Official ESCRS | European Society of Cataract & Refractive Surgeons


Association between macular thickness and visual function in healthy individuals: the Singapore Epidemiology of Eye Diseases (SEED) study

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Session Details

Session Title: Ocular Pathology/Education & Training

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 14:00

Venue: Free Paper Forum: Podium 4

First Author: : S.Poh SINGAPORE

Co Author(s): :    Y. Tham   E. Fenwick   W. Dai   M. Chee   T. Wong   C. Cheng              

Abstract Details


The normative database for macular thickness measured with optical coherence tomography (OCT) has been evaluated in several population-based studies, and recent studies also looked at the variations in macular thickness by gender, age, ethnicity, axial length and refractive profiles. However, whether macular thickness affect visual acuity and visual function in healthy eyes is not known. The purpose of this study was to evaluate the associations between OCT-measured macular thickness and visual outcomes in healthy eyes.


The study subjects were enrolled from the Singapore Epidemiology of Eye Diseases (SEED) Study from year 2009 to 2015.


This is a cross-sectional population-based study in Singapore comprises of 3 major ethnicities - Malay, Chinese and Indian. Participants had basic ocular examination, systemic examination, visual function assessment with VF-11 questionnaire, and spectral-domain OCT imaging. The association between macular thickness and the two main outcome, best corrected visual acuity (BCVA) and VF-11 scores, was assessed by linear regression.


A total of 14,908 eyes from 7,454 eligible subjects were included for analyses. The mean BCVA in LogMAR units was 0.10±0.11 and the mean Rasch-transformed VF-11 scores were 5.20±1.29. On multivariable regression analysis, a 20µm increase in average macular thickness, foveal central subfield thickness, and average GCIPL were associated with a better BCVA of -0.009 (p=0.001), -0.009 (p<0.001) and -0.031 (p<0.001) respectively. A 20µm increase in average macular thickness and average GCIPL thickness were associated with a better VF-11 scores of 0.04 (p=0.004) and 0.05 (p=0.019) respectively, independent of participants’ visual acuity.


Our study demonstrates novel findings that in healthy eyes, a thicker macula and in particular, ganglion cell inner plexiform layer thickness (GCIPL) thickness, was associated with better visual outcomes. These findings suggest that small variations in macular thickness have a significant association with visual function in healthy individuals.

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