The retinal thickness changes and their associated factors in highly myopic eyes

doi:10.3877/cma.j.issn.2095-2007.2024.01.005

Abstract

Abstract:

Objective

To explore the changes in retinal layer thickness and related factors in high myopia eyes.

Methods

A total of 128 highly myopic patients (128 eyes) who visited the Beijing Tongren Eye Center of Beijing Tongren Hospital affiliated with Capital Medical University from February 2023 to July 2023. Among them, there were 46 males (46 eyes) and 82 females (82 eyes) with an average age of (35.9±7.9) years (ranging from 21 to 69 years). According to axial length (AL), age, and gender, they were divided. The patient′s blood pressure, initial age of myopia, intraocular pressure, height and weight were recorded, and the height and body mass index (BMI) was calculated. The thickness of each layer of the retina and the thickness of the central fovea choroid was measured using coherent light tomography (OCT). The measurement data of the thickness of each layer of the retina conformed to a normal distribution through Kolmogorov-Smirnova normality test, and was described as ±s, and compared by analysis of variance in retinal thickness between different AL and age groups and used for further pairwise by Bonferroni if there was a statistically significant difference. The retinal thickness between different gender groups was compared by independent sample t test. Single factor linear regression was used to screen for factors related to the thickness of each layer of the retina. Then, the thickness of each layer of the retina was used as the dependent variable, and the factor with P ≤ 0.10 in the univariate analysis was used as the independent variable. Referring to previous results, age and AL were also used as independent variables for multiple linear regression analysis of their correlation.

Results

The thickness of the entire retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium layer (RPE), inner retinal layer (IRL), and outer retinal layer (ORL) in patients were measured. The AL<26.5 mm group was (258.9±20.0)μm, (10.1±2.9) μm, (13.1±5.0) μm, (18.5±4.0) μm, (15.4±4.4) μm, (24.8±5.5) μm, (87.6±9.4) μm, (17.2±1.7) μm, (169.2±20.1) μm and (89.7±3.5) μm, respectively. The groups with 26.5 mm ≤AL<27.5 mm were (266.6±26.1) μm, (10.8±2.9) μm, (15.2±8.6) μm, (19.6±5.3) μm, (17.7±5.4) μm, (26.2±6.8) μm, (87.5±12.2) μm, (17.1±2.4) μm, (176.5±27.6) μm and (90.1±4.5) μm, respectively. The AL≥27.5 mm groups were (271.0±24.1) μm, (11.6±2.8) μm, (17.3±7.6) μm, (21.3±5.1) μm, (18.9±5.8) μm, (28.4±7.3) μm, (86.5±9.3) μm, (16.7±2.5) μm, (184.2±23.6) μm and (86.9±4.5) μm, respectively. The age groups ≤ 30 years old were (263.3±23.0)μm, (10.8±3.2) μm, (14.7±7.6) μm, (19.5±5.1) μm, (17.0±4.2) μm, (26.0±4.1) μm, (86.7±9.7) μm, (17.0±1.9) μm, (173.9±22.8) μm and (89.5±3.5) μm, respectively. The age group of 31 to 39 years old was (263.8±26.1)μm, (10.7±3.1) μm, (15.2±7.3) μm, (19.7±5.0) μm, (17.0±5.4) μm, (25.5±6.1) μm, (87.0±11.8) μm, (17.1±2.1) μm, (174.8±26.8) μm and (89.1±4.3) μm, respectively. The age group ≥40 years old was (272.0±21.4)μm, (11.3±2.3) μm, (16.0±8.4) μm, (20.3±5.2) μm, (18.8±6.2) μm, (28.7±9.0) μm, (87.9±9.3) μm, (16.8±2.7) μm, (183.4±23.2) μm and (88.5±5.4) μm, respectively. The male groups were (277.7±22.1) μm, (11.8±2.4) μm, (16.9±6.3) μm, (21.3±4.3) μm, (19.3±5.3) μm, (27.9±7.7) μm, (91.4±11.5) μm, (17.1±2.1) μm, (188.7±22.3) μm and (89.0±3.7) μm, respectively. The female groups were (259.3±23.0) μm, (10.4±3.0) μm, (14.4±8.2) μm, (19.0±5.2) μm, (16.5±5.2) μm, (25.7±6.0) μm, (84.8±9.4) μm, (17.0±2.3) μm, (170.4±24.3) μm and (89.0±4.8) μm, respectively. The longer the AL, the thicker the thickness of IPL, INL, IRL, and ORL in the AL<26.5 mm group, 26.5 mm ≤AL<27.5 mm, and AL≥27.5 mm group, and the differences were statistically significant (F=3.09, 4.06, 3.37, 6.97; P<0.05). Further pairwise comparison revealed that patients with AL≥27.5 mm had thicker IPL, INL, and IRL compared to those with AL<26.5 mm, and the differences were statistically significant (t=2.58, 2.87, 2.90; P<0.05). The thickness of ORL in the AL≥27.5 mm group was thinner than that in the AL<26.5 mm group, and the AL≥27.5 mm group was thinner than that in the 26.5≤AL<27.5 group, with statistical significance (t=2.94, 3.30; P<0.05). However, there were no statistically significant differences in the retinal full thickness, RNFL, GCL, OPL, ONL, and RPE thickness among patients in different AL groups (F=2.33, 2.60, 2.88, 2.76, 0.13, 0.46; P>0.05). There were no statistically significant differences in the thickness of the entire retinal layer, RNLF, GCL, IPL, INL, OPL, ONL, RPE, IRL, and ORL among patients aged ≤30 years, 30-39 years, and ≥40 years (F=1.54, 0.63, 0.26, 0.22, 1.50, 2.68, 0.11, 0.24, 1.62, 0.45; P>0.05). The thickness of the entire retina, RNFL, IPL, INL, ONL, and IRL in the female group was thinner than that in the male group, and the differences were statistically significant (t=4.44, 2.97, 2.66, 2.88, 3.28, 4.32; P<0.05). Single factor linear regression was used to screen for factors related to the thickness of each layer of the retina, including patient′s age, gender, systolic and diastolic blood pressure, BMI, initial age of myopia, intraocular pressure, AL, and SFCT. The final multiple regression analysis found that the thickness of the full retinal layer, RNFL, INL, ONL, and IRL in the male group was thicker than that in the female group, and the correlation was statistically significant (β=- 15.40, -1.27, -2.57, -6.16, -16.77; P<0.05). The thickness of the entire retinal layer and IPL increases with increasing systolic blood pressure, and their correlation was statistically significant (β= 0.29, 0.06; P<0.05). The thickness of ORL decreases with increasing diastolic blood pressure, and its correlation was statistically significant (β=- 0.09, P<0.05). The thickness of RNFL, GCL, IPL, INL, OPL, and IRL increases with AL, and their correlation was statistically significant (β=0.49, 1.55, 0.80, 0.88, 1.21, 4.13; P<0.05).

Conclusions

The thickness of some retinal layers in patients with high myopia is related to gender, systolic blood pressure, diastolic blood pressure, and AL.

Key words: High myopia, Optical coherence tomography, Retinal thickness

Zhangfang Ma, Wei Song, Yaxing Wang. The retinal thickness changes and their associated factors in highly myopic eyes[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2024, 14(01): 26-33.

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Figures/Tables 6

References 23

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相关因素	统计值	视网膜全层厚度	RNFL	GCL	IPL	INL	OPL	ONL	RPE	IRL	ORL
年龄
	回归系数	0.40	0.30	0.08	0.04	0.11	0.07	0.09	0.008	0.43	－0.04
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10
性别
	回归系数	－18.36	－1.45	－2.53	－2.28	－2.81	－2.15	－6.51	－0.14	－18.31	0.003
	P值	<0.10	<0.10	>0.10	<0.10	<0.10	>0.10	<0.10	>0.10	<0.10	>0.10
收缩压
	回归系数	0.45	0.04	0.10	0.073	0.05	0.06	0.13	－0.008	0.48	－0.04
	P值	<0.10	<0.10	<0.10	<0.10	>0.10	>0.10	<0.10	>0.10	<0.10	>0.10
舒张压
	回归系数	0.55	0.05	0.13	0.09	0.11	0.09	0.12	－0.02	0.61	－0.07
	P值	<0.10	<0.10	<0.10	<0.10	<0.10	>0.10	>0.10	>0.10	<0.10	>0.10
BMI
	回归系数	1.57	0.15	0.29	0.25	0.24	0.22	0.32	－0.001	1.49	0.05
	P值	<0.10	<0.10	>0.10	<0.10	>0.10	>0.10	>0.10	>0.10	<0.10	>0.10
近视初始年龄
	回归系数	－0.44	－0.05	－0.15	－0.11	－0.01	－0.12	－0.06	0.08	－0.54	0.09
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10
眼压
	回归系数	－0.09	0.007	－0.13	－0.12	0.01	0.002	0.22	0.04	－0.07	－0.04
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10
AL
	回归系数	4.14	0.58	1.55	0.98	1.02	1.21	－0.44	－0.22	5.28	－1.09
	P值	<0.10	<0.10	<0.10	<0.10	<0.10	<0.10	>0.10	>0.10	<0.10	<0.10
SFCT
	回归系数	0.04	0.003	－0.004	0.01	－0.002	0.01	0.03	0.002	0.02	0.02
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	<0.10	>0.10	>0.10	<0.10

相关因素	统计值	视网膜全层厚度	RNFL	GCL	IPL	INL	OPL	ONL	RPE	IRL	ORL
年龄
	回归系数	0.40	0.30	0.08	0.04	0.11	0.07	0.09	0.008	0.43	－0.04
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10
性别
	回归系数	－18.36	－1.45	－2.53	－2.28	－2.81	－2.15	－6.51	－0.14	－18.31	0.003
	P值	<0.10	<0.10	>0.10	<0.10	<0.10	>0.10	<0.10	>0.10	<0.10	>0.10
收缩压
	回归系数	0.45	0.04	0.10	0.073	0.05	0.06	0.13	－0.008	0.48	－0.04
	P值	<0.10	<0.10	<0.10	<0.10	>0.10	>0.10	<0.10	>0.10	<0.10	>0.10
舒张压
	回归系数	0.55	0.05	0.13	0.09	0.11	0.09	0.12	－0.02	0.61	－0.07
	P值	<0.10	<0.10	<0.10	<0.10	<0.10	>0.10	>0.10	>0.10	<0.10	>0.10
BMI
	回归系数	1.57	0.15	0.29	0.25	0.24	0.22	0.32	－0.001	1.49	0.05
	P值	<0.10	<0.10	>0.10	<0.10	>0.10	>0.10	>0.10	>0.10	<0.10	>0.10
近视初始年龄
	回归系数	－0.44	－0.05	－0.15	－0.11	－0.01	－0.12	－0.06	0.08	－0.54	0.09
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10
眼压
	回归系数	－0.09	0.007	－0.13	－0.12	0.01	0.002	0.22	0.04	－0.07	－0.04
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10
AL
	回归系数	4.14	0.58	1.55	0.98	1.02	1.21	－0.44	－0.22	5.28	－1.09
	P值	<0.10	<0.10	<0.10	<0.10	<0.10	<0.10	>0.10	>0.10	<0.10	<0.10
SFCT
	回归系数	0.04	0.003	－0.004	0.01	－0.002	0.01	0.03	0.002	0.02	0.02
	P值	>0.10	>0.10	>0.10	>0.10	>0.10	>0.10	<0.10	>0.10	>0.10	<0.10

视网膜厚度或分层厚度	眼部因素或全身因素	β值	95%置信区间	P值
视网膜全层厚度
	收缩压	0.29	0.007, 0.56	<0.05
	性别	－15.40	－24.48, －6.29	<0.05
RNFL厚度
	AL	0.49	0.05, 0.93	<0.05
	性别	－1.27	－2.30, －0.24	<0.05
GCL厚度
	AL	1.55	0.39, 2.71	<0.05
IPL厚度
	AL	0.80	0.007, 1.60	<0.05
	收缩压	0.06	0.003, 0.12	<0.05
INL厚度
	年龄	0.12	0.004, 0.23	<0.05
	性别	－2.57	－4.47, －0.68	<0.05
	AL	0.88	0.07, 1.69	<0.05
OPL厚度
	AL	1.21	0.18, 2.25	<0.05
ONL厚度
	SFCT	0.02	0.001, 0.04	<0.05
	性别	－6.16	－9.83, －2.49	<0.05
IRL厚度
	性别	－16.77	－25.34, －8.20	<0.05
	AL	4.13	0.46, 7.80	<0.05
ORL厚度
	SFCT	0.02	0.01, 0.03	<0.05
	舒张压	－0.09	－0.15, －0.08	<0.05

视网膜厚度或分层厚度	眼部因素或全身因素	β值	95%置信区间	P值
视网膜全层厚度
	收缩压	0.29	0.007, 0.56	<0.05
	性别	－15.40	－24.48, －6.29	<0.05
RNFL厚度
	AL	0.49	0.05, 0.93	<0.05
	性别	－1.27	－2.30, －0.24	<0.05
GCL厚度
	AL	1.55	0.39, 2.71	<0.05
IPL厚度
	AL	0.80	0.007, 1.60	<0.05
	收缩压	0.06	0.003, 0.12	<0.05
INL厚度
	年龄	0.12	0.004, 0.23	<0.05
	性别	－2.57	－4.47, －0.68	<0.05
	AL	0.88	0.07, 1.69	<0.05
OPL厚度
	AL	1.21	0.18, 2.25	<0.05
ONL厚度
	SFCT	0.02	0.001, 0.04	<0.05
	性别	－6.16	－9.83, －2.49	<0.05
IRL厚度
	性别	－16.77	－25.34, －8.20	<0.05
	AL	4.13	0.46, 7.80	<0.05
ORL厚度
	SFCT	0.02	0.01, 0.03	<0.05
	舒张压	－0.09	－0.15, －0.08	<0.05

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