Elsevier

Ophthalmology

Volume 116, Issue 6, June 2009, Pages 1119-1124
Ophthalmology

Original article
Effects of Age on Optical Coherence Tomography Measurements of Healthy Retinal Nerve Fiber Layer, Macula, and Optic Nerve Head

Partially presented at: the American Glaucoma Society annual meeting, March 2008, Washington, DC.
https://doi.org/10.1016/j.ophtha.2009.01.004Get rights and content

Purpose

To determine the effects of age on global and sectoral peripapillary retinal nerve fiber layer (RNFL), macular thicknesses, and optic nerve head (ONH) parameters in healthy subjects using optical coherence tomography (OCT).

Design

Retrospective, cross-sectional observational study.

Participants

A total of 226 eyes from 124 healthy subjects were included.

Methods

Healthy subjects were scanned using the Fast RNFL, Fast Macula, and Fast ONH scan patterns on a Stratus OCT (Carl Zeiss Meditec, Dublin, CA). All global and sectoral RNFL and macular parameters and global ONH parameters were modeled in terms of age using linear mixed effects models. Normalized slopes were also calculated by dividing the slopes by the mean value of the OCT parameter for interparameter comparison.

Main Outcome Measures

Slope of each OCT parameter across age.

Results

All global and sectoral RNFL thickness parameters statistically significantly decreased with increasing age, except for the temporal quadrant and clock hours 8 to 10, which were not statistically different from a slope of zero. Highest absolute slopes were in the inferior and superior quadrant RNFL and clock hour 1 (superior nasal). Normalized slopes showed a similar rate in all sectors except for the temporal clock hours (8–10). All macular thickness parameters statistically significantly decreased with increasing age, except for the central fovea sector, which had a slight positive slope that was not statistically significant. The nasal outer sector had the greatest absolute slope. Normalized macular slope in the outer ring was similar to the normalized slopes in the RNFL. Normalized inner ring had shallower slope than the outer ring with a similar rate in all quadrants. Disc area remained nearly constant across the ages, but cup area increased and rim area decreased with age, both of which were statistically significant.

Conclusions

Global and regional changes caused by the effects of age on RNFL, macula, and ONH OCT measurements should be considered when assessing eyes over time.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Subjects

Healthy subjects from the University of Pittsburgh Medical Center Eye Center were enrolled in the study. The study was approved by the institutional review board ethics committee of the University of Pittsburgh and adhered to the Declaration of Helsinki and Health Insurance Portability and Accountability Act regulations. Informed consent was obtained from all participants.

Inclusion criteria were best corrected visual acuity of 20/40 or better, refractive error within ±6.0 Diopters, no media

Results

A total of 226 eyes of 124 healthy subjects were enrolled in this study. Of the 124 subjects, 80 were women and 44 were men; 103 were Caucasian, 12 were African American, 8 were Asian, and 1 was Hispanic. The average ± standard deviation age was 47.5±15.9 years, and ranged from 18 to 85 years. The distribution of ages is presented in Figure 1.

The population average ± standard deviation of overall RNFL thickness was 100.8±10.5 μm, overall macular thickness was 249.0±11.3 μm, and rim area was

Discussion

There was statistically significant detectable loss of RNFL associated with age in most of the regional thicknesses of the peripapillary RNFL and macula, except for the temporal quadrant RNFL and corresponding 8, 9, and 10 o'clock sectors. The slopes in the sectoral areas varied around the macula and the ONH, both in terms of absolute and normalized values. As would be expected, the overall mean RNFL and macular thickness slopes fall in the middle of the slopes of the sectoral parameters and

References (28)

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Manuscript no. 2008-1216.

Financial Disclosure(s): The author(s) have made the following disclosure(s):

Dr. Wollstein received research funding from Carl Zeiss Meditec and Optovue. Drs. Wollstein, Ishikawa, and Schuman receive royalties for intellectual property licensed by the University of Pittsburgh to Biopigen. Drs. Schuman and Fujimoto receive royalties for intellectual property licensed by Massachusetts Institute of Technology to Carl Zeiss Meditec. Dr. Fujimoto is a scientific advisor and has stock options with Optovue.

Supported by the National Institutes of Health R01-EY13178-09, R01-EY11289-23, P30-EY008098, The Eye and Ear Foundation (Pittsburgh, PA), and an unrestricted grant from Research to Prevent Blindness.

The first 2 authors (KRS and GW) contributed equally to the preparation of the manuscript.

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