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Quantification of peripapillary nerve fibre elevation and its association with axial length, optic disc tilt, and parapapillary atrophy area in young, healthy eyes

Eye volume 38, pages 1112–1117 (2024)Cite this article

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Abstract

Background

Eyes with peripapillary nerve fibre elevation (pNFE) may have a gap between the optic nerve papillary margin on colour fundus photography and Bruch’s membrane opening on cross-sectional optical coherence tomography (OCT). This study was conducted to evaluate the quantification of the height of pNFE in young healthy eyes and examine the relationship between pNFE height and axial length.

Methods

A prospective, observational, cross-sectional study was performed involving 117 right eyes. All participants (mean age 25.8 years) underwent comprehensive ophthalmologic examination involving axial length, fundus photography, and peripapillary and optic disc OCT. pNFE height was defined as the distance between the retinal surface plane and the upper edge of the pNFE in optic disc cross-sectional OCT images. Optic disc tilt was evaluated using a sine curve on retinal nerve fibre layer B-scan images. Parapapillary atrophy (PPA) area in colour fundus images was calculated using ImageJ and corrected using Bennett’s formula. We evaluated relationships between pNFE height, axial length, optic disc papillary tilt, and PPA area using Spearman’s correlation analysis.

Results

Sixty-five eyes had pNFE, with a mean pNFE height of 84.7 μm. pNFE height was significantly positively correlated with axial length (r = 0.32, p < 0.001), optic disc tilt (r = 0.25, p = 0.008), and PPA area (r = 0.27, p = 0.004).

Conclusions

pNFE is not rare in young healthy eyes. Eyes with higher pNFE had a longer axial length and larger optic disc tilt and PPA area.

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Fig. 1: Characteristics of peripapillary nerve fibre elevation (pNFE).
Fig. 2: Scheme of quantification of peripapillary nerve fibre elevation (pNFE) in an optic disc horizontal cross-sectional image.
Fig. 3: Relationship between pNFE height and ocular parameters.
Fig. 4: Representative cases of discrepancy in the degree of peripapillary nerve fibre elevation (pNFE) and parapapillary atrophy (PPA) area.

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Data availability

Data is available upon reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing. This work was supported in part by JSPS KAKENHI grant 15H04996. The funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.

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Authors and Affiliations

  1. Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

    Kazuki Fujiwara, Takehiro Yamashita, Hiroto Terasaki, Kumiko Nakao & Taiji Sakamoto

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  1. Kazuki Fujiwara
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  2. Takehiro Yamashita
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  3. Hiroto Terasaki
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  4. Kumiko Nakao
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  5. Taiji Sakamoto
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Contributions

Conception or design of the work: TY. Acquisition, analysis, or interpretation of data: KF, TY, HT, KN, TS. Draughting the work: KF, TY. Revising the work: HT, KN, TS.

Corresponding author

Correspondence to Hiroto Terasaki.

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The authors declare no competing interests.

Ethics

All the procedures conformed to the tenets of the Declaration of Helsinki. We obtained written informed consent from all participants following an explanation of the procedures used. We obtained official approval for this study from the Ethics Committee of Kagoshima University Hospital and registered it with the University Hospital Medical Network Clinical Trials Registry (the registration number; UMIN000007154).

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Fujiwara, K., Yamashita, T., Terasaki, H. et al. Quantification of peripapillary nerve fibre elevation and its association with axial length, optic disc tilt, and parapapillary atrophy area in young, healthy eyes. Eye 38, 1112–1117 (2024). https://doi.org/10.1038/s41433-023-02827-y

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