Soh Zhi-Da, Yu Marco, Chen Yanyan, Thakur Sahil, Lavanya Raghavan, Tham Yih Chung, Koh Victor, Aung Tin, Cheng Ching-Yu
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Clin Exp Ophthalmol. 2025 May-Jun;53(4):391-401. doi: 10.1111/ceo.14471. Epub 2025 Jan 5.
To evaluate the 6-year physiological rates-of-change in ganglion cell inner plexiform layer (GCIPL) and retinal nerve fibre layer (RNFL) thickness measured with optical coherence tomography.
We included 2202 out of 2661 subjects from the population-based Singapore Chinese Eye Study who returned for follow-up 6 years after baseline examination (follow-up rate 87.7%). OCT scans with signal strength (SS) <6, imaging errors, and ocular pathologies were excluded. A linear mixed model was used to measure the rates-of-change in GCIPL and RNFL thickness. Time and difference between baseline and follow-up scan SS were modelled as fixed effect. Baseline age, baseline measurement, gender, hypertensive medication, diabetes status, cardiovascular disease, smoking status, body mass index, spherical equivalent (SE), intraocular pressure and optic disc area were each analysed in an interaction term with time.
The adjusted mean rate-of-change in average GCIPL was -0.312 μm/year in males and -0.235 μm/year in females. Older age and thicker GCIPL thickness at baseline were associated with higher rates-of-change while females and more hyperopic SE were associated with lower rates-of-change. The adjusted mean rate-of-change in average RNFL was -0.374 μm, with higher rates-of-change in the vertical quadrants and no differences between genders. Older age and thicker RNFL thickness at baseline were associated with higher rates-of-change in average RNFL and RNFL thickness in the vertical quadrants, and vice versa for each unit increase in scan SS and SE.
Our population cohort provides data on physiological thinning of GCIPL and RNFL with age. Differentiating physiological changes in GCIPL and RNFL is important for more accurate clinical assessment.
评估采用光学相干断层扫描测量的神经节细胞内丛状层(GCIPL)和视网膜神经纤维层(RNFL)厚度的6年生理变化率。
我们纳入了基于人群的新加坡华人眼病研究中2661名受试者中的2202名,这些受试者在基线检查6年后返回进行随访(随访率87.7%)。排除信号强度(SS)<6的OCT扫描、成像误差和眼部病变。采用线性混合模型测量GCIPL和RNFL厚度的变化率。将时间以及基线和随访扫描SS之间的差异作为固定效应进行建模。对基线年龄、基线测量值、性别、高血压用药情况、糖尿病状态、心血管疾病、吸烟状况、体重指数、等效球镜度(SE)、眼压和视盘面积分别在与时间的交互项中进行分析。
男性平均GCIPL的调整后平均变化率为-0.312μm/年,女性为-0.235μm/年。年龄较大和基线时GCIPL厚度较厚与较高的变化率相关,而女性和更高度数的远视SE与较低的变化率相关。平均RNFL的调整后平均变化率为-0.374μm,垂直象限的变化率较高,且性别之间无差异。年龄较大和基线时RNFL厚度较厚与平均RNFL和垂直象限RNFL厚度的较高变化率相关,而扫描SS和SE每增加一个单位则情况相反。
我们的人群队列提供了GCIPL和RNFL随年龄生理性变薄的数据。区分GCIPL和RNFL的生理变化对于更准确的临床评估很重要。