Aim To study relationships between reported risk factors for glaucoma and neuroretinal rim area in normal eyes.
Methods The Kumejima study participants, 3762 of the 4632 eligible Kumejima residents 40 years and older, underwent a detailed ocular examination including sequential disc stereo photography. In a randomly chosen eye of a subject whose both eyes met the inclusion criteria, fundus photographs of 2474 ophthalmologically normal eyes of the 2474 subjects were analysed by computer-assisted planimetry to measure the disc, rim and β-peripapillary atrophy (PPA) areas. The rim was divided into the superior and inferior halves by a line connecting the fovea and disc centre.
Results The disc, superior and inferior halves rim and β-PPA areas averaged 2.53±0.50 (SD), 0.82±0.15, 0.84±0.16 and 0.45±0.66 mm2. After adjustment for other systemic and ocular factors including age, disc and β-PPA areas, disc–fovea distance (p=0.013, 0.016) correlated positively and intraocular pressure (IOP) (p=0.004, 0.006) and axial length (AL) (p<0.000, 0.004) negatively with the superior and inferior halves rim area, respectively; central corneal thickness (CCT) (p=0.008) and mean blood pressure (mBP) (p=0.020) correlated positively and male gender (p=0.012) negatively only with the superior half rims.
Conclusions Besides previously reported risk factors for glaucoma such as age or IOP, thinner CCT, lower mBP and male gender were newly found to significantly correlate with smaller rim area only in the superior half disc, and a greater disc–fovea distance with greater superior and inferior half rim areas in normal adult eyes.
- optic nerve
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SS since deceased
Contributors AI: conceptualisation, data curation, formal analysis, investigation, methodology, writing—original draft, writing—review and editing. SS: conceptualisation, data curation, funding acquisition, investigation, methodology, project administration, resources. KT: data analysis. TT: data analysis. MA: conceptualisation, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, writing—original draft, writing—review and editing.
Funding Grant-in-Aid for Scientific Research by the Ministry of Health, Labour and Welfare of Japan (H18-Sensory-General-001) and a Grant-in-Aid for Scientific Research (C) 17591845 from the Ministry of Education, Culture, Sports, Science and Technology, Japan, and funds from the Japan National Society for the Prevention of Blindness, Tokyo.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The ethics board of the regional council approved the study protocol.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement The data are from the Kumejima Study and are owned by the Japanese Glaucoma Society (JGS). Data access is strictly restricted to researchers who are members of the JGS and are accepted by the society. Data is restricted to JGS members due to a contract agreed between Kumejima Town and the JGS, following the municipal law of Kumejima Town for protecting private information. To manage the epidemiological data which the JGS gathered, the JGS has the Epidemiology Study Group Data Center (JGS Data Analysis Group, Tajimi Branch),
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