Hashemi Hassan, Khabazkhoob Mehdi, Heydarian Samira, Emamian Mohammad Hassan, Fotouhi Akbar
Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
Department of Medical Surgical Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Exp Optom. 2025 Aug;108(6):706-714. doi: 10.1080/08164622.2024.2410879. Epub 2024 Oct 7.
Distinguishing between the pathological thinning of the retinal nerve fibre layer (RNFL) and age-related reduction requires a comprehensive understanding of the longitudinal changes in RNFL thickness within a healthy population.
To determine five-year changes in RNFL thickness and associated factors in people aged 45-69 years.
This report pertains to the second and third phases of the Shahroud Eye Cohort Study. Participants were recruited by a multi-stage cluster sampling in Shahroud, Iran. Data on demographic details, visual acuity, non-cycloplegic refraction, and slit-lamp biomicroscopy were collected. High-definition optical coherence tomography was employed for retinal imaging.
A total of 1,524 eyes from 908 participants were examined. The average RNFL thickness was 92.2 ± 8.5 (95% CI: 91.6 to 92.8) and 93.1 ± 8.7 μm (95% CI: 92.5 to 93.7) in the first and second phases with a five-year mean change of 0.95 ± 4.15 μm (95% CI: 0.70 to 1.20). The RNFL thickness mean changes in the superior, inferior, nasal, and temporal quadrants were 2.51 ± 7.86 (95% CI: 2.01 to 3.02), 2.93 ± 7.39 (95% CI: 2.56 to 3.29), -0.53 ± 6.15 (95% CI: -0.84 to -0.21), and -1.01 ± 4.67 μm (95% CI: -1.27 to -0.75), respectively. The five-year changes in average RNFL thickness were inversely correlated with axial length (β = -0.69, < 0.001), mean keratometry (β = -0.37, = 0.017), and baseline RNFL thickness (β = -0.617, < 0.001). In hyperopic individuals, the increase in average RNFL thickness (β = 0.65, = 0.012) was significantly greater than in those with emmetropia. Macular volume (β = 1.65, < 0.001) showed a direct association with five-year changes in average RNFL thickness.
Over 5 years, RNFL thickness changes were clinically insignificant in the normal population. The mean RNFL thickness seems to remain stable unless there is ocular disease. However, increased axial length and steeper keratometric readings were linked to RNFL thinning. Those with thicker RNFL measurements were at higher risk of thinning over time.
区分视网膜神经纤维层（RNFL）的病理性变薄与年龄相关的变薄，需要全面了解健康人群中RNFL厚度的纵向变化。
确定45 - 69岁人群中RNFL厚度的五年变化及相关因素。
本报告涉及沙赫鲁德眼队列研究的第二和第三阶段。参与者通过在伊朗沙赫鲁德进行的多阶段整群抽样招募。收集了人口统计学细节、视力、非散瞳验光和裂隙灯生物显微镜检查的数据。采用高分辨率光学相干断层扫描进行视网膜成像。
共检查了908名参与者的1524只眼睛。第一阶段和第二阶段的平均RNFL厚度分别为92.2±8.5（95%可信区间：91.6至92.8）和93.1±8.7μm（95%可信区间：92.5至93.7），五年平均变化为0.95±4.15μm（95%可信区间：0.70至1.20）。RNFL厚度在上方、下方、鼻侧和颞侧象限的平均变化分别为2.51±7.86（95%可信区间：2.01至3.02）、2.93±7.39（95%可信区间：2.56至3.29）、 - 0.53±6.15（95%可信区间： - 0.84至 - 0.21）和 - 1.01±4.67μm（95%可信区间： - 1.27至 - 0.75）。平均RNFL厚度的五年变化与眼轴长度（β = - 0.69，<0.001）、平均角膜曲率（β = - 0.37，=0.017）和基线RNFL厚度（β = - 0.617，<0.001）呈负相关。在远视个体中，平均RNFL厚度的增加（β = 0.65，=0.012）明显大于正视个体。黄斑体积（β = 1.65，<0.001）与平均RNFL厚度的五年变化呈正相关。
在5年期间，正常人群中RNFL厚度变化在临床上无显著意义。除非患有眼部疾病，平均RNFL厚度似乎保持稳定。然而，眼轴长度增加和角膜曲率读数变陡与RNFL变薄有关。RNFL测量值较厚的人随着时间推移变薄的风险更高。
