Age-Related Optic Nerve Optical Coherence Tomography and Optical Coherence Tomography Angiography Changes in Subjects Without Glaucoma: A 5-Year Prospective Study.

Abstract

To describe non-glaucomatous age-related changes in optic nerve optical coherence tomography (OCT) and OCT angiography (OCTA). Prospective-cohort study. Daxing Eye Study participants age ≥ 50 years without glaucoma were included. OCT, OCTA, and other systemic or ocular examinations were performed at baseline and after 5 years. Peripapillary retinal nerve fiber layer (pRNFL) thickness, macular ganglion cell complex (mGCC) thickness, superficial macular vessel density, and radial peripapillary capillary (RPC) density at baseline and after 5 years. This study included 1003 eyes of 579 subjects, with a follow-up of 5.8 ± 0.4 years. Over 5 years, there were significant decrease in pRNFL (mean = 1.7 µm, 95% CI: 1.5 µm to 1.9 µm, P < .01), mGCC (mean = 0.8 µm, 95% CI: 0.6 µm to 1.0 µm, P < .01), superficial macular vessel density (mean = 2.4%, 95% CI: 2.1% to 2.7%, P < .01), and RPC density (mean = 0.3%, 95% CI: 0.1% to 0.5%, P = .02). In the multivariable analysis, after adjusting for the change of signal strength index of the tests, we observed the following associations: mGCC changes were significantly associated with hyperlipidemia (linear regression coefficient B = -0.75, P = .03) and intraocular pressure (B = -0.13, P < .01). RPC changes were significantly associated with pulse (B = 0.02, P = .04), systolic blood pressure (B = 0.02, P = .02), age (B = -0.04, P = .04) and axial length (B = -0.25, P = .04). Superficial macular vessel changes were associated with axial length (B = -0.30, P < .05). During 5 years of normal aging, participants experienced declines in pRNFL thickness, mGCC thickness, RPC density, and superficial macular vessel density. These age-related changes should be taken into account when diagnosing and monitoring glaucoma patients.