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      The Effect of Axial Length on the Thickness of Intraretinal Layers of the Macula

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          Abstract

          Purpose

          The aim of this study was to evaluate the effect of axial length (AL) on the thickness of intraretinal layers in the macula using optical coherence tomography (OCT) image analysis.

          Methods

          Fifty three randomly selected eyes of 53 healthy subjects were recruited for this study. The median age of the participants was 29 years (range: 6 to 67 years). AL was measured for each eye using a Lenstar LS 900 device. OCT imaging of the macula was also performed by Stratus OCT. OCTRIMA software was used to process the raw OCT scans and to determine the weighted mean thickness of 6 intraretinal layers and the total retina. Partial correlation test was performed to assess the correlation between the AL and the thickness values.

          Results

          Total retinal thickness showed moderate negative correlation with AL (r = -0.378, p = 0.0007), while no correlation was observed between the thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCC), retinal pigment epithelium (RPE) and AL. Moderate negative correlation was observed also between the thickness of the ganglion cell layer and inner plexiform layer complex (GCL+IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL) and AL which were more pronounced in the peripheral ring (r = -0.402, p = 0.004; r = -0.429, p = 0.002; r = -0.360, p = 0.01; r = -0.448, p = 0.001).

          Conclusions

          Our results have shown that the thickness of the nuclear layers and the total retina is correlated with AL. The reason underlying this could be the lateral stretching capability of these layers; however, further research is warranted to prove this theory. Our results suggest that the effect of AL on retinal layers should be taken into account in future studies.

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          Most cited references31

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          Effects of age, sex, and axial length on the three-dimensional profile of normal macular layer structures.

          To identify sex-related differences and age-related changes in individual retinal layer thicknesses in a population of healthy eyes across the lifespan, using spectral domain optical coherence tomography (SD-OCT). In seven institutes in Japan, mean thicknesses of the 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), photoreceptor inner segment (IS), and photoreceptor outer segment (OS) were measured using SD-OCT with a new automated segmentation protocol in 256 healthy subjects. Interoperator coefficients of variability for measurements of each layer ranged from 0.012 to 0.038. The RNFL, GCL, IPL, and INL were thinnest in the foveal area, whereas the OPL+ONL and OS were thickest in this area. Mean thicknesses of the INL and the OPL+ONL were significantly greater in men (P = 0.002 and 0.001, respectively). However, mean RNFL thickness was greater in women (P = 0.006). Thicknesses of the RNFL, GCL, IPL, INL, and IS correlated negatively with age. Thickness of the OPL+ONL was not correlated with age, and thickness of the OS correlated positively with age. Inner retinal (RNFL+GCL+IPL) thickness over the whole macula correlated negatively with age (P < 0.001), but outer retinal (OPL+ONL+IS+OS) thickness did not. Thicknesses of layers did not correlate with axial length. Macular layer thicknesses measured on SD-OCT images in healthy eyes showed significant variations by sex and age. These findings should inform macular layer thickness analyses in SD-OCT studies of retinal diseases and glaucoma.
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            Biomechanical properties of keratoconus and normal corneas.

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              Macular thickness variations with sex, age, and axial length in healthy subjects: a spectral domain-optical coherence tomography study.

              To assess the relationship between macular retinal thickness and volume and age, sex, and refractive error/axial length with spectral domain-optical coherence tomography (SD-OCT). One randomly selected eye of 198 consecutive ophthalmically normal subjects (104 men, 94 women) between July 2008 and January 2009, with corrected visual acuities better than 20/30 were included in this cross-sectional study. Complete ophthalmic examination, axial length measurement with a laser interferometer, and macular cube 512 x 128 scan by SD-OCT were performed. The mean age was 55.6 +/- 16.4 years (range, 17-83), average refractive error was -2.17 +/- 4.82 (range, -23.50-3.75), and average axial length was 24.73 +/- 1.98 mm (range, 21.52-32.51). The central subfield thickness, average inner macular thickness, and overall macular volume were significantly lower in the female subjects (partial correlation: P = 0.009, P = 0.027, and P = 0.042, respectively). As age increased, average inner macular thickness, average outer macular thickness, overall average macular thickness, and macular volume decreased significantly (partial correlation: P = 0.002, P = 0.002, P = 0.002, and P = 0.000, respectively). Refractive error had no significant influence in partial correlation analysis. Axial length correlated negatively with average outer macular thickness, overall average macular thickness, and macular volume (partial correlation: P = 0.006, P = 0.044, and P = 0.003, respectively). In normal subjects, SD-OCT showed that retinal thickness is related to age, sex, and axial length, with regional variations.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                6 November 2015
                2015
                : 10
                : 11
                : e0142383
                Affiliations
                [1 ]Department of Ophthalmology, Semmelweis University, Budapest, Hungary
                [2 ]Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States of America
                Massachusetts Eye & Ear Infirmary, Harvard Medical School, UNITED STATES
                Author notes

                Competing Interests: The University of Miami and Dr. Cabrera DeBuc hold a pending patent used in the study and have the potential for financial benefit from its future commercialization. The remaining authors declared that no competing interests exist. The data of the patent are the following: Name: System and method for early detection of diabetic retinopathy using optical coherence tomography Pub. No.: WO/2010/080576 International Application No.: PCT/US2009/068653. This does not alter the authors′ adherence to all the PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: A. Szigeti ET GMS. Performed the experiments: ZZN JN BEV ET. Analyzed the data: A. Szigeti A. Szamosi ET. Contributed reagents/materials/analysis tools: JN ZZN GMS DCD. Wrote the paper: A. Szigeti ET BEV JN ZZN A. Szamosi GMS DCD.

                Article
                PONE-D-15-16942
                10.1371/journal.pone.0142383
                4636257
                26544553
                2c6a4dd5-648f-4a20-8009-12c24f9e691f
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 19 April 2015
                : 21 October 2015
                Page count
                Figures: 2, Tables: 2, Pages: 11
                Funding
                This study was supported in part by a Juvenile Diabetes Research Foundation Grant, a NIH Grant No. NIH R01EY020607, a NIH Center Grant No. P30-EY014801, by an unrestricted grant to the University of Miami from Research to Prevent Blindness, Inc., by a research fellowship of the Helen Keller Foundation for Research and Education (GMS), the Eötvös Scholarship of the Hungarian Scholarship Fund, and by the Zsigmond Diabetes Fund of the Hungarian Academy of Sciences.
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                All relevant data are within the paper and its Supporting Information files.

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