Document Type
Article
Publication Date
5-1-2025
Abstract
PURPOSE: Retinal nerve fiber layer thickness (RNFLT), a glaucoma biomarker, has a wide normative range affecting its sensitivity and specificity for abnormality detection. The interindividual RNFLT peak location variability contribution to this wide normative range has not been directly evaluated. The purpose of this study is to assess the effect of RNFLT peak normalization (PN) on normative variability.
METHODS: Circumpapillary RNFLT profiles at 1.7 mm radius from the optic nerve head (ONH) were re-sampled from optical coherence tomography (OCT) volumes (Cirrus HD-OCT, 200 × 200) obtained from one eye of 83 healthy individuals. Fovea-ONH axis (FOA) was calculated from corresponding scanning laser ophthalmoscope images. Supratemporal (ST) and infratemporal (IT) RNFLT peaks of each profile were aligned to respective average peak locations. Normative ranges were calculated by averaging individual profiles before and after PN (with and without FOA to horizontal image axis (HA) alignment).
RESULTS: RNFLT-PN resulted in an overall decrease in coefficient of variation (CoV) of the normative range by 4.2% (P = 0.02). CoV was reduced by more than 10% in clock-hours 10 (11.9%), 8 (10.6%), 6 (10.4%) after PN, and 7 (16.3%), 10 (11.4%), and 12 (10.4%) after PN with FOA-HA alignment. RNFLT-PN corrected for abnormality categorization because of peak misalignment in RNFLT profiles of healthy and glaucoma suspect subjects.
CONCLUSIONS: RNFLT-PN reduces normative variability, especially in the ST and IT regions.
TRANSLATIONAL RELEVANCE: RNFLT-PN reduces normative variability and improves sectoral abnormality categorization, potentially leading to better sensitivity and specificity of RNFLT measure in glaucoma detection.
Recommended Citation
Gowrisankaran, Sowjanya; Abbasi, Ashkan; Song, Xubo; Schuman, Joel; Wollstein, Gadi; Antony, Bhavna; and Ishikawa, Hiroshi, "Normative Variability in Retinal Nerve Fiber Layer Thickness: Does It Matter Where the Peaks Are?" (2025). Wills Eye Hospital Papers. Paper 250.
https://jdc.jefferson.edu/willsfp/250
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
40354067
Language
English
Included in
Biological Factors Commons, Diagnosis Commons, Eye Diseases Commons, Investigative Techniques Commons, Ophthalmology Commons
Comments
This article is the author's final published version in Translational vision science & technology, Volume 14, Issue 5, May 2025, Article number 13.
The published version is available at https://doi.org/10.1167/tvst.14.5.13.
Copyright © 2025 The Authors