Retinal nerve fibre layer thickness in a normal black South African population

Ismail, Sarah; Ally, Naseer; Alli, Hassan Dawood

doi:10.1038/s41433-019-0677-7

Cited by 5 publications

(9 citation statements)

References 23 publications

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“…Unlike previous studies, 3 , 6 , 27 we did not find any substantial impacts of ethnicity on RNFL thickness in this study. Compared to those of European ancestry, participants of East and Southeast Asian ancestry had thicker temporal RNFL and thinner nasal RNFL, but this was largely explained by differences in axial length between the groups.…”

Section: Discussioncontrasting

confidence: 99%

“…Published studies have examined predominantly older age groups, and studies in Germany, Singapore, and the United States all identified thinner average RNFL than found in this study, 6 , 17 , 18 in keeping with the known association between older age and thinner RNFL. 6 , 19 However, studies conducted in China, 5 India, 20 and South Africa 3 found slightly thicker mean RNFL (102 µm, 104.8 µm, and 108.7 µm, respectively) compared to this study. The South African study excluded participants with axial length >26 mm, which may partly explain the much thicker RNFL in their study.…”

Section: Discussioncontrasting

confidence: 85%

“…An RNFL thickness that is present in the lowest ≤1% of values in the reference population is categorized as outside normal limits (ONL), an RNFL thickness present in >1% and ≤5% of the lowest RNFL values in the reference population is categorized as borderline (BL), and RNFL thicknesses present in the upper 95% of values in the reference population are classified as within normal limits (WNL). 3 Therefore, an appropriate reference database is imperative to ensure accurate classifications. Normative RNFL data from large studies have been published on Australian adolescents 4 and on older adult populations around the world, such as Beijing, 5 Singapore, 6 and Germany 7 ; however, data on the normal distribution of RNFL thickness in young adults are sparse.…”

Section: Introductionmentioning

confidence: 99%

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Distribution and Classification of Peripapillary Retinal Nerve Fiber Layer Thickness in Healthy Young Adults

Lingham

Lee

Charng

et al. 2021

Trans. Vis. Sci. Tech.

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To report the distribution of peripapillary retinal nerve fiber layer (RNFL) thickness in healthy young adults, investigate factors associated with RNFL thickness, and report the percentage of outside normal limits (ONL) and borderline (BL) RNFL thickness classifications based on the optical coherence tomography (OCT) manufacturer reference database.Methods: Participants of the Raine Study Generation 2 cohort (aged 18-22 years) underwent spectral domain OCT imaging with an RNFL circle scan. Eyes with inadequate scans or optic nerve pathology were excluded. Linear mixed models were used to analyze associations.Results: Data were available for 1288 participants (mean age, 20.0 years). Mean RNFL thicknesses in right and left eyes, respectively, were global = 100.5 μm, 100.3 μm (P = 0.03); temporal = 73.1 μm, 68.9 μm (P < 0.001); superotemporal = 140.6 μm, 136.3 μm (P < 0.001); superonasal = 104.9 μm, 115.1 μm (P < 0.001); nasal = 79.7 μm, 79.1 μm (P = 0.09); inferonasal = 109.8 μm, 111.5 μm (P < 0.001); and inferotemporal = 143.2 μm, 143.6 μm (P = 0.51). Longer axial length was associated with thinner RNFL globally, nasally, inferotemporally, superotemporally, superonasally, and inferonasally, as well as thicker RNFL temporally. The prevalence of ONL and BL classifications was generally higher than the expected rates of 1% and 4%, respectively, in temporal sectors and lower than expected in nasal sectors. The prevalence of global BL classifications was lower than expected (right eye, 2.3%; left eye, 2.6%). Conclusions:Measured RNFL thickness differs with axial length and between right and left eyes. More reference data are needed to better define the normal limits of RNFL variation in different populations.Translational Relevance: This study provides an improved understanding of normal variation in RNFL thickness in young adults.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Distribution and Classification of Peripapillary Retinal Nerve Fiber Layer Thickness in Healthy Young Adults

Lingham

Lee

Charng

et al. 2021

Trans. Vis. Sci. Tech.

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“…Our report showed that the inferior sectors were largely thicker than the superior sectors, in keeping with other reports on the subject from the country [17] and other parts of Africa [13], irrespective of the machine used. All measured values showed a significant reduction in thickness with aging.…”

Section: Discussionsupporting

confidence: 92%

“…These limitations have become a point of discussion as multiple reports have shown that the normative databases used in the OCTs show significant ethnic, age, and sex variability compared to other groups. For example, using the Spectralis SD-OCT, Ismail et al [ 13 ] demonstrated that South African eyes had thicker RNFL than the normative database Spectralis SD-OCT employed [ 13 ]. Other reports using the Spectralis SD-OCT demonstrated this difference among eyes in India, Nepal, and Brazil [ 14 - 16 ].…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Retinal Nerve Fibre Layer and Ganglion Cell Complex Measurements in Normal Southern Nigerian Eyes

Obasuyi¹,

Osuji²,

Ifijen³

et al. 2022

Cureus

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IntroductionGlaucoma is the leading cause of irreversible blindness worldwide. It is more severe in people with African heritage, and intraocular pressure remains the only modifiable risk factor in managing glaucoma. Attempts to improve the diagnosis and monitoring of glaucoma are ongoing. One of those attempts is the development of optical coherence tomography (OCT). However, there is a theoretical possibility of a delayed or wrong diagnosis of glaucoma using the OCT because of racial, age, and sex differences in the RNFL (retina nerve fibre layer), GCL (ganglion cell layer), and GCL+IPL (ganglion cell layer and inner plexiform layer) thickness. ObjectiveThis study aims to provide the measurements of RNFL, GCL, and GCL+IPL in normal eyes of southern Nigerian patients and specifically to evaluate the relationship of these measurements to gender, age, intraeye variability, and the Topcon SD-OCT normative database. MethodThree hundred and four eyes of 152 patients who had normal OCT scans using the 6x6 RNFL (four sectors) and Macula scans of the Topcon OCT-1 3D Maestro OCT machine were included for analysis. Parametric tests were used to interrogate the relationship between normally distributed parameters and gender, age, and the Topcon reference database. Non-parametric tests were used for non-normally distributed data. ResultsThe male-to-female ratio was 1:1, and ages ranged between 18 and 71 for both genders. The average RNFL values were 111.49 ± 10.44 (right eye -RE) and 111.96 ± 9.66 (left eye -LE). For the GCL, average values were 66. 23 ± 4.4 (RE) and 66.34 ± 4.19 (LE). GCL+IPL values were 104.02 ± 6.71 (RE) and 103.89 ± 6.66 (LE). There was no difference between genders (X 2 = 56.467; df = 46; p = 0.160), and RNFL, GCL, and GCL+IPL values showed a significant reduction as the age of the respondents increased. There was a significant difference between RNFL, GCL, and GCL+IPL values and the Topcon reference database, p < 0.001. ConclusionSignificant differences exist between the Southern Nigerian eyes' RNFL, GCL, and GCL+ IPL values and the Topcon OCT-1 3D Maestro reference database. While randomised control trials and extensive multi-centre studies have not been conducted to determine the possible effects of these differences between measured values and reference databases of the OCTs, they need to be considered while diagnosing and managing glaucoma with the OCT.

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Retinal nerve fibre layer thickness measured with SD-OCT in a population-based study: the Handan Eye Study

Chen

et al. 2022

Br J Ophthalmol

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PurposeTo examine the normative profile of retinal nerve fibre layer (RNFL) thickness and ocular parameters based on spectral-domain optical coherence tomography (SD-OCT) and its associations with related parameters among the Chinese population.MethodsThis population-based cohort Handan Eye Study (HES) recruited participants aged≥30 years. All subjects underwent a standardised ophthalmic examination. Peripapillary RNFL thickness was obtained using SD-OCT. Mixed linear models were adopted to evaluate the correlation of RNFL thickness with ocular parameters as well as systemic factors. R V.3.6.1 software was used for statistical analysis.Results3509 subjects (7024 eyes) with the average age of 55.54±10.37 were collected in this analysis. Overall mean RNFL thickness measured was 113.46±10.90 µm, and the thickest quadrant of parapapillary RNFL was the inferior quadrant, followed by the superior quadrant, the nasal quadrant and the temporal quadrant. In the multivariate linear regression model, thinner RNFL thickness was remarkable association with male (p<0.001), older age (p<0.001), increased body mass index (>30, p=0.018), absence of diabetes (p=0.009), history of cataract surgery (p=0.001), higher intraocular pressure (p=0.007), lower spherical equivalent (p<0.001) and increased axial length (p=0.048).ConclusionsIn non-glaucoma individuals, this difference of RNFL thickness in Chinese population should be noted in making disease diagnoses. Meanwhile, multiple ocular and systemic factors are closely related to the thickness of RNFL. Our findings further emphasise the need to demonstrate ethnic differences in RNFL thickness and the specificity of associated ocular and systemic factors, as well as to develop better normative databases worldwide.Trial registration numberHES was registered in Chinese Clinical Trial Registry website, and the registry number was ChiCTR-EOC-17013214.

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Retinal nerve fibre layer thickness in a normal black South African population

Cited by 5 publications

References 23 publications

Distribution and Classification of Peripapillary Retinal Nerve Fiber Layer Thickness in Healthy Young Adults

Distribution and Classification of Peripapillary Retinal Nerve Fiber Layer Thickness in Healthy Young Adults

Optical Coherence Tomography Retinal Nerve Fibre Layer and Ganglion Cell Complex Measurements in Normal Southern Nigerian Eyes

Retinal nerve fibre layer thickness measured with SD-OCT in a population-based study: the Handan Eye Study

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