Estimated Rates of Retinal Ganglion Cell Loss with Aging.
Vilasboas-Campos Verônica, Jammal Alessandro A, Gracitelli Carolina P B, Gameiro Gustavo R, Costa Vital P, Medeiros Felipe A
AI Summary
This study found healthy eyes lose ~6769 retinal ganglion cells (0.6%) annually with age. This confirms age-related RGC decline, emphasizing its consideration when monitoring glaucoma progression.
Abstract
Purpose
To evaluate the effect of aging on estimated retinal ganglion cell (RGC) counts over time in healthy eyes, obtained from a combination of structural and functional information.
Design
Longitudinal observational cohort study.
Participants
One hundred healthy eyes of 50 subjects.
Methods
Estimated RGC counts were obtained by a previously described method using standard automated perimetry sensitivity thresholds and OCT retinal nerve fiber layer thickness measurements. Linear mixed-effects models were applied to investigate the effect of aging, as well as other covariates, on rates of change in estimated RGC counts over time.
Main outcome measures
Rates of change in estimated RGC counts in healthy eyes.
Results
Subjects had a mean age of 49.6 ± 15.7 years at baseline (range 22.8-89.9 years) and were followed up for 3.5 ± 2.5 years. Thirty-three (66%) patients were female and 11 (22%) self-identified as Black. At baseline, the eyes had an average estimated RGC count of 1 144 010 ± 222 084 cells. After adjusting for confounding factors, the mean rate of change in estimated RGC counts was -6769 RGC/year (95% confidence interval: -10 994 to -2544 RGC/year; P = 0.002), or 0.6%/year. Older age and longer axial length were significantly associated with lower RGC counts at baseline.
Conclusions
A significant age-related decline in estimated RGC counts was found in healthy subjects with a combined metric integrating imaging and functional testing. The estimated mean age-related decline was remarkably similar to estimates from previous histologic studies in cadaver eyes, reinforcing the validity of the proposed combined metric and highlighting the importance of considering age when evaluating RGC count changes over time for monitoring glaucoma progression.
Financial disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Shields Classification
Key Concepts5
The mean rate of change in estimated retinal ganglion cell (RGC) counts in healthy subjects was -6769 RGC/year (95% confidence interval: -10 994 to -2544 RGC/year; P = 0.002), or 0.6%/year, after adjusting for confounding factors.
Older age and longer axial length were significantly associated with lower estimated retinal ganglion cell (RGC) counts at baseline in healthy subjects.
Estimated retinal ganglion cell (RGC) counts in healthy eyes were obtained using a method combining standard automated perimetry sensitivity thresholds and OCT retinal nerve fiber layer thickness measurements.
The mean age of subjects at baseline was 49.6 ± 15.7 years (range 22.8-89.9 years) in a longitudinal observational cohort study of healthy eyes, and they were followed up for 3.5 ± 2.5 years.
At baseline, healthy eyes had an average estimated retinal ganglion cell (RGC) count of 1,144,010 ± 222,084 cells.
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