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. 2023 Feb 1;64(2):17.
doi: 10.1167/iovs.64.2.17.

Asymmetry of Peripapillary Retinal Blood Vessel and Retinal Nerve Fiber Layer Thickness Between Healthy Right and Left Eyes

Jack Quach  1   2 , Glen P Sharpe  1 , Shaban Demirel  3 , Christopher A Girkin  4 , Christian Y Mardin  5 , Alexander F Scheuerle  6 , Claude F Burgoyne  3 , Balwantray C Chauhan  1 , Jayme R Vianna  1
Affiliations

Asymmetry of Peripapillary Retinal Blood Vessel and Retinal Nerve Fiber Layer Thickness Between Healthy Right and Left Eyes

Jack Quach et al. Invest Ophthalmol Vis Sci. .

Abstract

Purpose: The purpose of this study was to determine if there is asymmetry in retinal blood vessel (RBV) position and thickness between right and left eyes (R-L) and evaluate whether R-L asymmetry in RBV thickness is related to R-L asymmetry of retinal nerve fiber layer thickness (RNFLT).

Methods: We analyzed peripapillary circle scan optical coherence tomography (OCT) examinations from healthy White subjects to measure RNFLT and RBV thickness and position relative to the fovea to Bruch's membrane opening axis, for all visible RBV. The R-L asymmetries of RNFLT and RBV thickness were computed for each A-scan. Four major vessels (superior temporal artery [STA] and superior temporal vein [STV], inferior temporal artery [ITA], and vein [ITV]) were identified using infrared images.

Results: We included 219 individuals. The mean (standard deviation) number of RBV measured per eye was 15.0 (SD = 2.2). The position of the STV and STA was more superior in left eyes than in right eyes, by 2.4 degrees and 3.7 degrees, respectively (P < 0.01). There was no region with significant R-L asymmetry in RBV thickness. RNFLT was thicker in right eyes in the temporal superior region and thicker in left eyes in the superior and nasal superior regions, with the asymmetry profile resembling in a "W" shape. This shape was also present in post hoc analyses in two different populations. The R-L asymmetries of RBV and RNFLT at each A-scan were not significantly associated (P = 0.37).

Conclusions: There is little R-L asymmetry in RBV, and it is not related to RNFLT asymmetry. This study suggests that R-L RNFLT asymmetry is due to factors other than RBV.

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Conflict of interest statement

Disclosure: J. Quach, None; G.P. Sharpe, None; S. Demirel, None; C.A. Girkin, National Eye Institute (F), Research to Prevent Blindness (F), EyeSight Foundation of Alabama (F), Heidelberg Engineering (research support) (F); C.Y. Mardin, None; A.F. Scheuerle, None; C.F. Burgoyne, National Institutes of Health R01 Awards (C), Heidelberg Engineering , instruments and unrestricted research support, no personal income or intellectual property (C); Life BioSciences (C); B.C. Chauhan, CenterVue (equipment support) (F), Heidelberg Engineering (research and equipment support) (F), Novartis (speaker bureau) (F), Topcon (equipment support) (F); J.R. Vianna, Eadietech (C)

Figures

Figure 1.
Figure 1.
Example of infrared fundus image showing the position and size of the 3.5 mm circular scan pattern with optical coherence tomography. The fovea to Bruch's membrane opening (FoBMO) axis and the measured major retinal blood vessels is indicated in the image. STA, superior temporal artery; STV, superior temporal vein; ITA, inferior temporal artery; ITV, inferior temporal vein.
Figure 2.
Figure 2.
Example of retinal blood vessel (RBV) measurement, in the same eye presented in Figure 1. Top: Optical coherence tomography image of a peripapillary retinal nerve fiber layer scan. Bottom: Same image as the top, with overlays in green showing the RBV limits. The A-scan number of the two limit points were recorded by an investigator. Quadrants: T = temporal, S = superior, N = nasal, and I = inferior.
Figure 3.
Figure 3.
Examples of profiles of retinal blood vessel thickness (RBV, panels A, B, C, top) and retinal nerve fiber layer thickness (RNFLT, panels D, E, F, bottom) from a study participant, the same participant presented in Figures 1 and 2. A and D Profiles for the participant's right eye. B and E Profiles for the participant's left eye. C and F Profiles for the participant's right eye minus left eye asymmetry (R-L). T = temporal, S = superior, N = nasal, and I = inferior.
Figure 4.
Figure 4.
(A) Profile of mean right eye minus left eye (R-L) retinal nerve fiber layer thickness (RNFLT) asymmetry for all participants shown by the black line. (B) Profile of mean R-L retinal blood vessel (RBV) thickness asymmetry for all participants shown by the black line. The 95% confidence intervals of the mean are indicated by the shaded area. T = temporal, S = superior, N = nasal, and I = inferior.
Figure 5.
Figure 5.
(A) Profile of mean right eye minus left eye (R-L) retinal nerve fiber layer thickness (RNFLT) asymmetry for all participants shown by the black line. (B) Profile of mean R-L retinal blood vessel (RBV) thickness asymmetry for all participants shown by the black line. The 95% distribution range (i.e. from percentile 2.5% to 97.5%) is indicated by the shaded area. T = temporal, S = superior, N = nasal, and I = inferior.
Figure 6.
Figure 6.
Scatterplot of mean right eye minus left eye (R-L) retinal blood vessel (RBV) thickness and mean R-L retinal nerve fiber layer thickness (RNFLT) in each A-scan. Points are color-graded to their position around the optic disc. Generalized least squares model did not show a significant association (beta 0.02, P = 0.37).
Figure 7.
Figure 7.
Profile of mean right eye minus left eye (R-L) retinal nerve fiber layer thickness (RNFLT) asymmetry for Brazilian (n = 220) and Japanese (n = 218) subjects shown by the black lines. The 95% confidence intervals of the mean are indicated by the shaded area. T = temporal, S = superior, N = nasal, and I = inferior.
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