Longitudinal and Cross-Sectional Analyses of Age Effects on Retinal Nerve Fiber Layer and Ganglion Cell Complex Thickness by Fourier-Domain OCT

PURPOSE We studied the effects of age and intraocular pressure (IOP) on retinal nerve fiber layer (NFL) and macular ganglion cell complex (GCC) thickness in normal eyes. METHODS Data from subjects from the multicenter Advanced Imaging for Glaucoma Study (AIGS) were analyzed. The data included yearly visits from the normal subjects in the AIGS study. Fourier-domain optical coherence tomography (FD-OCT) was used to measure retinal NFL and macular GCC on each visit. Mixed effect models were used to evaluate the longitudinal effect of age and IOP on the NFL and GCC thickness. The measurements at baseline were used to examine the cross-sectional effects. RESULTS The analysis included 192 eyes (92 participants) from AIGS between 2009 and 2013. The longitudinal analyses showed overall GCC thickness decreased 0.25 ± 0.05 μm per year (P < 0.001) while the overall NFL thickness decreased 0.14 ± 0.07 μm per year (P = 0.04). The cross-sectional analyses showed the GCC thickness was 0.17 ± 0.05 μm thinner per year of baseline age (P < 0.001), while the NFL was 0.21 ± 0.06 μm thinner (P < 0.001). There was no significant IOP effect on either GCC or NFL from either the longitudinal or cross-sectional analysis. CONCLUSIONS Longitudinal and cross-sectional analyses provided consistent rates of approximately 0.2% per year of age-related thinning in NFL and GCC thicknesses. This is relevant in establishing criteria to detect glaucoma-related thinning (disease progression) in excess of normal aging. IOP does not seem to be a significant confounder for progression analysis. TRANSLATIONAL RELEVANCE This study demonstrated the relevance of advanced imaging technology in diagnosing and monitoring glaucoma disease.