Axial Length-Adjusted Normative Reference Values for Retinal Layer Thickness in a Population-Based OCT Study.
- 1Department of Ophthalmology, Sensory Organ Research Institute, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
- 2Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
Purpose
To establish axial length-adjusted normative reference values for retinal layer thickness using population-based optical coherence tomography (OCT) data and evaluate their clinical implications in highly myopic eyes.Methods
This cross-sectional study used Korea National Health and Nutrition Examination Survey 2017-2021 data. Participants aged ≥19 years with reliable OCT and axial length measurements and without major ophthalmic disease were included. Sampling-weighted quantile regression adjusted for age and sex estimated axial length-specific percentiles for peripapillary retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), and outer retinal thickness, with cluster-bootstrap 95% confidence intervals respecting the survey design. Reference values covered the data-supported range (22-28 mm). RNFL abnormality was reclassified in highly myopic eyes (axial length ≥26.5 mm; sensitivity analysis, ≥26.0 mm).Results
Overall, 10,062 participants were included. Between axial lengths of 22 and 27 mm, median RNFL thickness decreased significantly by 12.4 µm (13.1%; 95% confidence interval [CI], 10.9-13.5; P < 0.001) and GCIPL by 8.2 µm (10.1%; 95% CI, 7.2-9.3; P < 0.001), whereas outer retinal thickness decreased by only 3.2 µm (2.5%). Among 402 highly myopic eyes, the proportion with abnormal average RNFL thickness fell from 16.7% to 4.0% after axial length adjustment (51 of 67 abnormal eyes reclassified as normal), whereas the temporal quadrant showed the opposite pattern.Conclusions
Retinal layer thickness varies substantially according to axial length, particularly in inner retinal layers. Axial length-adjusted normative references may improve OCT interpretation in highly myopic eyes.Translational relevance
Incorporating axial length into OCT normative interpretation may improve clinical assessment of retinal thickness in increasingly myopic populations.
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BibTeX
@article{song2026axial,
title = {{Axial Length-Adjusted Normative Reference Values for Retinal Layer Thickness in a Population-Based OCT Study.}},
author = {Mi Yeon Song and Min Seong Kim and Mingui Kong},
journal = {Translational vision science \& technology},
year = {2026},
month = oct,
doi = {10.1167/tvst.15.10.5},
url = {https://europepmc.org/article/MED/42836718},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Axial Length-Adjusted Normative Reference Values for Retinal Layer Thickness in a Population-Based OCT Study.
AU - Mi Yeon Song
AU - Min Seong Kim
AU - Mingui Kong
PY - 2026
DA - 2026/10/01
JO - Translational vision science & technology
DO - 10.1167/tvst.15.10.5
UR - https://europepmc.org/article/MED/42836718
AB - Purpose To establish axial length-adjusted normative reference values for retinal layer thickness using population-based optical coherence tomography (OCT) data and evaluate their clinical implications in highly myopic eyes.Methods This cross-sectional study used Korea National Health and Nutrition Examination Survey 2017-2021 data. Participants aged ≥19 years with reliable OCT and axial length measurements and without major ophthalmic disease were included. Sampling-weighted quantile regression adjusted for age and sex estimated axial length-specific percentiles for peripapillary retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), and outer retinal thickness, with cluster-bootstrap 95% confidence intervals respecting the survey design. Reference values covered the data-supported range (22-28 mm). RNFL abnormality was reclassified in highly myopic eyes (axial length ≥26.5 mm; sensitivity analysis, ≥26.0 mm).Results Overall, 10,062 participants were included. Between axial lengths of 22 and 27 mm, median RNFL thickness decreased significantly by 12.4 µm (13.1%; 95% confidence interval [CI], 10.9-13.5; P < 0.001) and GCIPL by 8.2 µm (10.1%; 95% CI, 7.2-9.3; P < 0.001), whereas outer retinal thickness decreased by only 3.2 µm (2.5%). Among 402 highly myopic eyes, the proportion with abnormal average RNFL thickness fell from 16.7% to 4.0% after axial length adjustment (51 of 67 abnormal eyes reclassified as normal), whereas the temporal quadrant showed the opposite pattern.Conclusions Retinal layer thickness varies substantially according to axial length, particularly in inner retinal layers. Axial length-adjusted normative references may improve OCT interpretation in highly myopic eyes.Translational relevance Incorporating axial length into OCT normative interpretation may improve clinical assessment of retinal thickness in increasingly myopic populations.
SN - 2164-2591
ER -