Surgical and radiologic anatomy : SRA · 2026
Quadrant-specific anatomical architecture of the peripapillary retinal nerve fiber layer: a spectral-domain optical coherence tomography study.
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Doğan Banu Çiçek, Kapakin Samet, Sirem Muhammed Raşit
Аннотация
PURPOSE: To evaluate the quadrant-specific anatomical organization of the peripapillary retinal nerve fiber layer (RNFL) and identify the independent determinants of global RNFL thickness in healthy adults using spectral-domain optical coherence tomography (SD-OCT).
METHODS: This retrospective cross-sectional study included 188 healthy adults (18-76 years). Medical records containing SD-OCT-derived peripapillary RNFL and optic nerve head measurements were reviewed retrospectively. Only right eyes were analyzed to avoid inter-eye correlation. Quadrant-specific RNFL differences were evaluated using the Friedman test with Bonferroni-adjusted pairwise comparisons. Associations with age, spherical equivalent, and neuroretinal rim area were examined using Spearman's correlation, followed by multiple linear regression analysis.
RESULTS: Mean global RNFL thickness was 107.86 ± 8.97 μm. RNFL thickness followed the ISNT pattern (inferior > superior > nasal > temporal). Quadrant differences were significant (χ2 = 476.315, p < 0.001; Kendall's W = 0.845). Global RNFL thickness correlated negatively with age (ρ = - 0.158, p = 0.031) and positively with neuroretinal rim area (ρ = 0.288, p < 0.001). Myopic participants had thinner RNFL than emmetropic participants (adjusted p = 0.013). Age, spherical equivalent, and neuroretinal rim area were independent predictors of RNFL thickness, whereas sex was not (p = 0.133).
CONCLUSION: In healthy adults, peripapillary RNFL thickness exhibits a highly organized anatomical architecture characterized by the ISNT pattern, consistent with the topographic organization of retinal ganglion cell axons around the optic nerve head. OCT-derived RNFL measurements should therefore be interpreted in the context of age, refractive status, and neuroretinal rim area.
METHODS: This retrospective cross-sectional study included 188 healthy adults (18-76 years). Medical records containing SD-OCT-derived peripapillary RNFL and optic nerve head measurements were reviewed retrospectively. Only right eyes were analyzed to avoid inter-eye correlation. Quadrant-specific RNFL differences were evaluated using the Friedman test with Bonferroni-adjusted pairwise comparisons. Associations with age, spherical equivalent, and neuroretinal rim area were examined using Spearman's correlation, followed by multiple linear regression analysis.
RESULTS: Mean global RNFL thickness was 107.86 ± 8.97 μm. RNFL thickness followed the ISNT pattern (inferior > superior > nasal > temporal). Quadrant differences were significant (χ2 = 476.315, p < 0.001; Kendall's W = 0.845). Global RNFL thickness correlated negatively with age (ρ = - 0.158, p = 0.031) and positively with neuroretinal rim area (ρ = 0.288, p < 0.001). Myopic participants had thinner RNFL than emmetropic participants (adjusted p = 0.013). Age, spherical equivalent, and neuroretinal rim area were independent predictors of RNFL thickness, whereas sex was not (p = 0.133).
CONCLUSION: In healthy adults, peripapillary RNFL thickness exhibits a highly organized anatomical architecture characterized by the ISNT pattern, consistent with the topographic organization of retinal ganglion cell axons around the optic nerve head. OCT-derived RNFL measurements should therefore be interpreted in the context of age, refractive status, and neuroretinal rim area.