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Samantha Sze-Yee Lee, Alex W Hewitt, David A Mackey; Change in peripapillary retinal nerve fibre layer thickness from 20 to 28 years old. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1629 – A0124.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma diagnosis almost definitely always lags disease onset by several months if not years. However, it is unclear when exactly does glaucoma start. Moreover, little is known of how the peripapillary retinal nerve fibre layer (pRNFL) thickness change during young adulthood. To address these gaps in our knowledge, we investigated whether pRNFL thinning could be detected at a young age by mapping the 8-year change in pRNFL thickness in a community-based cohort of young adults. We further tested the hypothesis that those with a family history of glaucoma have faster rates of pRNFL thinning than those without a known family history.
Generation 2 participants from the Raine Study attended an eye examination when they were 20 and 28 years old. The pRNFL thickness globally and at 6 sectors were measured with spectral-domain optical coherence tomography (SD-OCT) imaging. Information on family history of glaucoma was collected using questionnaires administered to the participants and their parents. The 8-year longitudinal change in pRNFL thickness was explored using linear mixed-effect models with random intercept and slope for participants to account for the within-participant correlation between two eyes.
After excluding eyes with pathology and low-quality or erroneous scans, 1,313 eyes of 693 participants were included in the analysis. The pRNFL was thinner at 28 years old than at 20 years globally and at all sectors. The global pRNFL thinned by -0.34µm/year (95% confidence interval= -0.37 to -0.31), with the nasal and superonasal sectors showing the most thinning (-0.46 and -0.45µm/year), followed by the inferotemporal (-0.38µm/year), temporal (-0.29µm/year), superotemporal (-0.22µm/year), and inferonasal (-0.14µm/year) sectors. There was no significant association between family history of glaucoma and rate of pRNFL thinning.
The pRNFL starts to thin at least from the third decade of life, albeit at a very slow rate. There was no evidence that the pRNFL thins at a faster rate in those with a family history of glaucoma. Nonetheless, longer-term follow-up of this cohort is warranted to ascertain the rate of pRNFL thinning in a reference population and in those who eventually develop glaucoma.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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