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Normative Percentiles and Age-Related Change Points for RNFL and GCIPL Thickness in Healthy Korean Adults Based on
Jae Ryong Song1, Seong-Joon Kim1, Jae Ho Jung1
1Department of Ophthalmology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Korea.
Purpose:
To generate decade-specific normative percentiles for Korean adults and identify age-related change points in retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness using Cirrus HD optical coherence tomography (OCT).
Methods:
Cross-sectional, population-based study of 8,558 healthy Korean adults from the Korea National Health and Nutrition Examination Survey (KNHANES) 2017-2021. Cirrus HD-OCT imaging used Optic Disc Cube 200 × 200 protocol for RNFL and Macular Cube 512 × 128 protocol for GCIPL measurements. Simple linear regression change-point (SLRCP) analysis identified age-related change points. Decade-specific percentiles (5th, 25th, 50th, 75th, 95th) were calculated.
Results:
Cohort included 4,654 women (54.4%) and 3,904 men (45.6%) aged 47.4 ± 13.5 years. Mean RNFL thickness was 95.7 ± 9.1 μm, and GCIPL thickness was 82.7 ± 5.8 μm. Linear regression showed significant age-related decline: RNFL at -0.116 μm/year (95% CI, -0.133 to -0.100; p < .001) and GCIPL at -0.044 μm/year (95% CI, -0.055 to -0.034; p < .001). Women showed thicker RNFL (96.6 vs. 94.9 μm; p < .001), while men had thicker GCIPL (83.0 vs. 82.4 μm; p < .001). SLRCP analysis identified change points with accelerated thinning: GCIPL 51 years (slopes: +0.056 to -0.248 μm/year) and RNFL at 52 years (slopes: -0.079 to -0.240 μm/year). Median RNFL declined from 97 μm (20-29 years) to 87 μm (80-89 years) and GCIPL from 82 μm to 76 μm.
Conclusion:
RNFL and GCIPL demonstrate nonlinear age-related thinning with accelerated decline beginning in the fifth to sixth decades. These decade-specific normative values and change points provide population- and device-specific references which improve diagnostic accuracy.
