Effects of Age, Sex, and Axial Length on the Three-Dimensional Profile of Normal Macular Layer Structures

Ooto, Sotaro; Hangai, Masanori; Tomidokoro, Atsuo; Saito, Hitomi; Araie, Makoto; Otani, Tomohiro; Kishi, Shoji; Matsushita, Kazunobu; Maeda, Naoyuki; Shirakashi, Masataka; Abe, Haruki; Ohkubo, Shinji; Sugiyama, Kazuhisa; Iwase, Aiko; Yoshimura, Nagahisa

doi:10.1167/iovs.11-8388

Cited by 234 publications

(292 citation statements)

References 50 publications

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“…Neither the presence of any DR at inclusion, nor progression of DR after inclusion was associated with any change in the NFL or GCL+IPL, nor did age, blood pressure, or HbA1c level influence the thickness of the NFL or GCL-IPL. As expected, female sex was associated with significantly thinner parafoveal NFL and GCL at inclusion (22).…”

Section: Resultssupporting

confidence: 81%

Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Sohn

Dijk

Jiao

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

510

437

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Diabetic retinopathy (DR) has long been recognized as a microvasculopathy, but retinal diabetic neuropathy (RDN), characterized by inner retinal neurodegeneration, also occurs in people with diabetes mellitus (DM). We report that in 45 people with DM and no to minimal DR there was significant, progressive loss of the nerve fiber layer (NFL) (0.25 μm/y) and the ganglion cell (GC)/inner plexiform layer (0.29 μm/y) on optical coherence tomography analysis (OCT) over a 4-y period, independent of glycated hemoglobin, age, and sex. The NFL was significantly thinner (17.3 μm) in the eyes of six donors with DM than in the eyes of six similarly aged control donors (30.4 μm), although retinal capillary density did not differ in the two groups. We confirmed significant, progressive inner retinal thinning in streptozotocin-induced "type 1" and B6.BKS(D)-Lepr db /J "type 2" diabetic mouse models on OCT; immunohistochemistry in type 1 mice showed GC loss but no difference in pericyte density or acellular capillaries. The results suggest that RDN may precede the established clinical and morphometric vascular changes caused by DM and represent a paradigm shift in our understanding of ocular diabetic complications.diabetes | retina | neurodegeneration | diabetic retinopathy | optical coherence tomography

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Section: Resultssupporting

confidence: 81%

Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Sohn

Dijk

Jiao

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

510

437

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“…An age-matched control group was used to compare retinal layer thickness in the study groups [13,14] . Gender was taken in consideration, as retinal layer thickness measured on Cirrus SD-OCT in healthy eyes showed significant variations by gender [13,15,16] .…”

Section: Discussionmentioning

confidence: 99%

Retinal Layer Location of Increased Retinal Thickness in Eyes with Subclinical and Clinical Macular Edema in Diabetes Type 2

et al. 2015

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Purpose: To identify the retinal layer predominantly affected in eyes with subclinical and clinical macular edema in diabetes type 2. Methods: A cohort of 194 type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20/35) were examined with Cirrus spectral-domain optical coherence tomography (OCT) at the baseline visit (ClinicalTrials.gov identifier: NCT01145599). Automated segmentation of the retinal layers of the eyes with subclinical and clinical macular edema was compared with a sample of 31 eyes from diabetic patients with normal OCT and an age-matched control group of 58 healthy eyes. Results: From the 194 eyes in the study, 62 had subclinical macular edema and 12 had clinical macular edema. The highest increases in retinal thickness (RT) were found in the inner nuclear layer (INL; 33.6% in subclinical macular edema and 81.8% in clinical macular edema). Increases were also found in the neighboring layers. Thinning of the retina was registered in the retinal nerve fiber, ganglion cells and inner plexiform layers in the diabetic eyes without macular edema. Conclusions: The increase in RT occurring in diabetic eyes with macular edema is predominantly located in the INL but extends to neighboring retinal layers indicating that it may be due to extracellular fluid accumulation.

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“…Earlier studies using SD-OCT showed similar symmetrical thicknesses of the GCL, IPL, and GCLþIPL of healthy eyes in an elliptical annulus. 7,10,13,19,26 The GCIPL thicknesses on all 360 spokes should be equivalent if the symmetry is perfect; and, consequently, the initial RGC loss limited to a small local area would be detectable as a decrease of the GCIPL thickness on the spokes, leading to minimum GCIPL thickness. Thus, this parameter should theoretically detect early or initial RGC loss with high sensitivity.…”

Section: Discussionmentioning

confidence: 99%

A Novel Method to Detect Local Ganglion Cell Loss in Early Glaucoma Using Spectral-Domain Optical Coherence Tomography

Takayama

Hangai

Durbin

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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112

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PURPOSE.To test the glaucoma-discriminating ability of a new method for detecting local ganglion cell loss using spectraldomain optical coherence tomography (OCT).METHODS. This study included 58 glaucomatous and 48 healthy eyes from Japanese subjects. Combined thickness of the ganglion cell layer and inner plexus layer (GCIPL) was measured on a macular cube scan in Cirrus HD-OCT. Average GCIPL thickness within a macular elliptical annulus and minimum GCIPL thickness on 360 spokes extending from the inner to the outer radius of the elliptical annulus were calculated. Area under the receiver operating characteristic curve (AROC) to discriminate between healthy eyes and early (mean deviation [MD], ‡À6 dB)/advanced (MD, <À6 dB) glaucomatous were compared between parameters.RESULTS. Forty-three were normal-tension glaucoma, and 15 were high-tension glaucoma. The mean minimum GCIPL thickness was 77.0 lm in healthy eyes and 60.6 lm in glaucomatous eyes (P < 0.001). For the intersession repeatability, the coefficients of variation for average GCIPL and minimum GCIPL were 0.98 and 1.85 in glaucomatous eyes, and 0.89 and 1.85 in healthy eyes, respectively. Minimum GCIPL thickness AROC (0.896) was significantly higher (P ¼ 0.0062) than average GCIPL thickness (0.821) for early glaucoma, whereas minimum GCIPL AROC (0.991) was comparable (P ¼ 0.103) to average GCIPL (0.964) for advanced glaucoma. The minimum GCIPL thickness AROC was comparable (P ¼ 0.861) to average circumpapillary retinal nerve fiber layer (cpRNFL) thickness (0.890) for early glaucoma.CONCLUSIONS. In Japanese patients with 74.1% of normal-tension glaucoma, the minimum GCIPL on spokes may be useful for detecting early glaucoma. (Invest Ophthalmol Vis Sci. 2012; 53:6904-6913)

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Effects of Age, Sex, and Axial Length on the Three-Dimensional Profile of Normal Macular Layer Structures

Abstract: Macular layer thicknesses measured on SD-OCT images in healthy eyes showed significant variations by sex and age. These findings should inform macular layer thickness analyses in SD-OCT studies of retinal diseases and glaucoma.

Cited by 234 publications

References 50 publications

Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Retinal Layer Location of Increased Retinal Thickness in Eyes with Subclinical and Clinical Macular Edema in Diabetes Type 2

A Novel Method to Detect Local Ganglion Cell Loss in Early Glaucoma Using Spectral-Domain Optical Coherence Tomography

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