured. pRNFL profiles were compared between different refraction groups and the angle between the maxima of pRNFL thickness in the upper and lower hemisphere (AMR) was computed. Multivariable linear regression analysis was carried out to determine the association of the pRNFL profile (AMR) including age, sex, optic disc size, and axial length and corneal curvature in model 1 and refractive error in model 2.

Results : 6139 participants (age 58.2 ±10.7 years, 48.8% female) were included in this cross-sectional analysis. AMR was 145.3 ± 23.4° in right eyes and 151.8 ± 26.7 ° in left eyes and the pRNFL profile showed significant differences. The AMR decreased with increasing axial length by -5.86°/mm (95%-CI: [-6.44; -5.29], p<0.001), female sex (-7.68°; 95%-CI: [-8.78; -6.58], p<0.001), and increased with higher age (0.08°/year; 95%-CI: [0.03; 0.14], p=0.002) and larger optic disc size (2.35°/mm²; 95%-CI: [1.23; 3.47], p<0,001), but was not associated with corneal curvature (p=0.11). In phakic eyes, AMR increased with hyperopic refractive error by 2.60°/dpt (95%-CI: [2.35; 2.85], p<0,001).

Conclusions : Axial length, refraction and gender have an influence on the profile of peripapillary retinal nerve fiber layer thickness and distribution. This has to be considered when using pRNFL measures in diagnostics, i.e. in glaucoma.

This is a 2020 ARVO Annual Meeting abstract.

 

pRNFL profile and its relation to spherical equivalent. Data from the population-based Gutenberg Health Study (2012-2017) including phakic eyes. left eyes.

 

pRNFL profile and its relation to eye side. Data from the population-based Gutenberg Health Study (2012-2017). The red marked positions indicate statistically significant differences between right and left eyes (p<10^-5).