الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Purpose: The aim of this study was to assess the effect of refractive status and axial length on peripapillary retinal nerve fiber layer thickness in normal people and glaucomatous patients using optical coherence tomography. Patients &methods: This study is a prospective study. It was done on Mansoura Ophthalmology Hospital during a period from October 2020 to October 2021. In this study 108 eyes of 54 patients were included and divided into two groups: • group (A): included 54 eyes of 27 normal people with no sign of any ocular disease, patients were selected from outpatient clinic in Mansoura ophthalmology hospital. • group (B): included 54 eyes of 27 glaucomatous patients; these patients were selected from glaucoma clinic in Mansoura ophthalmology hospital. Each group was divided into three subgroups (myopic, hypermetropic and emmetropic). All participants had been subjected to careful history taking, complete ophthalmologic examination (uncorrected and best corrected visual acuity, refraction by auto refractometer, intraocular pressure measurement by Goldman applanation tonometer, examination with the slitlamp biomicroscopy, fundus examination by 90D lens and indirect ophthalmoscopy. Axial length was measured in each eye by A- scan ultrasound biometry (sonomed, Escalon Medical Corp, USA), and RNFL thickness was measured using Spectral domain optical coherence tomography (carl zeiss meditec, Dublin, CA). After finishing all subjects‘ imaging, statistical analysis was done. Results: There was no statistically significant difference between age and sex of both groups (normal and glaucomatous) in the three subgroups. The current study showed that the glaucomatous group had a statistically significant lower Best-corrected visual acuity (BCVA) when compared with the normal one in all the three subgroups. The current study also showed that in the normal group; myopic and hypermetropic subgroups had a significant higher IOP than emmetropic ones. The current study showed that in both groups, (normal and glaucomatous), there was a statistically significant shorter axial length in the hyperopic subgroup (with mean AL 21.86mm), and longer in the myopic subgroup (with mean AL 24.01) mm than the emmetropic subgroup (with mean AL 22.8mm). The current study also showed that in the normal group there was statistically significant larger cup disc to ratio in the myopic subgroup and statistically significant smaller cup to disc ratio in the hypermetropic one than emmetropic ones. The current study also showed that there was a statistically significant large cup to disc ratio in the glaucomatous patient in all subgroups more than in the normal group. Our study also showed that, in the normal group: average retinal nerve fiber layer thickness, superior, inferior and nasal quadrants was significantly higher in hypermetropic and lower in myopic than emmetropic subgroup. Our study also showed that, in the glaucomatous group: average retinal nerve fiber layer thickness was significantly higher in hypermetropic and lower in myopic than emmetropic subgroup. Thinning in myopic subgroup in inferior and nasal quadrants is more than emmetropic subgroup while there was no difference in superior and temporal quadrants thinning in different subgroups of glaucoma. This study also showed that glaucomatous patients had a statistically significant thinning in inferior, nasal quadrants and average retinal nerve fiber thickness when compared with the normal one in all the three subgroups. This study also showed that there was a significant negative correlation between axial length and retinal nerve fiber layer thickness in different quadrants except temporal quadrant which show no or nonsignificant correlation and this result was in both groups (normal and glaucomatous ) in the myopic and hypermetropic subgroups. While there was a significant positive correlation between error of refraction and RNFL thickness in both groups normal and glaucomatous in myopic and hypermetropic sub groups. The current study also showed a significant negative correlation between age and retinal nerve fiber layer thickness in both groups normal and glaucomatous in myopic, emmetropic and hypermetropic subgroups and this correlation appear especially in superior quadrant.