Retinal thickness among normal myopic Filipinos using spectral domain optical coherence tomography

Camille Elaine Zabala; Jubaida Mangondato-Aquino; Jose Ma. Martinez; John Mark de Leon

doi:10.35119/asjoo.v17i2.537

Camille Elaine Zabala
Jubaida Mangondato-Aquino
Jose Ma. Martinez
John Mark de Leon East Avenue Medical Center

DOI: https://doi.org/10.35119/asjoo.v17i2.537

Keywords: Filipino, macular thickness, myopia, retinal nerve fiber layer thickness, spectral-domain OCT

Abstract

Purpose: To determine mean macular and retinal nerve fiber layer (RNFL) thickness of myopic Filipinos using spectral domain optical coherence tomography (SD-OCT) and to evaluate influence of age, gender, and degree of myopia.

Design: Observational clinic-based cohort.

Methods: Participants were divided into two groups: low-moderate myopia [spherical equivalent (SE) -0.50 D to -6.00 D] and high-pathologic myopia (SE < -6.00 D and AL > 26.5 mm). Subgroup analyses between low myopia (refraction < -3.00 D or less) and moderate myopia (> -3.00 D to -6.00 D), and high myopia (> -6.00 D to -8.00 D) and pathologic myopia (more than -8.00 D) were done. Macular and RNFL thickness were measured by a SD-OCT and axial length (AL) with non-contact biometry.

Results: Of 156 eyes, 88/156 (56%) had low-moderate myopia, 68/156 (44%) had high-pathologic myopia. There were 67/156 (43%) male and 89/156 (57%) female subjects. Mean central foveal subfield thickness measurements were 264 ± 24 μm for low myopia, 258 ± 17 μm for moderate myopia, 253 ± 25 μm for high myopia, and 218 ± 48 μm for pathologic myopia. Mean RNFL thickness measurements were 105.62 ± 3.89 μm
for low myopia, 97.6 ± 2.45 μm for moderate myopia, 85.9 ± 3.87 μm for high myopia, and 75.14 ± 3.89 μm for pathologic myopia. Average SE (p < 0.0001) decreased while AL (p < 0.0001) increased with more myopia. Myopia and age significantly affected macular and RNFL thickness parameters except for the following where only the degree of myopia was a significant factor: central foveal, temporal parafoveal, nasal perifoveal, inferior and nasal RNFL thicknesses.

Conclusion: Retinal SD-OCT thickness measurements decreased with increasing level of myopia and age. Central foveal, temporal parafoveal, nasal perifoveal, inferior and nasal RNFL thicknesses may be more appropriate SD-OCT parameters among myopic Filipino patients to monitor for glaucoma since they may be less influenced by age.

Author Biography

John Mark de Leon, East Avenue Medical Center

Dr. John Mark de Leon has a special interest for visual fields and imaging in glaucoma. He is an avid educator and a heart for glaucoma research. He finished is medical education at the University of the Philippines and his residency in ophthalmology at the Cardinal Santos Medical Center. He completed glaucoma clinical research fellowships at the Massachusetts Eye and Ear Infirmary, Boston, the Singapore Eye Research Institute, and most recently at the Jules Stein Eye Institute, University of California, Los Angeles, where he was awarded the 2014 International Fellow Excellence in Research Award for his study “Differential Effects of the Fast and Slow Components of Visual Field Decay after Trabeculectomy”. He is presently a board member of the Philippine Glaucoma Society and head of the committee of continuing medical education. He is affiliated with the Cardinal Santos Medical Center, St Luke’s Medical Center. and East Avenue Medical Center.

References

Wang Q, Klein BE, Klein R, Moss SE. Refractive status in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1994;35:4344-4347. https://www.ncbi.nlm.nih.gov/pubmed/8002254.

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;129:427-435. https://www.ncbi.nlm.nih.gov/pubmed/10764849

Lin LL, Shih YF, Hsiao CK, Chen CJ, Lee LA, Hung PT. Epidemiologic study of the prevalence and severity of myopia among schoolchildren in Taiwan in 2000. J Formos Med Assoc. 2001;100:684-691. https://www.ncbi.nlm.nih.gov/pubmed/11760374.

Ling SL, Chen AJ, Rajan U, Cheah WM. Myopia in ten year old children—a case control study. Singapore Med J. 1987;28:288-292. https://www.ncbi.nlm.nih.gov/pubmed/3423791.

Reyes KB, Uy HS. Refractive errors in Filipino eyes in a single-center study population. Philipp J Ophthalmol. 2010;35:50-55. paojournal.com/vol35no2/toc.php.

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. Invest Ophthalmol Vis Sci. 2010;51:4075-4083. https://www.ncbi.nlm.nih.gov/pubmed/20237247.

Foster PJ, Jiang Y. Epidemiology of myopia. Eye (Lond). 2014;28:202-208. https://www.ncbi.nlm.nih.go/pubmed/24406412.

Emerole CG, Nneli RO, Osim EE. Prevalence, distribution and determinants of myopia in Owerri, Nigeria. J Exp Clin Anat. 2013;12: 57-61. http://www.jecajournal.org/article.asp?issn=1596-2393;year=2013;volume=12;issue=2;spage=57;epage=61;aulast=Emerole.

Saw SM, Gazzard G, Shi-Yen E, Chua WH. Myopia and associated pathological complications. Ophthal Physio Opt. 2005;25:381-391. https://www.ncbi.nlm.nih.gov/pubmed/16101943.

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. Invest Ophthalmol Vis Sci. 2011;52:1098-1102. https://www.ncbi.nlm.nih.gov/pubmed/21051712.

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. Invest Ophthalmol Vis Sci. 2015;56:6573-6580. https://iovs.arvojournals.org/article.aspx?articleid=2464683.

Holden B, Fricke T, Wilson D, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Am J Ophthalmol. 2016;123:1036-1042. https://www.ncbi.nlm.nih.gov/pubmed/26875007.

Jonas JB, Xu L. Histological changes of high axial myopia. Eye. 2014;28:113-117. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930258.

Beresford J, Crewther S, Kiely P, Crewther DP. Comparison of refractive state and circumferential morphology of retina, choroid and sclera in chick models of experimentally induced ametropia. Optom Vis Sci. 2002;78:40-49. https://www.ncbi.nlm.nih.gov/pubmed/11233334.

Grover S, Murthy R, Brar V, Chalam KV. Normative data for macular thickness by high-definition spectral-domain optical coherence tomography (Spectralis®). Am J Ophthalmol. 2009;148:266-271. https://www.ncbi.nlm.nih.gov/pubmed/19427616.

Kanai K, Abe T, Murayama K, Yoneya S. Retinal thickness and changes with age. Nippon Ganka Gakkai Zasshi. 2002;106:162-165. https://www.ncbi.nlm.nih.gov/pubmed/11925953.

Chan A, Duker JS, Ko TH, Fujimoto JG, Schuman JS. Normal macular thickness measurements in healthy eyes using Stratus optical coherence tomography. Arch Ophthalmol. 2006;124:193-198. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1941772/.