Age-Related Changes in and Determinants of the Peripapillary Retinal Nerve Fiber Layer in Normal Adults

Abstract

Objective: \nTo determine age-related changes in and the determinants of high-definition optical coherence tomography (HD-OCT) measurements of the peripapillary retinal nerve fiber layer (pRNFL) thickness in normal adults in order to provide evidence for the progressive analysis of glaucoma. \n \n \nMethods: \nThis was a case series study. One hundred ninety-five (390 eyes) people were recruited from June 2016 to September 2016 in the Beijing Tongren Hospital Health Examination Center from specific groups, including staffs and retired staffs. Age ranged from 21 to 90 years. Participants underwent Cirrus HD-OCT measurements of the pRNFL. One-way analysis of variance was used to compare mean pRNFL thickness between 7 decade-based age groups (21-30 years, 31-40 years, 41-50 years, 51-60 years, 61-70 years, 71-80 years, 81-90 years) and between sectors. Multiple regression analysis and linear regression determined the association between pRNFL thickness and age, gender, intraocular pressure (IOP) and spherical equivalent (SE). \n \n \nResults: \nMean pRNFL thickness in the 352 eyes was 96±10 μm. Mean pRNFL thickness decreased by 0.21 μm (χ2=46.34, P<0.001) per year with an increase in age. It showed two steep drops with age, first in the 4th and next in the 7th decade with relative stability between them. pRNFL thickness was associated with SE (β=-1.49, χ2=11.93, P=0.001) but not with gender (β=0.73, χ2=0.34, P=0.560) or IOP (β=-0.24, χ2=2.10, P=0.148). \n \n \nConclusions: \nMean pRNFL thickness shows a small age-related linear decrease with two steep drops in the 4th and 7th decades. A thinner pRNFL was independently associated with age and a higher SE in myopia, but not with gender or IOP within the normal range. These factors should be considered if using pRNFL to detect the progression of glaucoma and other optic neuropathies. \n \n \nKey words: \nretinal nerve fiber layer;\xa0age;\xa0optical coherence tomography