Peripapillary Nerve Fiber Elevation in Young Healthy Eyes

PURPOSE Eyes with a peripapillary nerve fiber elevation (pNFE) are those with a discrepancy between the optic disc margin in a color fundus photograph and the Bruch's membrane opening in an optical coherent tomographic (OCT) cross-sectional image. The purpose of this study was to determine the prevalence of pNFE in young healthy eyes, and to compare the axial length and optic disc tilt between pNFE and non-pNFE groups. METHODS This was a prospective, observational, cross-sectional study of 117 right eyes. All participants (mean age 25.8 ± 4.0 years) underwent a comprehensive ophthalmologic examination. The pNFE was determined from the color fundus photographs, scanning laser ophthalmoscopic images, and optic disc cross-sectional OCT images. The degree of optic disc tilt was determined by the sine curve technique. Mann-Whitney U tests were used to determine the significance of the differences in the axial length and optic disc tilt between the pNFE and non-pNFE groups. RESULTS Fifty-nine eyes were placed in the pNFE group and 58 eyes in the non-pNFE group. The axial length of the pNFE group (26.0 ± 1.4 mm) was significantly longer than that of the non-pNFE group (24.9 ± 1.2 mm; P < 0.001). The optic disc tilt of the pNFE group (42.1 ± 16.5 pixels) was significantly greater than that of the non-pNFE group (33.2 ± 16.8 pixels; P = 0.003). CONCLUSIONS The presence of pNFE is not rare in young healthy eyes. The eyes with pNFE have longer axial lengths and greater optic disc tilt. The pNFE should be considered when the disc margin is assessed.