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Peaks of circumpapillary retinal nerve fibre layer and associations in healthy eyes: the Beijing Eye Study 2011
  1. Qing Zhang1,
  2. Liang Xu1,
  3. Liang Zhao1,
  4. Rahul A Jonas2,
  5. Ya Xing Wang1,
  6. Jost B Jonas1,3,4
  1. 1 Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
  2. 2 Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
  3. 3 Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
  4. 4 Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
  1. Correspondence to Dr Ya Xing Wang, Beijing Tongren Hospital, Beijing 100005, China; yaxingw{at}


Aims To investigate the distribution and associations of the circumpapillary retinal nerve fibre layer thickness (RNFLT) profile, characterised as peak height and peak position, in healthy eyes.

Methods 667 healthy participants (294 male) were randomly selected from the Beijing Eye Study 2011. RNFLT was measured at 768 points at 3.4 mm circumpapillary position using spectral-domain optical coherence tomography (OCT). The location and height of the superior temporally peak (PeakST), superior nasal peak (PeakSN) and inferior temporal peak (PeakIT) were assessed.

Results The RNFLT was thickest at PeakIT (194±25 µm; location: 288±12°), followed by PeakST (182±25 µm; 73±10°) and PeakSN (125±23 µm; 135°±13°). In multivariable analysis, peak RNFLT decreased with longer axial length (p<0.001; correlation coefficient beta: −0.18 to −0.15; all peaks), older age (all p<0.01, beta: −0.10; PeakST and PeakIT), female gender (p=0.026, beta: −0.09; PeakST), and larger parapapillary gamma zone and beta zone width (p≤0.004, beta: −0.16 to−0.11; PeakSN). The temporal peaks were located more closely to the horizontal line in women (p≤0.020, beta: 0.09–0.11) and with longer axial length (p<0.001, beta: 0.27–0.31), while they were located more inferiorly in eyes with larger Bruch’s membrane openings (BMOs) (p≤0.01, beta:0.10~0.11).

Conclusions Peak RNFLT decreased by 0.34 µm for each increase of year in age (PeakST and PeakIT), by 3.2–3.5 µm for each 1 mm increase in axial length (all three peaks), and was 4.5 µm thinner in women than in men. The position of temporal peaks depended on gender, axial length and BMO diameter. These associations should be taken into count in OCT-based RNFLT assessment for disease finding, especially in glaucoma evaluation.

  • glaucoma
  • imaging
  • optic nerve

Data availability statement

Data are available on reasonable request. Anonymous population database, which will be available on reasonable request.

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Data availability statement

Data are available on reasonable request. Anonymous population database, which will be available on reasonable request.

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  • Contributors Conception and design: YXW, JBJ; Data analysis: QZ, YXW. Interpretation: YXW, QZ, LZ, RAJ; Writing: QZ, YXW, JBJ; Data collection: YXW, LZ, JBJ. YXW and JBJ share the last authorship.

  • Funding This study was funded by National Natural Science Foundation of China (#81570835).

  • Disclaimer All the figures were illustrated by YXW.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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