The morphology of the optic nerve head in the Singaporean Chinese population (the Tanjong Pagar study): part 1--optic nerve head morphology

Bourne, Rupert; Foster, Paul J.; Bunce, Catey; Hitchings, R A; Khaw, PT; Seah, S.K.W.; Garway-Heath, David F.

doi:10.1136/bjo.2007.123273

Cited by 29 publications

(20 citation statements)

References 49 publications

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“…Additionally, population-based studies using fundus photography have found that the area of the ONH ranges from 2.09 to 2.94 mm 2 [27]–[31]. We found that in our patients, the mean disc area was 2.45 mm 2 , a result that was consistent with earlier reports.…”

Section: Discussionsupporting

confidence: 92%

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

et al. 2014

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PurposeThe Glaucoma Stereo Analysis Study (GSAS), a cross sectional multicenter collaborative study, used a stereo fundus camera to assess various morphological parameters of the optic nerve head (ONH) in glaucoma patients and investigated the relationships between these parameters and patient characteristics.Subjects and MethodsThe study included 187 eyes of 187 subjects with primary open angle glaucoma or normal tension glaucoma (male: female = 100: 87, age = 61±9 years). Stereo pairs of ONH photographs were made with a stereo fundus camera (nonmyd WX). ONH morphological parameters were calculated with prototype analysis software. In addition to 35 standard parameters, we defined three novel parameters: disc tilt angle, rim decentering, and the absolute value of rim decentering. The correlation between each parameter and patient characteristics was analyzed with Spearman's rank correlation coefficient.ResultsPatient characteristics included refractive error of −3.38±3.75 diopters, intraocular pressure (IOP) of 13.6±2.6 mmHg, and visual field mean deviation (MD) of −4.71±3.26 dB. Representative ONH parameters included a horizontal disc width of 1.66±0.28 mm, vertical disc width of 1.86±0.23 mm, disc area of 2.42±0.63 mm2, cup area of 1.45±0.57 mm2, and cup volume of 0.31±0.22 mm3. Correlation analysis revealed significant negative associations between vertical cup-to-disc ratio (0.82±0.08) and MD (r = −0.40, P<0.01) and between disc tilt angle (10.5±12.5 degrees) and refractive error (r = −0.36, P<0.01). Seventy-five percent of the eyes had a positive value for rim decentering (0.30±0.42), indicating that rim thinning manifested more often as an inferior lesion than a superior lesion.ConclusionWe used stereoscopic analysis to establish a database of ONH parameters, which may facilitate future studies of glaucomatous changes in ONH morphology.

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Section: Discussionsupporting

confidence: 92%

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

et al. 2014

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“…Most previous cross-sectional studies 20–27 did not find an age-related decline in disc margin based rim parameters in normal subjects. In contrast, in the current study, BMO-MRW decreased significantly with age, at a rate of around 4.0% per decade of life, suggesting that this index is more in line with the decrease in RGCs with age observed in histomorphological studies.…”

Section: Discussionmentioning

confidence: 64%

Bruch's Membrane Opening Minimum Rim Width and Retinal Nerve Fiber Layer Thickness in a Normal White Population

et al. 2015

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Objective Conventional optic disc margin-based neuroretinal rim measurements lack a solid anatomical and geometrical basis. An optical coherence tomography (OCT) index, Bruch’s membrane opening minimum rim width (BMO-MRW), addresses these deficiencies and has higher diagnostic accuracy for glaucoma. We characterized BMO-MRW and peripapillary retinal nerve fiber layer thickness (RNFLT) in a normal population. Design Multi-centred cross-sectional study. Participants Normal White subjects. Methods Approximately equal number of subjects in each decade group (20–90 years) was enrolled in 5 centers. Subjects had normal ocular and visual field examinations. We obtained OCT images of the optic nerve head (24 radial scans) and peripapillary retina (1 circular scan). The angle between the fovea and BMO center (FoBMO), relative to the horizontal axis of the image frame, was first determined and all scans were acquired and analyzed relative to this eye-specific FoBMO axis. Variation of BMO-MRW and RNFLT was analyzed with respect to age, sector and BMO shape. Main Outcome Measures Age-related decline and between-subject variability in BMO-MRW and RNFLT. Results There were 246 eyes of 246 subjects with a median age of 52.9 (range, 19.8 to 87.3) years. The median FoBMO angle was −6.7° (range, 2.5° to −17.5°). BMO was predominantly vertically oval with a median area of 1.74 mm2 (range, 1.05 to 3.40 mm2). Neither FoBMO angle nor BMO area was associated with age or axial length. Both global mean BMO-MRW and RNFLT declined with age at a rate of −1.34 µm/y and −0.21 µm/y, equivalent to 4.0% and 2.1% loss per decade of life, respectively. Sectorally, the most rapid decrease occurred inferiorly and the least temporally, however, the age association was always stronger with BMO-MRW than with RNFLT. There was a modest relationship between mean global BMO-MRW and RNFLT (r = 0.35), while sectorally the relationship ranged from moderate (r = 0.45, inferotemporal) to non-existent (r = 0.01, temporal). Conclusions There was significant age-related loss of BMO-MRW in healthy subjects and notable differences between BMO-MRW and RNFLT in their relationship with age and between each other. Adjusting BMO-MRW and RNFLT for age and sector is important in ensuring optimal diagnostics for glaucoma.

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“…High interindividual variability of the optic nerve head size and morphology was demonstrated in a population-based study. 35 In another study, all optic nerve head parameters measured by confocal scanning laser ophthalmoscopy (Heidelberg retina tomograph; Heidelberg Engineering, GmbH) were correlated significantly between the right and left eyes of normal subjects, and there was no significant intereye difference in disc area, cup area, mean and maximum cup depths, and cup-to-disc area ratio. 36 Therefore, the results of our intereye comparison may have been less affected by possible ocular confounding factors (e.g., vertical disc diameter and disc ovality index), as well as by possible systemic confounding factors (e.g., cerebrospinal fluid pressure around the optic nerve), than the results of our interindividual comparison.…”

Section: Discussionmentioning

confidence: 95%

Posterior Displacement of the Lamina Cribrosa in Glaucoma: In Vivo Interindividual and Intereye Comparisons

Furlanetto

Park

Damle

et al. 2013

Invest. Ophthalmol. Vis. Sci.

103

104

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The morphology of the optic nerve head in the Singaporean Chinese population (the Tanjong Pagar study): part 1--optic nerve head morphology

Abstract: The morphometric characteristics of optic discs in Chinese Singaporeans are very similar to those described in other groups, with the temporal sector rim having the smallest area. Disc and rim areas vary with sex (men > women). Disc area (but not that of the rim) increases with age.

Cited by 29 publications

References 49 publications

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

Stereoscopic Analysis of Optic Nerve Head Parameters in Primary Open Angle Glaucoma: The Glaucoma Stereo Analysis Study

Bruch's Membrane Opening Minimum Rim Width and Retinal Nerve Fiber Layer Thickness in a Normal White Population

Posterior Displacement of the Lamina Cribrosa in Glaucoma: In Vivo Interindividual and Intereye Comparisons

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