Age-related changes in optical coherence tomography glaucoma-related parameters: A systematic review

Area of Science:

• Ophthalmology
• Medical Imaging
• Gerontology

Background:

• Optical coherence tomography (OCT) is crucial for detecting glaucoma progression.
• Glaucoma parameter measurements can be affected by normal aging processes.
• Accurate glaucoma diagnosis requires accounting for age-related changes.

Purpose of the Study:

• To summarize age-related changes in OCT glaucoma parameters in healthy individuals.
• To inform the interpretation of OCT data for glaucoma progression assessment.

Main Methods:

• Systematic review and meta-analysis of 51 longitudinal studies.
• Analysis of age-related changes in retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) and ganglion cell-inner plexiform layer (GCIPL) thickness, Bruch's membrane opening-minimum rim width (BMOMRW), and vessel density (VD) using OCT and OCT-angiography (OCTA).

Main Results:

• RNFL thickness decreased annually by -0.47 ± 0.27 μm (Spectralis® OCT), -0.44 ± 0.17 μm (Cirrus® OCT), and -0.25 ± 0.21 μm (Optovue® OCT).
• GCIPL thickness decreased by -0.24 ± 0.08 μm/year (Cirrus® OCT), GCC thickness by -0.40 ± 0.26 μm/year (Optovue® OCT), and BMOMRW by -1.61 ± 0.14 μm/year (Spectralis® OCT).
• VD showed a change of -0.33 ± 0.50 %/year on OCTA (Optovue® OCT).

Conclusions:

• Healthy aging leads to a consistent, progressive decline in key OCT-assessed glaucoma parameters.
• These age-related normative changes must be factored into clinical assessments to avoid misinterpreting normal aging as glaucoma progression.
• Adjusting for age-related changes will enhance the specificity of OCT and OCTA in diagnosing true glaucoma progression.