Age-related changes of individual macular retinal layers among Asians

Abstract

We characterized the age-related changes of the intra-retinal layers measured with spectral-domain optical coherence tomography (SD-OCT; Cirrus high-definition OCT [Carl Zeiss Meditec]. The Singapore Epidemiology of Eye Diseases is a population-based, cross-sectional study of Chinese, Malays and Indians living in Singapore. Iowa Reference Algorithms (Iowa Institute for Biomedical Imaging) were used for intra-retinal layer segmentation and mean thickness of 10 intra-retinal layers rescaled with magnification correction using axial length value. Linear regression models were performed to investigate the association of retinal layers with risk factors. After excluding participants with history of diabetes or ocular diseases, high-quality macular SD-OCT images were available for 2,047 participants (44–89 years old). Most of the retinal layers decreased with age except for foveal retinal nerve fiber layer (RNFL) and the inner/outer segments of photoreceptors where they increased with age. Men generally had thicker retinal layers than women. Chinese have the thickest RNFL and retinal pigment epithelium amongst the ethnic groups. Axial length and refractive error remained correlated with retinal layers in spite of magnification correction. Our data show pronounced age-related changes in retinal morphology. Age, gender, ethnicity and axial length need be considered when establishing OCT imaging biomarkers for ocular or systemic disease.

Normative Database for All Retinal Layer Thicknesses Using SD-OCT Posterior Pole Algorithm and the Effects of Age, Gender and Axial Lenght

“…We documented that full RETINA thickness was significantly thicker in men than in women, which is consistent with many previous research works [ 20 , 21 , 28 , 34 , 39 , 45 ]. Previous studies [ 20 , 21 , 31 , 46 ] have reported that GCL, IPL, INL and ONL thicknesses were significantly thicker in men than in women, which falls in line with our results.…”

“…Finally, we observed that ONL and RPE thicknesses did not correlate with AXL, as described by Invernizzi et al [ 20 ]. However, other authors [ 45 ] have documented a significantly negative correlation between AXL and ONL and RPE thicknesses in the extrafoveal rings of the ETDRS map, probably because these authors did not exclude high myopic eyes.…”

“…Our results are thus contrary to those of Invernizzi et al [ 20 ], who reported a significantly decreased thickness with AXL in the outer ring of the ETDRS map. Several studies [ 45 , 46 , 47 , 48 ] have documented a significant positive correlation of retinal thickness with AXL in the foveal subfield of the ETDRS map and a significant negative correlation in the inner and outer rings. In our study, we failed to document a negative correlation of full RETINA thickness and AXL, which could be due to the different inclusion criteria, as we excluded high myopic eyes (sphere ≥ 5D), while other authors [ 45 , 46 , 47 , 48 ] did not establish any limits for refractive defects.…”

“…Several studies [ 45 , 46 , 47 , 48 ] have documented a significant positive correlation of retinal thickness with AXL in the foveal subfield of the ETDRS map and a significant negative correlation in the inner and outer rings. In our study, we failed to document a negative correlation of full RETINA thickness and AXL, which could be due to the different inclusion criteria, as we excluded high myopic eyes (sphere ≥ 5D), while other authors [ 45 , 46 , 47 , 48 ] did not establish any limits for refractive defects. We observed that GCL, IPL and INL thicknesses showed a significantly positive correlation with AXL in central cells and a significantly negative correlation in the cells near the optic disk, as similarly reported [ 47 ].…”

Macular Microvasculature and Associated Retinal Layer Thickness in Pediatric Amblyopia: Magnification-Corrected Analyses

“…Specifically, measurements performed with OCT/OCTA have inherent errors when the scale of retinal image is not corrected for axial length (AL) of each eye. [13][14][15][16][17] Of note, a recent systematic review 17 reported that only 41 of 989 peer-reviewed articles (8%) in PubMed that use quantitative OCTA values used AL to correct the scale of OCTA images. This is particularly problematic in pediatric patients with amblyopia, who may have significant differences in AL between the affected and unaffected eyes (especially those with anisometric amblyopia) and considering the fact that measurement of the FAZ area may deviate up to 51% if AL is not factored into the analysis.…”