Ten-Year Incidence of Retinal Nerve Fiber Layer Defects: The Beijing Eye Study 2001/2011.

PURPOSE

We examined the 10-year incidence of localized retinal nerve fiber layer defects (RNFLDs) and associated factors in adult Chinese.

METHODS

The population-based longitudinal Beijing Eye Study, which included 4439 subjects (age, 40+ years) in 2001, was repeated in 2011 with 2695 subjects participating (66.4% of the survivors). Color fundus photographs taken at baseline and 10 years later were examined for localized RNFLDs, defined as wedge-shaped defects running toward the optic disc.

RESULTS

Fundus photographs were available for 2422 (89.9%) subjects. Incident-localized RNFLDs were detected in 114/2422 persons (4.7% ± 0.2%) or 139/4867 eyes (2.9% ± 0.2%). A total of 25 (22%) persons had incident-localized RNFLDs bilaterally, and 89 (78%) persons unilaterally. Among the 114 persons with incident RNFLDs, 78 persons showed newly developed localized RNFLDs, while 36 subjects showed an enlargement of a preexisting localized RNFLD. In binary logistic regression analysis, a higher 10-year incidence of localized RNFLDs was significantly associated with a higher prevalence of arterial hypertension (P = 0.002; odds ratio [OR], 2.31; 95% confidence interval (CI), 1.35, 3.97), higher diastolic blood pressure (P = 0.02; OR, 1.02; 95% CI, 1.004,1.04), higher prevalence of previous cerebrovascular infarctions (P = 0.007; OR, 2.61; 95% CI, 1.30, 5.22), younger age (P = 0.01; OR, 0.97; 95% CI, 0.94, 0.99), higher prevalence of diabetic retinopathy (P = 0.001; OR, 4.70; 95% CI, 1.92, 11.5), higher prevalence of open-angle (P < 0.001; OR, 39.8; 95% CI, 19.7, 80.5) and angle-closure (P < 0.001; OR, 21.3; 95% CI, 7.90, 57.5) glaucoma, and thinner retinal nerve fiber layer (P < 0.001; OR, 0.97; 95% CI, 0.95, 0.98).

CONCLUSIONS

The 10-year incidence of localized RNFLDs in adult Chinese is 4.7% ± 0.2%. It is strongly associated with arterial hypertension and higher prevalence of cerebrovascular infarcts, in addition to ocular reasons, such as glaucoma and diabetic retinopathy. Ophthalmologically normal subjects with incident-localized RNFLDs may be screened for arterial hypertension and cerebrovascular infarcts.