10-Year Progression of Myelinated Retinal Nerve Fibers. The Beijing Eye Study 2001/2011

Abstract

Purpose : To assess the 10-year changes of myelinated retinal nerve fibers (MRNF) and the related systematic and ocular factors in a population-based cohort study.

Methods : Out of 4439 participants aged 40+ years and who participated in the Beijing Eye Study in 2001, 2695 (66.4% of the surviving) individuals were followed in 2011. All participants underwent a detailed physical and ocular examination. Eyes with detected MRNFs at baseline were included into the present study. Changes in the appearance of the MRNFs were examined using a flicker method of fundus photographs taken at baseline and at follow-up. The area covered by the MRNFs was delineated and measured with the Image J program. The progression rate was defined as the ratio of the MRNF area at study end divided by the MRNF area at baseline.

Results : Out of 35 eyes (29 participants) with detected MRNFs at baseline, 23 eyes from 20 individuals (11 women, 55%) were re-examined in 2011. Out of these 23 persons, 17 participants (85%) had unilateral MRNFs, while three participants had bilateral MRNFs. An increase in the size of MRNF area was detected in all 19 eyes with clear images from both visits, while the quality of the fundus photographs of 4 eyes did not allow a quantitative follow-up examination. The mean MRNF area was 4233±3670 µm² (range: 178-11643 µm²) and 5243±4092 µm² (range: 196-13297µm²), at baseline and at follow-up, respectively (P<0.001). The MRNF area increased by 1010±1026 µm2 (18-3967 µm2) or by 47%±74% (9-315%), . A more pronounced enlargement of MRNF area was associated with a higher serum concentration of low density lipoproteins (P<0.001, B=0.53, 95%CI: 0.30, 0.77), a MRNF location distant from the optic disc as compared to a peripapillary location (P=0.001, B=-0.89, 95%CI: -1.34, -0.44), and a smaller MRNF area at baseline (P=0.02, B=-0.09; 95% CI: -0.16, -0.02).

Conclusions : An enlargement of the MRNF area was commonly found in adults in a population-based 10-year follow-up study. The finding is of importance for the natural history and pathogenesis of myelination within the globe, and may perhaps give some clues for the intracranial myelination.

This is a 2021 ARVO Annual Meeting abstract.

 

The progression of MRNFL in three patients (A, B, C) in 2001 and 2011. Blue area shows the baseline MRNFL in 2001, while pink area shows the enlarged area in 2011.