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Peer-reviewedCC BY 4.0Translational Vision Science & Technology

Associations of Optic Nerve Head and Parapapillary Atrophy Changes With Retinal Nerve Fiber Layer and Ganglion Cell Complex Thinning in Healthy Eyes

  • Caixia Li1
  • Yanyan Cheng2
  • Liqin Song3
  • Mengyang Li4
  • Xiaohua Pan5,6
  • Fei Xiang4
  • Yi Wang4
  • Junying Ren4
  • Zehua Wang4
  • Yawen Li7
  • Li Guo8
  • Hongyu Wei9
2 more authors
  • Xian Shao9
  • Shuning Li4
9 affiliations
  1. 1Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, Shaanxi, China
  2. 2Hebei Eye Hospital, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Xingtai, Hebei, China
  3. 3Chenzhou Aier Eye Hospital, Chenzhou, Hunan, China
  4. 4Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Capital Medical University, Beijing, China
  5. 5Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, Shenzhen, Guangdong, China
  6. 6Shenzhen Eye Hospital, Shenzhen Eye Center, Southern Medical University, Shenzhen, Guangdong, China
  7. 7Shijiazhuang People's Hospital, Shijiazhuang, Hebei, China
  8. 8Handan City Eye Hospital (The Third Hospital of Handan), Handan, Hebei, China
  9. 9The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Abstract

Purpose: To determine whether retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thinning occurs in association with changes in the optic nerve head (ONH) and parapapillary atrophy (PPA) over five years’ follow-up.

Methods: This longitudinal observational study recruited participants aged ≥50 years. Participants were classified into ONH/PPA changed and ONH/PPA unchanged groups based on changes in ONH shape, the position of retinal vessels, and PPA morphology. Changes in RNFL and GCC were compared between the two subgroups. Linear regression models were used to evaluate the associations between changes in RNFL and GCC thickness and both ocular and systemic factors.

Results: A total of 149 healthy eyes were included. During the five-year follow-up period, both RNFL and GCC thickness exhibited significant thinning. Specifically, the RNFL thinned by 1.59 µm, and the GCC thinned by 1.11 µm. Significant differences were observed in the change of the inferior RNFL between the two subgroups (Padj = 0.044), whereas no statistically significant differences were found for other parameters. The change in inferior RNFL was independently associated with baseline axial length (AL) (P = 0.025), change in AL (P = 0.003), change in disc area (P < 0.001) and change in ONH/PPA (P = 0.045); whereas the change in average GCC was not significantly associated with any of the evaluated parameters.

Conclusions: Significant longitudinal changes in RNFL and GCC thickness were observed in healthy eyes. GCC parameters appear to be unrelated to morphological changes of the ONH and PPA, which may facilitate the early detection of glaucoma and its progression in individuals with age-related ONH/PPA alterations.

Translational Relevance: This study provides clinicians with a key insight: GCC parameters may offer greater clinical utility than RNFL parameters for detecting early glaucoma and monitoring disease progression in individuals with age-related structural alterations of the ONH and PPA region.

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Cite

BibTeXRIS
BibTeX
@article{li2026associations,
  title = {{Associations of Optic Nerve Head and Parapapillary Atrophy Changes With Retinal Nerve Fiber Layer and Ganglion Cell Complex Thinning in Healthy Eyes}},
  author = {Caixia Li and Yanyan Cheng and Liqin Song and Mengyang Li and Xiaohua Pan and Fei Xiang and Yi Wang and Junying Ren and Zehua Wang and Yawen Li and Li Guo and Hongyu Wei and Xian Shao and Shuning Li},
  journal = {Translational Vision Science \& Technology},
  year = {2026},
  month = oct,
  doi = {10.1167/tvst.15.10.34},
  url = {https://doi.org/10.1167/tvst.15.10.34},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Associations of Optic Nerve Head and Parapapillary Atrophy Changes With Retinal Nerve Fiber Layer and Ganglion Cell Complex Thinning in Healthy Eyes
AU  - Caixia Li
AU  - Yanyan Cheng
AU  - Liqin Song
AU  - Mengyang Li
AU  - Xiaohua Pan
AU  - Fei Xiang
AU  - Yi Wang
AU  - Junying Ren
AU  - Zehua Wang
AU  - Yawen Li
AU  - Li Guo
AU  - Hongyu Wei
AU  - Xian Shao
AU  - Shuning Li
PY  - 2026
DA  - 2026/10/23
JO  - Translational Vision Science & Technology
DO  - 10.1167/tvst.15.10.34
UR  - https://doi.org/10.1167/tvst.15.10.34
AB  - Purpose: To determine whether retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thinning occurs in association with changes in the optic nerve head (ONH) and parapapillary atrophy (PPA) over five years’ follow-up.  Methods: This longitudinal observational study recruited participants aged ≥50 years. Participants were classified into ONH/PPA changed and ONH/PPA unchanged groups based on changes in ONH shape, the position of retinal vessels, and PPA morphology. Changes in RNFL and GCC were compared between the two subgroups. Linear regression models were used to evaluate the associations between changes in RNFL and GCC thickness and both ocular and systemic factors.  Results: A total of 149 healthy eyes were included. During the five-year follow-up period, both RNFL and GCC thickness exhibited significant thinning. Specifically, the RNFL thinned by 1.59 µm, and the GCC thinned by 1.11 µm. Significant differences were observed in the change of the inferior RNFL between the two subgroups (Padj = 0.044), whereas no statistically significant differences were found for other parameters. The change in inferior RNFL was independently associated with baseline axial length (AL) (P = 0.025), change in AL (P = 0.003), change in disc area (P < 0.001) and change in ONH/PPA (P = 0.045); whereas the change in average GCC was not significantly associated with any of the evaluated parameters.  Conclusions: Significant longitudinal changes in RNFL and GCC thickness were observed in healthy eyes. GCC parameters appear to be unrelated to morphological changes of the ONH and PPA, which may facilitate the early detection of glaucoma and its progression in individuals with age-related ONH/PPA alterations.  Translational Relevance: This study provides clinicians with a key insight: GCC parameters may offer greater clinical utility than RNFL parameters for detecting early glaucoma and monitoring disease progression in individuals with age-related structural alterations of the ONH and PPA region.
SN  - 2164-2591
ER  -