{"doi":"10.1016/j.xops.2024.100549","title":"Biological and Methodological Variability in Retinal Nerve Fiber Layer OCT: The Framingham Heart Study","abstract":"Objective: To explore participant-level biological attributes and scan-level methodological attributes associated with retinal nerve fiber layer (RNFL) thickness variability in a population-based sample of elderly United States adults. Design: Cross-sectional analysis using data from the Framingham Heart Study. Participants: One thousand three hundred forty-seven eyes from 825 participants with ≥1 OCT scan and axial length data were included. Methods: Three or more successive RNFL scans of each eye of each participant were obtained in a single session. Multivariable linear mixed models were employed to explore the associations between average RNFL thickness with participant-level biological attributes (age, gender, race, ethnicity, and axial length) and scan-level attributes (signal strength [SS]) as independent variables in the whole population as well as a subsample of adults with no self-reported history of glaucoma. Similar analyses were designed to assess methodological variability with average within-eye standard deviation (SD) for repeated scans as the dependent variable. Main Outcomes Measures: (1) Biological variability: average RNFL thickness, and (2) methodological variability: average within-participant SD across repeated scans. Results: > 0.05). In analyses designed to assess methodological variability, higher RNFL thickness (β = +0.02 per micron increase, [95% CI: 0.01, 0.03]), and lower SS (β = +0.19 per 1 unit lower SS, [95% CI: 0.10, 0.27]) were significantly associated with greater RNFL variability. In adults with no self-reported history of glaucoma (n of eyes = 1165, n of participants = 712), female gender was not associated with RNFL, while African American race was associated with thicker RNFL (β = +4.65 microns vs. Whites, [95% CI: 1.28, 8.03]). Conclusions: Retinal nerve fiber layer thickness is lower with older age, male gender, greater axial length, lower SS, and Whites (as compared with African Americans) without self-reported glaucoma. Measurement variability (SD) is higher with greater RNFL thickness and lower SS. Understanding these biological and methodological variations is important to aid in OCT interpretation. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.","journal":"Ophthalmology Science","year":2024,"id":438308,"datarank":0.4128039152921033,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.053119624372347636,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.053119624372347636,"corpus_percentile":55.27964724994198,"corpus_rank":5782,"citation_count":10,"citer_count":8,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.7801,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":971481,"name":"Jasdeep Sabharwal","orcid":null,"position":1,"is_corresponding":false},{"id":745734,"name":"Anoush Shahidzadeh","orcid":"0000-0003-2269-9257","position":2,"is_corresponding":false},{"id":1248514,"name":"Ana Collazo Martinez","orcid":null,"position":3,"is_corresponding":false},{"id":1248107,"name":"Shu Jie Ting","orcid":"0009-0002-5577-7696","position":4,"is_corresponding":false},{"id":1248515,"name":"Brinda Vaidya","orcid":null,"position":5,"is_corresponding":false},{"id":481082,"name":"Xuejuan Jiang","orcid":"0000-0002-5637-666X","position":6,"is_corresponding":false},{"id":614515,"name":"Tim Kowalczyk","orcid":"0000-0003-1806-059X","position":7,"is_corresponding":false},{"id":216030,"name":"Alexa Beiser","orcid":null,"position":8,"is_corresponding":false},{"id":54632,"name":"Lucia Sobrin","orcid":"0000-0003-1575-0819","position":9,"is_corresponding":false},{"id":17639,"name":"Sudha Seshadri","orcid":"0000-0001-6135-2622","position":10,"is_corresponding":false},{"id":342307,"name":"Pradeep Y. Ramulu","orcid":"0000-0002-9275-0401","position":11,"is_corresponding":false},{"id":382741,"name":"Amir H. Kashani","orcid":"0000-0001-9767-7920","position":12,"is_corresponding":false},{"id":1042021,"name":"Louay Almidani","orcid":"0009-0001-6769-5519","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T02:00:38.888629Z","pmid":"39161752","pmcid":"PMC11331915","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}