The Effect of Age on Increasing Susceptibility to Retinal Nerve Fiber Layer Loss in Glaucoma.
Jammal Alessandro A, Berchuck Samuel I, Thompson Atalie C, Costa Vital P, Medeiros Felipe A
AI Summary
This study found older glaucoma patients experience faster retinal nerve fiber layer loss for the same IOP, suggesting age increases susceptibility to glaucoma progression.
Abstract
Purpose
To determine whether aging modifies the effect of intraocular pressure (IOP) on progressive glaucomatous retinal nerve fiber layer (RNFL) thinning over time.
Methods
This was a retrospective cohort study involving patients with glaucoma or suspected of having glaucoma who were followed over time from the Duke Glaucoma Registry. Rates of RNFL loss from spectral-domain optical coherence tomography (SD-OCT) were used to assess disease progression. Generalized estimating equations with robust sandwich variance estimators were used to investigate the effects of the interaction of age at baseline and mean IOP on rates of RNFL loss over time. Models were adjusted for gender, race, diagnosis, central corneal thickness, follow-up time, and baseline disease severity.
Results
The study included 85,475 IOP measurements and 60,026 SD-OCT tests of 14,739 eyes of 7814 patients. Eyes had a mean follow-up time of 3.5 ± 1.9 years. The average rate of change in RNFL thickness was -0.70 µm/year (95% confidence interval, -0.72 to -0.67). There was a significant interaction between age and mean IOP and the rate of RNFL loss (P = 0.001), with older eyes having significantly faster rates of RNFL loss than younger ones for the same level of IOP. The effect of IOP on rates of change was greater in the inferior and superior regions of the optic disc.
Conclusions
Age is a significant modifier of the relationship between IOP and glaucomatous loss in RNFL thickness over time. Older patients may be more susceptible to glaucomatous progression than younger patients at the same level of IOP.
MeSH Terms
Shields Classification
Key Concepts4
The average rate of change in retinal nerve fiber layer (RNFL) thickness in patients with glaucoma or suspected of having glaucoma was -0.70 µm/year (95% confidence interval, -0.72 to -0.67) in a retrospective cohort study.
There was a significant interaction between age and mean intraocular pressure (IOP) and the rate of retinal nerve fiber layer (RNFL) loss (P = 0.001) in patients with glaucoma or suspected of having glaucoma, with older eyes having significantly faster rates of RNFL loss than younger ones for the same level of IOP.
The effect of intraocular pressure (IOP) on rates of change in retinal nerve fiber layer (RNFL) thickness was greater in the inferior and superior regions of the optic disc in patients with glaucoma or suspected of having glaucoma.
Age is a significant modifier of the relationship between intraocular pressure (IOP) and glaucomatous loss in retinal nerve fiber layer (RNFL) thickness over time, suggesting older patients may be more susceptible to glaucomatous progression than younger patients at the same level of IOP.
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