Monitor Peripapillary RNFL, Macular GCC Thickness Changes from Age

This study found no significant association between intraocular pressure and changes in pRNFL, RPC or superficial macular vessels. However, a weak correlation was observed between IOP and changes in mGCC. In glaucoma, mGCC loss is often considered to precede pRNFL thinning, which may partly explain the observed association in healthy individuals. Photo: Michael Cymbor, OD. Click image to enlarge.There is a notable scarcity of studies investigating the characteristics of age-related changes in OCT and OCT angiography (OCT-A) indicators that indicate glaucoma progression. In a recent study published in American Journal of Ophthalmology, using data from a large prospective cohort of Chinese rural individuals 50 years old and older, researchers analyzed changes in peripapillary retinal nerve fiber layer (pRNFL) thickness, macular ganglion cell complex (mGCC) thickness, radial peripapillary capillary (RPC) density and superficial macular vessel density over a five-year period in non-glaucomatous individuals.“By prospectively observing 1,003 non-glaucomatous eyes over five years, we elucidated age-related changes in neuroretinal parameters used for monitoring glaucoma,” the study authors wrote in their paper. “These data may help inform screening for glaucoma and detection of disease progression in glaucoma patients. pRNFL thickness measured by OCT is the most widely used structural parameter for assessing glaucoma progression.”This study included 1,003 eyes of 579 participants, with a follow-up of 5.8 years. Over five years, there were significant decreases in pRNFL (mean=1.7μm), mGCC (mean=0.8μm), superficial macular vessel density (mean=2.4%) and RPC density (mean=0.3). Multivariable analysis revealed that mGCC changes were significantly associated with hyperlipidemia and intraocular pressure. RPC changes were significantly associated with pulse, systolic blood pressure, age and axial length. Superficial macular vessel changes were associated with axial length.“This study elucidates age-related characteristics of pRNFL changes, showing a diffuse decline with the fastest thinning in the SN sector and the slowest in the TI sector,” the researchers noted. “In glaucoma patients, pRNFL thickness in the inferior and inferior temporal sectors is a more reliable predictor of progression.”The team concluded that clinicians should closely monitor age-related changes when evaluating glaucoma incidence and progression to ensure accurate clinical judgments and appropriate treatment initiation or adjustments for patients over 50 years of age. They also thought that future research should help differentiate between the normal aging changes demonstrated in the present study and glaucomatous optic nerve damage due to the diseases.Click here for the journal source. Pang R, Kolli A, Li R, et al. Age-related optic nerve OCT and OCT-A changes in subjects without glaucoma: a five-year prospective study. Am J Ophthalmol. November 22, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.