Prevalence of retinal nerve fiber layer defects: The Korea National Health and Nutrition Examination Survey 2008–2012

PurposeTo investigate the prevalence and associated factors of retinal nerve fiber layer defects (RNFLDs) in a Korean population.MethodsThe Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based study using a complex, stratified, multistage, probability-cluster survey. We performed a review of 2008–2012 data from the KNHANES. Two masked ophthalmologists evaluated fundus photography to detect RNFLDs. All participants underwent ocular and systemic evaluations.ResultsA total of 28,637 subjects aged ≥ 19 years with at least one evaluable fundus photograph were enrolled. The estimated prevalence of RNFLDs in this Korean population was 4.8% (95% confidence interval, 4.4%–5.3%). The estimated percentages of glaucomatous RNFLD and non-glaucomatous RNFLD subjects were 34.4% and 65.6%, respectively. In a multivariate analysis, the prevalence of RNFLDs was significantly associated with older age (P P = 0.047), glycosylated hemoglobin (P = 0.048), disc hemorrhage (P = 0.016), ISNT rule (P P ConclusionsThe prevalence of RNFLDs in a large Korean population-based sample with a minimum age of 19 years was 4.8%. RNFLD prevalence was associated with old age, male gender, glycosylated hemoglobin, disc hemorrhage, and glaucomatous optic disc.研究目的：本研究旨在调查韩国人群视网膜神经纤维层缺损（retinal nerve fiber layer defects, RNFLDs）的患病率及其相关影响因素。方法：韩国国民健康与营养检查调查（Korea National Health and Nutrition Examination Survey, KNHANES）是一项基于人群的复杂分层、多阶段整群概率抽样调查研究。本研究回顾分析了2008至2012年KNHANES的调研数据。由两名设盲的眼科医师对眼底照片进行评估以检测视网膜神经纤维层缺损。所有受试者均接受了眼部及全身系统检查。结果：本研究共纳入28637名年龄≥19岁且至少拥有一张可评估眼底照片的受试者。韩国人群中视网膜神经纤维层缺损的估算患病率为4.8%（95%置信区间：4.4%~5.3%）。其中青光眼性视网膜神经纤维层缺损与非青光眼性视网膜神经纤维层缺损的受试者占比分别为34.4%与65.6%。多因素分析结果显示，视网膜神经纤维层缺损的患病率与高龄（P<0.001）、男性性别（P=0.022）、糖化血红蛋白（P=0.048）、视盘出血（P=0.016）以及ISNT法则（ISNT rule）异常（P<0.001）显著相关。结论：在年龄≥19岁的大型韩国人群抽样队列中，视网膜神经纤维层缺损的患病率为4.8%。该缺损的患病率与高龄、男性性别、糖化血红蛋白水平、视盘出血及青光眼性视盘改变显著相关。