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Morphometric Analysis of Human Peripapillary Retinal Nerve Fiber Layer Thickness

From the Department of Ophthalmology, Hadassah–Hebrew University Medical Center, Jerusalem, Israel.

PURPOSE. The peripapillary retinal nerve fiber layer (RNFL) thickness pattern in the normal human eye has been well characterized using data obtained with scanning laser polarimetry and optical coherence tomography. The authors sought to characterize the normative peripapillary RNFL thickness and pattern using histologic sections obtained from healthy postmortem human eyes.

METHODS. Seventeen unpaired normal postmortem eyes were recruited into this study. Each eye was sectioned using the "umbrella technique" to obtain four concentric peripapillary rings, each centered on the optic disc, with diameters of 3.0, 3.5, 4.0, and 4.5 mm. RNFL thickness data along each ring section was measured at 100 equidistant locations. Thickness data, for each ring diameter, across all eyes were averaged to arrive at normative thickness values for the peripapillary RNFL thickness in eyes processed using this technique.

RESULTS. Average RNFL thicknesses (±SD) for the 3.5-mm diameter ring were as follows: overall, 60.3 ± 19.5 µm; superior, 75.3 ± 26.5 µm; inferior, 69.4 ± 22.4 µm; nasal, 48.1 ± 15 µm; temporal, 49.2 ± 26.4 µm. Qualitatively, the RNFL thickness showed a double-hump pattern with relatively similar superior and inferior peaks and with temporal and nasal troughs. Progressively larger peripapillary rings showed progressively thinner RNFL thickness at all quadrants. In contrast, the relative thickness percentage for each quadrant remained unchanged among the four different diameter rings.

CONCLUSIONS. Histologic data from a group of healthy postmortem eyes demonstrate the pattern of RNFL thickness in normal eyes. These data corroborate imaging findings of peripapillary RNFL thickness patterns obtained using commercially available RNFL imaging devices.