Refractive status in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1994;35:4344â4347. 2. Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, Ellwein LB.
Spectral domain optical coherence tomography retinal thickness measurements among normal myopic Filipinos Camille Elaine L. Zabala, MD Jubaida Mangondato Aquino MD, John Mark de Leon MD, Jose Ma Martinez MD DOH Eye Center, East Avenue Medical Center Philippines
OBJECTIVES: • •
To provide mean macular and retinal nerve fiber layer (RNFL) thickness measurements of myopic Filipinos using spectral domain optical coherence tomography (SD-OCT) To evaluate the effects of age, gender, and the different degrees of myopia on these measurements
METHODS: •
All consecutive patients seen at the OPD from August 22- September 2, 2016
INCLUSION CRITERIA • age >18 years • Best corrected visual acuity better than/ equal to 20/40 • No history of previous intraocular and refractive surgery • Refraction of -0.50D or worse
à
SCREENING
EXCLUSION CRITERIA • Other ocular diseases • Glaucoma • Chorio retinitis/ retinal abnormalities • Other neurologic diseases
MACULAR AND RETINAL NERVE FIBER LAYER MEASUREMENTS: Spectral Domain OCT AXIAL LENGTH MEASUREMENT: Non-contact optical biometry
High to pathologic
Low to moderate low Spherical Equivalent
RESULTS:
moderate
-0.50 to -3.00D Total: 156
high
-3.25 to -6.00D
eyes
Age (years) Mean ± SD Median (IQR) Age groups (years), n (%) 19 – 40 41 – 60 > 60 Gender, n (%) Male Female Spherical Equivalent (D) Mean ± SD Median (IQR) Axial Length (mm) Mean ± SD Median (IQR)
pathologic
-6.25 to -8.00D
Worse than -8.00D
Low (n = 55)
Moderate (n = 33)
High (n = 27)
Pathologic (n = 41)
36 ± 13 31 (14)
31 ± 10 30 (8)
41 ± 13 37 (23)
43 ± 14 42 (28)
40 (73%) 10 (18%) 5 (42%)
31 (29%) 1 (3%) 1 (8%)
17 (63%) 8 (30%) 2 (17%)
18 (44%) 19 (46%) 4 (33%)
30 (54%) 25 (46%)
10 (30%) 23 (70%)
11 (41%) 16 (59%)
16 (39%) 25 (61%)
0.140
-1.7 ± 0.8 -2.0 (1.0)
-4.1 ± 0.5 -4.0 (0.75)
-6.8 ± 0.6 -6.8 (0.8)
-13.7 ± 4.2 -12.8 (5.9)
0.000*
24.3 ± 0.7 24.4 (0.9)
25.7 ± 0.6 25.8 (0.9)
26.9 ± 0.9 26.7 (0.4)
29.4 ± 2.3 28.4 (3.0)
0.000*
p-value 0.001* 0.001*
Table 1. Demographics of patients.
CENTRAL FOVEAL THICKNESS
RNFL THICKNESS MEASUREMENTS
(IN MICROMETERS)
350 300 250 200 150 100 50 0
(IN MICROMETERS)
120 100 80 60 40 20
Mean: 249 ± 33 um
Low
Moderate
High
Global mean: 92.51 ± 18.60
0
Low
Pathologic
Figure 1. Summary of Central foveal measurements.
Moderate
High
perifoveal
Based on regression analysis, the degree of myopia and age significantly affect retinal nerve fiber thickness measures except for those highlighted in red, namely: central foveal subfield thickness, temporal parafoveal thickness, nasal perifoveal thickness, and inferior and nasal RFNL. In these areas only the degree of myopia was a significant factor.
Pathologic
Figure 2. Summary of RNFL measurements.
superior
parafoveal
temporal
Central foveal
nasal
temporal
global
nasal
inferior inferior
Macular measurements
RNFL measurements
CONCLUSIONS: • Macular thickness and RNFL measurement parameters ü Gender is not a factor ü Affected by the degree of myopia and age • May differ from the normative data of OCT machines ü Use of reference values derived from a myopic population of the same race may be helpful in the clinical setting • Parameters that are less influenced by age may be better SD-OCT measurement parameters to monitor for disease among myopic Filipinos ü Central foveal subfield, temporal parafoveal, nasal perifoveal, inferior RNFL and nasal RNFL thicknesses References: 1. Wang Q, Klein BE, Klein R, Moss SE. Refractive status in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1994;35:4344–4347.
2. Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, Ellwein LB. Refractive Error Study in Children: results from Shunyi District, China. Am J Ophthalmol 2000; 129(4): 427–435 3. Lin LL, Shih YF, Hsiao CK, et al. Epidemiologic study of the prevalence and severity of myopia among schoolchildren in Taiwan in 2000. J Formos Med Assoc 2001;100:684–91. 4. Ling SL, Chen AJ, Rajan U, Cheah WM. Myopia in ten year old children—a case control study. Singapore Med J 1987;28:288 –92 5. Reyes KB, Uy HS, Refractive errors in Filipino eyes in a single-center study population. Philipp J Ophthalmol. 2010; 35 (2). 50-55. 6. Wang Q, Klein BE, Klein R, Moss SE. Refractive status in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1994;35:4344–4347.
7. Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, Ellwein LB. Refractive Error Study in Children: results from Shunyi District, China. Am J Ophthalmol 2000; 129(4): 427–435 8. Lin LL, Shih YF, Hsiao CK, et al. Epidemiologic study of the prevalence and severity of myopia among schoolchildren in Taiwan in 2000. J Formos Med Assoc 2001;100:684–91. 9. Ling SL, Chen AJ, Rajan U, Cheah WM. Myopia in ten year old children—a case control study. Singapore Med J 1987;28:288 –92 10. Reyes KB, Uy HS, Refractive errors in Filipino eyes in a single-center study population. Philipp J Ophthalmol. 2010; 35 (2). 50-55. 11. Shoji T, Sato H, Ishida M, Takeuchi M, Chihara E, Assessment of glaucomatous changes in subjects with high myopia using spectral domain optical coherence tomography. IOVS. 2011; 52(2): 1098-1102 12. Akashi A, Kanamori A, Ueda K, Inoue Y, Yamada Y, Nakamura M, The ability of SD-OCT to differentiate early glaucoma with high myopia from highly myopic controls and non-highly myopic control. Investigative Ophthalmology and Visual Science. 2015; 56:6753-6580 13. Kang SH, Hong, SW, Im SK, Lee SH, Ahn MD, Effect of myopia on the thickness of the retinal nerve fiber layer measured by Cirrus HD optical coherence tomography, Investigative Ophthalmology and Visual Science. 2010; 51(8):4075-4083
