Peripapillary Retinal Nerve Fiber Layer Profile in Relation to Refractive Error and Axial Length: Results From the Gutenberg Health Study

Purpose: To investigate the retinal nerve fiber layer profile measured by optical coherence tomography and its relation to refractive error and axial length. Methods: The Gutenberg Health Study is a population-based study in Mainz, Germany. At the five-year follow-up examination, participants underwent optical coherence tomography, objective refraction and biometry. Peripapillary retinal nerve fiber layer (pRNFL) was segmented using proprietary software. The pRNFL profiles were compared between different refraction groups and the angle between the maxima, i.e., the peaks of pRNFL thickness in the upper and lower hemisphere (angle between the maxima of pRNFL thickness [AMR]) was computed. Multivariable linear regression analysis was carried out to determine associations of pRNFL profile (AMR) including age, sex, optic disc size, and axial length in model 1 and spherical equivalent in model 2. Results: A total of 5387 participants were included. AMR was 145.3 degrees +/- 23.4 degrees in right eyes and 151.8 degrees +/- 26.7 degrees in left eyes and the pRNFL profile was significant different in the upper hemisphere. The AMRdecreased with increasing axial length by-5.86 degrees/mm (95% confidence interval [CI]: [-6.44; -5.29], P < 0.001), female sex (-7.61 degrees; 95% CI: [-8.71; -6.51], P < 0.001) and increased with higher age (0.08 degrees/year; 95% CI: [0.03; 0.14], P = 0.002) and larger optic disc size (2.29 degrees/mm2; 95% CI: [1.18; 3.41], P < 0.001). In phakic eyes, AMRincreased with hyperopic refractive errorby 2.60 degrees/diopters (dpt) (95% CI: [2.33; 2.88], P < 0.001). Conclusions: The pRNFL profiles are related to individual ocular and systemic parameters. Translational Relevance: Biometric parameters should be considered when pRNFL profiles are interpreted in diagnostics, i.e., in glaucoma.