Br J Ophthalmol. 2026 Mar 19:bjo-2025-328651. doi: 10.1136/bjo-2025-328651. Online ahead of print.
ABSTRACT
BACKGROUND/AIMS: To determine the proportion of progressive retinal nerve fibre layer thickness (RNFLT) change that can be attributed to normal ageing.
METHODS: This prospective, longitudinal, cohort study included one eye each of 200 patients treated for open-angle glaucoma and 73 healthy control subjects who were followed with optical coherence tomography (OCT) every 6 months. A linear mixed-effects (LME) model was used to estimate the mean RNFLT slope and the difference between the two groups to evaluate factors affecting the slope, while adjusting for other variables.
RESULTS: The median (IQR) age and follow-up of all participants was 68.3 (61.8 to 74.7) years and 10.1 (6.4 to 12.9) years, respectively. The median baseline mean deviation in patients with glaucoma was -3.79 (-6.84 to -1.57) dB. Among those classified within normal limits for baseline RNFLT (39 (19.5%) patients with glaucoma and 68 (93.2%) healthy subjects), the individual RNFLT slopes were significantly steeper in patients with glaucoma (median, -0.76 (-1.13 to -0.49) µm/year) compared with healthy subjects (-0.51 (-0.72 to -0.19) µm/year, p<0.01). The LME model showed a statistically significant negative RNFLT slope in healthy subjects (-0.54 µm/year, p<0.01). After adjusting for covariates, diagnosis of glaucoma contributed an additional -0.47 µm/year (p<0.01). Baseline global RNFLT had a slightly negative impact on RNFLT slope (-0.01/year, p<0.01), while baseline age had a significant positive effect (0.01 μm/year2, p<0.01).
CONCLUSIONS: Normal ageing contributed around one half of RNFLT thinning observed in patients treated for glaucoma.
PMID:41856770 | DOI:10.1136/bjo-2025-328651
