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Retinal Nerve Fiber Layer Thickness in a Multiethnic Normal Asian Population: The Singapore Epidemiology of Eye Diseases Study.

Publication ,  Journal Article
Ho, H; Tham, Y-C; Chee, ML; Shi, Y; Tan, NYQ; Wong, K-H; Majithia, S; Cheung, CY; Aung, T; Wong, TY; Cheng, C-Y
Published in: Ophthalmology
May 2019

PURPOSE: To describe variations in retinal nerve fiber layer (RNFL) thickness based on spectral-domain (SD) OCT in a multiethnic Asian population. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Ethnic Chinese, Malay, and Indian adults older than 48 years without glaucoma who were recruited from the Singapore Epidemiology of Eye Diseases Study. METHODS: All participants underwent standardized systemic and ocular examinations. Retinal nerve fiber layer thickness was measured using SD OCT. Participants with poor-quality scans were excluded. Linear regression models were used to investigate the associations of ocular and systemic factors with average RNFL thickness. Generalized estimating equation models were used to account for correlation between both eyes. MAIN OUTCOME MEASURE: Average RNFL thickness. RESULTS: Four thousand four hundred seventy-five participants (8178 eyes) consisting of 1371 Chinese, 1303 Malay, and 1801 Indian adults contributed to this analysis. Average RNFL thickness measured was 95.7±9.6 μm in Chinese participants, 94.9±10.6 μm in Malay participants, and 87.3±10.6 μm in Indian participants (P < 0.001). Multivariate analysis adjusted for age, gender, and ethnicity revealed a reduction in RNFL thickness with increased intraocular pressure and axial length (P < 0.001 for both), as well as a diagnosis of diabetes (P = 0.04); greater RNFL thickness was associated with increased disc area (P < 0.001), signal strength (P < 0.001), and low-density lipoprotein cholesterol (P = 0.02). When these significant variables were taken into account, the average RNFL thickness of Indian participants was significantly thinner compared with Chinese participants (7.45 μm thinner on average [95% confidence interval, 6.75-8.15 μm; P < 0.001]), whereas there was no significant difference in average RNFL thickness between Malay and Chinese participants (P = 0.15). CONCLUSIONS: Average and regional RNFL thicknesses were significantly thinner in Indian eyes compared with Chinese and Malay eyes. Results of the study highlight the need to acquire more refined normative data for the comparison of individual patients with others of similar ethnic background while accounting for ocular factors that could influence RNFL thickness. This in turn may improve the sensitivity and specificity of glaucoma detection.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

May 2019

Volume

126

Issue

5

Start / End Page

702 / 711

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Singapore
  • Retinal Ganglion Cells
  • Reference Values
  • Prevalence
  • Ophthalmology & Optometry
  • Nerve Fibers
  • Middle Aged
  • Male
  • Humans
 

Citation

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Ho, H., Tham, Y.-C., Chee, M. L., Shi, Y., Tan, N. Y. Q., Wong, K.-H., … Cheng, C.-Y. (2019). Retinal Nerve Fiber Layer Thickness in a Multiethnic Normal Asian Population: The Singapore Epidemiology of Eye Diseases Study. Ophthalmology, 126(5), 702–711. https://doi.org/10.1016/j.ophtha.2018.11.031
Ho, Henrietta, Yih-Chung Tham, Miao Li Chee, Yuan Shi, Nicholas Y. Q. Tan, Kah-Hie Wong, Shivani Majithia, et al. “Retinal Nerve Fiber Layer Thickness in a Multiethnic Normal Asian Population: The Singapore Epidemiology of Eye Diseases Study.Ophthalmology 126, no. 5 (May 2019): 702–11. https://doi.org/10.1016/j.ophtha.2018.11.031.
Ho H, Tham Y-C, Chee ML, Shi Y, Tan NYQ, Wong K-H, et al. Retinal Nerve Fiber Layer Thickness in a Multiethnic Normal Asian Population: The Singapore Epidemiology of Eye Diseases Study. Ophthalmology. 2019 May;126(5):702–11.
Ho, Henrietta, et al. “Retinal Nerve Fiber Layer Thickness in a Multiethnic Normal Asian Population: The Singapore Epidemiology of Eye Diseases Study.Ophthalmology, vol. 126, no. 5, May 2019, pp. 702–11. Pubmed, doi:10.1016/j.ophtha.2018.11.031.
Ho H, Tham Y-C, Chee ML, Shi Y, Tan NYQ, Wong K-H, Majithia S, Cheung CY, Aung T, Wong TY, Cheng C-Y. Retinal Nerve Fiber Layer Thickness in a Multiethnic Normal Asian Population: The Singapore Epidemiology of Eye Diseases Study. Ophthalmology. 2019 May;126(5):702–711.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

May 2019

Volume

126

Issue

5

Start / End Page

702 / 711

Location

United States

Related Subject Headings

  • Tomography, Optical Coherence
  • Singapore
  • Retinal Ganglion Cells
  • Reference Values
  • Prevalence
  • Ophthalmology & Optometry
  • Nerve Fibers
  • Middle Aged
  • Male
  • Humans