Normal gözlerde yaş ve cinsiyetin retina kalınlığına etkisi’

Abstract

Amaç: Bu çalışmanın amacı normal gözlerde makula kalınlığının ve peripapiller retinal sinir lifi kalınlığının yaş ve cinsiyet ile ilişkisini optik koherans tomografi ile değerlendirmektir.

Gereç ve yöntem: Çalışmaya 2017 Şubat ve 2018 Ocak tarihleri arası Burdur Devlet Hastanesi Göz Hastalıkları Kliniği’ne başvuran sağlıklı 500 kişi alındı. Çalışmaya herhangi bir göz hastalığı olmayan ve daha önce oküler cerrahi öyküsü, sistemik hastalığı olmayan 18-100 yaş arası bireyler dahil edildi. Poliklinik kayıtlarından; düzeltilmiş en iyi görme keskinliği  Snellen eşeline göre 20/20, göz içi basıncı 10-20 mmhg, refraktif değerleri +/- 3,00 dioptri olan gözler ve optik koherans tomografi sonuçları alındı. Makula kalınlığını yaş grupları arasında karşılaştırmada ve cinsiyet ilişkili değişiklikleri analiz etmek ve sektörler arasındaki retina kalınlıklarını karşılaştırılmak için bağımsız örneklem t testi kullanıldı. Santral foveal kalınlıkta yaş gruplarında cinsiyet farklılıklarını karşılaştırmak için  iki yönlü varyans analizi kullanıldı.

Bulgular: Çalışmaya alınan 500 kişinin 247’si kadın 253‘ü erkekti. Santral foveal kalınlık erkeklerde kadınlara göre anlamlı olarak daha kalın saptandı (p=0,001). Yaş artışı ile birlikte santral fovea kalınlığında anlamlı bir değişiklik saptanmadı (p=0,068). Yaş ve cinsiyet grupları arasında; total peripapiller retina sinir lifi tabakası kalınlığı, üst ve alt kadran retinal sinir lifi tabakası kalınlığı, optik disk çukurluk ve disk alanları ile çukurluk/disk oranında  da anlamlı bir değişiklik görülmemiştir (p=0,001).

Sonuç: Retinal kalınlıklarında yaş ve cinsiyete bağlı olarak anlamlı değişiklikler görülmüştür. Yaşla birlikte santral fovea kalınlığında anlamlı bir değişiklik saptanmazken erkeklerde kadınlara göre anlamlı olarak daha kalın saptandı. Perisantral halkada temporal ve üst sektör kalınlıklarında yaşa bağlı anlamlı incelme görülmüştür. Bu nedenle, bu bulgular hem sistemik hem de retinal hastalıklarla ilişkili retinal tabaka kalınlığını analiz ederken dikkate alınmalıdır.

Keywords

• optik koherans tomografi,cinsiyet,yaş

Effect of age and sex on retinal thickness in normal eyes.

Abstract

Purpose: The aim of this study is to evaluate the effect of sex and age on macular thickness and peripapillary retinal nerve fiber thickness in normal population with optical coherence tomography.

Materials and methods: Mediacal records of 500 healthy people aged 18-100  who applied to the Burdur State Hospital Ophthalmology Clinic between February 2017 and January 2018 were enrolled. Exclusion criterias were having any eye disease or  ocular surgery history and systemic disease.Best corrected visual acuity of 20/20 according to Snellen's chart, 10-20 mmHg of intraocular pressure, +/- 3.00 diopters of refractive values ​​and optical coherence tomography measurements were received. Statistical data was analyzed with a IBM SPSS 21; software program. Independent sample t-test was used to compare macular thickness between age groups and to analyze sex related changes and to compare retinal thicknesses across sectors. Two-way variance analysis  was used to compare gender differences in age groups in central foveal thickness.

Results: Central foveal thickness was significantly thicker in men than in women (p=0.001). There was no significant change in central foveal thickness with age (p=0.068). Among age and gender groups; total peripapillary retinal nerve fiber layer thickness, retinal nerve fiber layer thickness in superior and inferior quadrant, optic disc cup and disc areas, and cup / disc ratio were not significantly changed.

Conclusion: Significant changes were observed in retinal layers depending on the age and sex. Therefore, these results must be considered when analyzing the retina associated with both systemic and retinal disease.

Keywords

• Optic Coherance Tomography,Age Related Macular Thickness,Retinal Nerve Fiber Layer

References

1. 1- Neuville JM, Bronson-Castain K, Bearse MAJr, et al. OCT reveals regional differences in macular thickness with age. Optom Vis Sci 2009;86:E810–6.
2. 2- Song WK, Lee SC, Lee ES, et al. Macular thickness variations with sex, age, and axial length in healthy subjects: a spectral domain-optical coherence tomography study. Invest Ophthalmol Vis Sci 2010;51: 3913–8.
3. 3- Sung KR, Wollstein G, Bilonick RA, et al. Effects of age on optical coherence tomography measurements of healthy retinal nerve fiber layer, macula, and optic nerve head. Ophthalmology 2009;116:1119–24.
4. 4- Bonnel S, Mohand-Said S, Sahel JA: The aging of the retina. Exp Gerontol 2003, 38(8):825-831.
5. 5- Grunwald JE, Piltz J, Patel N, Bose S, Riva CE: Effect of aging on retinal macular microcirculation: A blue field simulation study. Invest Ophthalmol Vis Sci 1993, 34(13):3609-3613.
6. 6- Xu HP, Chen M, Forrester JV:Para-inflammation in the aging retina. Prog Retin Eye Res 2009, 28(5):348-368.
7. 7-. Kaur I, Ghanekar Y, Chakrabarti S: Understanding the genetics of agerelated macular degeneration: Some insights into the disease pathogenesis. International Journal of Human Genetics 2008, 8(1-2):161-169.
8. 8- Gupta PD, Johar K, Nagpal K, Vasavada AR: Sex hormone receptors in thehuman eye. Surv Ophthalmol 2005, 50(3):274-284.

9. 9- Feskanich D, Cho E, Schaumberg DA, Colditz GA, Hankinson SE: Menopausal and reproductive factors and risk of age-related macular degeneration. Arch Ophthalmol 2008, 126(4):519-524.
10. 10- Evans JR, Schwartz SD, McHugh JDA, Thamby-Rajah Y, Hodgson SA,Wormald RPL, Gregor ZJ: Systemic risk factors for idiopathic macular holes: A case-control study. Eye 1998, 12:256-259.
11. 11- Eisner A, Toomey MD: The color appearance of stimuli detected via short-wavelength-sensitive cones: Comparisons with visual adaptation and visual field data for peri- or post-menopausal women under 70 years of age. Vision Res 2008, 48(26):2663-2672.
12. 12- Jagle H, Heine J, Kurtenbach A: L:M-cone ratio estimates of the outer and inner retina and its impact on sex differences in erg amplitudes.Doc Ophthalmol 2006, 113(2):105-113.
13. 13- Bagci AM, Shahidi M, Ansari R, Blair M, Blair NP, Zelkha R. Thickness profiles of retinal layers by optical coherence tomography image segmentation. Am J Ophthalmol. 2008; 146:679–687.
14. 14- Garvin MK, Abramoff MD, Kardon R, Russell SR, Wu X, Sonka M. Intraretinal layer segmentation of macular optical coherence tomography images using optimal 3-D graph search. IEEE Trans Med Imaging. 2008;27:1495–1505.
15. 15- Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7. Ophthalmology 1991;98(5 Suppl):741–56.
16. 16- Alamouti B, Funk J. Retinal thickness decreases with age: an OCT study. Br J Ophthalmol. 2003;87:899–901.
17. 17-Duan XR, Liang YB, Friedman DS, et al. Normal macular thickness measurements using optical coherence tomography in healthy eyes of adult Chinese persons: the Handan Eye Study. Ophthalmology. 2010;117:1585–1594.
18. 18- Eriksson U, Alm A. Macular thickness decreases with age in normal eyes: a study on the macular thickness map protocol in the Stratus OCT. Br J Ophthalmol. 2009;93:1448–1452.
19. 19-Nieves-Moreno M, Martínez-de-la-Casa JM, Morales-Fernández L, Sánchez-Jean R, Sáenz-Francés F, García-Feijoó J. Impacts of age and sex on retinal layer thicknesses measured by spectral domain optical coherence tomography with Spectralis. PLoS One. 2018 Mar 9;13(3):e0194169. doi:10.1371/journal.pone.0194169. 20- 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(2):193-198.
20. 21- Falsini B, Ziccardi L, Stifano G, Iarossi G, Merendino E, Minnella AM, Fadda A, Balestrazzi E: Temporal response properties of the macular cone system: Effect of normal aging and age-related maculopathy. Invest Ophthalmol Vis Sci 2007, 48(10):4811-4817.
21. 22- Wong ACM, Chan CWN, Hui SP: Relationship of gender, body mass index, and axial length with central retinal thickness using optical coherence tomography. Eye 2005, 19(3):292-297.
22. 23- Kelty PJ, Payne JF, Trivedi RH, Kelty J, Bowie EM, Burger BM: Macular thickness assessment in healthy eyes based on ethnicity using stratus oct optical coherence tomography. Invest Ophthalmol Vis Sci 2008, 49(6):2668-2672.
23. 24-Kanai K, Abe T, Murayama K, Yoneya S. Retinal thickness and changes with age. Nihon Ganka Gakkai Zasshi. 2002; 106(3):162±165. PMID: 11925953
24. 25- Manassakorn A, Chaidaroon W, Ausayakhun S, Aupapong S, Wattananikorn S. Normative database of retinal nerve fiber layer and macular retinal thickness in a Thai population. Jpn J Ophthalmol. 52 (6):450±456. https://doi.org/10.1007/s10384-008-0538-6 PMID: 19089565
25. 26- Appukuttan B, Giridhar A, Gopalakrishnan M, Sivaprasad S. Normative spectral domain optical coherence tomography data on macular and retinal nerve fiber layer thickness in Indians. Indian J Ophthalmol. 2014; 62(3):316±321 https://doi.org/10.4103/0301-4738.116466 PMID: 24008793
26. 27- Lam DS, Leung KS, Mohamed S, et al. Regional variations in the relationship between macular thickness measurements and myopia. Invest Ophthalmol Vis Sci 2007;48:376–82.
27. 28-Huang J, Liu X,Wu Z, et al. Macular thickness measurements in normal eyes with time-domain and Fourier-domain optical coherence tomography. Retina 2009;29:9807.
28. 29-Grover S, Murthy RK, Brar VS, et al. Comparison of retinal thickness in normal eyes using Stratus and Spectralis optical coherence tomography. Invest Ophthalmol Vis Sci 2010;51:2644–7.
29. 30- Leung CK, Cheung CY, Weinreb RN, et al. Comparison of macular thickness measurements between time domain and spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci 2008;49:4893–7.
30. 31- Kakinoki M, Sawada O, Sawada T, et al. Comparison of macular thickness between Cirrus HD-OCT and Stratus OCT. Ophthalmic Surg Lasers Imaging 2009;40:135–40.
31. 32- Sull AC, Vuong LN, Price LL, et al. Comparison of spectral/Fourier domain optical coherence tomography instruments for assessment of normal macular thickness. Retina 2010;30:235–45.
32. 33- Chan A, Duker JS, Ko TH, et al. Normal macular thickness measurements in healthy eyes using Stratus optical coherence tomography. Arch Ophthalmol 2006;124:193–8.
33. 34- Lam DS, Leung KS, Mohamed S, et al. Regional variations in the relationship between macular thickness measurements and myopia. Invest Ophthalmol Vis Sci 2007;48:376–82.
34. 35- Kelty PJ, Payne JF, Trivedi RH, et al. Macular thickness assessment in healthy eyes based on ethnicity using Stratus OCT optical coherence tomography. Invest Ophthalmol Vis Sci 2008;49:2668–72.
35. 36- Eriksson U, Alm A. Macular thickness decreases with age in normal eyes: a study on the macular thickness map protocol in the Stratus OCT. Br J Ophthalmol 2009;93:1448–52.
36. 37- Legarreta JE, Gregori G, Punjabi OS, et al. Macular thickness measurements in normal eyes using spectral domain optical coherence tomography. Ophthalmic Surg Lasers Imaging 2008;39:S43–9.
37. 38- Grover S, Murthy RK, Brar VS, et al. Normative data for macular thickness by high-definition spectral-domain optical coherence tomography (spectralis). Am J Ophthalmol 2009;148:266–71.
38. 39- Ooto S, Hangai M, Sakamoto A, et al. Three-dimensional profile of macular retinal thickness in normal Japanese eyes. Invest Ophthalmol Vis Sci 2010;51:465–73.
39. 40- Staurenghi G, Sadda S, Chakravarthy U, et al. Proposed lexicon for anatomic landmarks in normal posterior segment spectral-domain optical coherence tomography: the IN•OCT consensus. Ophthalmology 2014;121:1572–8.