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Within-subject variability in human retinal nerve fiber bundle width.
William H Swanson1, Brett J King1, Stephen A Burns1
1School of Optometry, Indiana University, Bloomington, Indiana, United States of America.
Plos One
|October 17, 2019
Summary
Retinal nerve fiber bundle width measurements show high variability within individuals, limiting their clinical use for detecting glaucoma. This variability suggests potential selection bias in bundle width assessments.
Area of Science:
- Ophthalmology
- Optometry
- Medical Imaging
Background:
- High-resolution imaging fuels interest in new retinal nerve fiber layer (RNFL) integrity metrics.
- Retinal nerve fiber bundle (RNFB) width measurement is proposed for glaucoma detection due to low between-subject variability.
- Concerns exist regarding substantial within-subject variability in individual RNFB width.
Purpose of the Study:
- To assess within-subject variability in RNFB width as a potential source of selection bias.
- To evaluate the clinical utility of RNFB width measurements in glaucoma diagnosis.
Main Methods:
- Adaptive optics scanning laser ophthalmoscope (AOSLO) used to measure individual RNFB widths.
- Pilot study on one participant, followed by main study on 10 healthy young adults.
- Measurements focused on RNFL in healthy eyes to determine variability.
Main Results:
- RNFB widths ranged from 9 μm to 55 μm across all participants.
- Every measured eye exhibited significant within-subject variability in RNFB width (exceeding 19 μm).
- Width variation observed even over short distances (<300 μm) within single RNFBs.
Conclusions:
- High within-subject variability in RNFB width complicates accurate disease assessment.
- RNFB width measurements are susceptible to selection bias, limiting their clinical applicability for glaucoma.
- Further research may be needed to explore alternative metrics for RNFL integrity.
