ArticleOphthalmology2020
Sex-Specific Differences in Circumpapillary Retinal Nerve Fiber Layer Thickness.
Article in Ophthalmology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 72 citations in OpenAlex.
- In Vivo Human Cone Photoreceptor Inner Segment Diameter Database Using Adaptive Optics Retinal Imaging.Investigative ophthalmology & visual science · 2026Article
- RNFL Thickness in a Population-Based Cohort: The Canadian Longitudinal Study on Aging M2M (Machine-to-Machine) Study.American journal of ophthalmology · 2026Article
- The Rates of Retinal Nerve Fiber Layer Change in Children With Optic Disc Drusen.Ophthalmology science · 2026Article
- Gender disparities in the association between macular thickness and cognitive function among elderly individuals in China.BMC geriatrics · 2025Article
- The Association of Polygenic Risk Score With Glaucoma and Its Related Traits: Results From Two German Population-Based Studies.Investigative ophthalmology & visual science · 2025Article
- Retinal OCT biomarkers and their association with cognitive function-clinical and AI approaches.Die Ophthalmologie · 2025Article
- Retinal nerve fibre layer thickness is associated with attention and predicts risk states of dementia.Brain communications · 2025Article
- Development and evaluation of customized software to automatically align macula and optic disc centered scanning laser ophthalmoscope fundus images.PeerJ. Computer science · 2025Article
- Association between retinal layer thickness and postoperative delirium in older patients.General psychiatry · 2025Article
- A cross-sectional study on the impact of hemodialysis duration on retinal nerve fiber layer thinning in hemodialysis patients.Scientific reports · 2024Article
- Glucose tolerance and insulin resistance/sensitivity associate with retinal layer characteristics: the LIFE-Adult-Study.Diabetologia · 2024Article
- Papillary and peripapillary vascular densities and corresponding correlation with peripapillary retinal thicknesses using optical coherence tomography angiography in healthy children and adolescents.Scientific reports · 2024Article
- Aging-associated changes of optical coherence tomography-measured ganglion cell-related retinal layer thickness and visual sensitivity in normal Japanese.Japanese journal of ophthalmology · 2024Observational
- [Retinal optical coherence tomography biomarkers and their association with cognitive functions : Clinical and artificial intelligence approaches. German version].Die Ophthalmologie · 2024Review
- Normative Percentiles of Retinal Nerve Fiber Layer Thickness and Glaucomatous Visual Field Loss.Translational vision science & technology · 2023Article
- Retinal hypoplasia and degeneration result in vision loss in Friedreich ataxia.Annals of clinical and translational neurology · 2023Article
- Development of a deep learning system to detect glaucoma using macular vertical optical coherence tomography scans of myopic eyes.Scientific reports · 2023Article
- Prevalence and Characteristics of Peripapillary Gamma Zone in Children With Different Refractive Status: The Hong Kong Children Eye Study.Investigative ophthalmology & visual science · 2023Article
- Cohort Profile: The LIFE-Adult-Study.International journal of epidemiology · 2023Article
- Sex-related difference in the retinal structure of young adults: a machine learning approach.Frontiers in medicine · 2023Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeTo investigate the role of sex on retinal nerve fiber layer (RNFL) thickness at 768 circumpapillary locations based on OCT findings.
designPopulation-based cross-sectional study.
participantsWe investigated 5646 eyes of 5646 healthy participants from the Leipzig Research Centre for Civilization Diseases (LIFE)-Adult Study of a predominantly white population.
methodsAll participants underwent standardized systemic assessments and ocular imaging. Circumpapillary RNFL (cRNFL) thickness was measured at 768 points equidistant from the optic nerve head using spectral-domain OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany). To control ocular magnification effects, the true scanning radius was estimated by scanning focus. Student t test was used to evaluate sex differences in cRNFL thickness globally and at each of the 768 locations. Multivariable linear regression and analysis of variance were used to evaluate individual contributions of various factors to cRNFL thickness variance.
main outcome measuresDifference in cRNFL thickness between males and females.
resultsOur population consisted of 54.8% females. The global cRNFL thickness was 1 μm thicker in females (P < 0.001). However, detailed analysis at each of the 768 locations revealed substantial location specificity of the sex effects, with RNFL thickness difference ranging from -9.98 to +8.00 μm. Females showed significantly thicker RNFLs in the temporal, superotemporal, nasal, inferonasal, and inferotemporal regions (43.6% of 768 locations), whereas males showed significantly thicker RNFLs in the superior region (13.2%). The results were similar after adjusting for age, body height, and scanning radius. The superotemporal and inferotemporal RNFL peaks shifted temporally in females by 2.4° and 1.9°, respectively. On regions with significant sex effects, sex explained more RNFL thickness variance than age, whereas the major peak locations and interpeak angle explained most of the RNFL thickness variance unexplained by sex.
conclusionsSubstantial sex effects on cRNFL thickness were found at 56.8% of all 768 circumpapillary locations, with specific patterns for different sectors. Over large regions, sex was at least as important in explaining the cRNFL thickness variance as was age, which is well established to have a substantial impact on cRNFL thickness. Including sex in the cRNFL thickness norm could therefore improve glaucoma diagnosis and monitoring.
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