• A large-scale population-based study using swept-source optical coherence tomography evaluated macular ganglion cell complex (mGCC), macular retinal nerve fiber layer (mRNFL), and peripapillary retinal nerve fiber layer (pRNFL) thickness. • Significant sex-related differences were observed in regional RNFL and GCC thickness. • RNFL and mGCC thickness showed a significant age-related decrease across most regions. • mGCC thickness was negatively associated with age and positively associated with pseudophakia. • mRNFL thickness decreased with age but was positively associated with axial length and pseudophakia. • pRNFL thickness was negatively associated with age, cardiovascular disease, intraocular pressure, and axial length. To investigate the impact of sex and age on macular ganglion cell complex (mGCC) and retinal nerve fiber layer (RNFL) thickness, and to identify associated determinants. In the population-based Beichen Eye Study involving 5,840 participants aged 50 years and older, mGCC, macular RNFL (mRNFL), and peripapillary RNFL (pRNFL) thickness were measured using swept-source optical coherence tomography. Sex- and age-related variations in these thickness parameters were analyzed. Generalized estimating equation (GEE) models were applied to assess the influence of demographic, ocular, and systemic factors on the thickness parameters (mGCC, mRNFL, and pRNFL). This study included 4,703 eyes from 2,670 participants (mean age 61.9 ± 6.4 years). No significant sex differences were found in average mGCC or mRNFL thickness, but regional variations were present. Males exhibited greater thickness in inner subfields, while females showed thicker outer subfields. In terms of pRNFL, females had a significantly thicker average thickness, as well as in the temporal, superior, and inferior quadrants compared to males. All layers experienced significant age-related thinning. GEE analysis indicated that average mGCC thickness was associated with age (β = -0.30) and pseudophakia (β = 2.55). The mRNFL thickness was associated with age (β = -0.08), pseudophakia (β = 2.20), and axial Length (AL) (β = 1.07). The pRNFL thickness was associated with age (β = -0.20), cardiovascular disease (CVD) (β = -1.39), intraocular pressure (IOP) (β = -0.22), and AL (β = -1.92). All associations were statistically significant (p < 0.05). Regional sex-related differences were observed in mGCC and mRNFL thickness, while pRNFL thickness showed significant sex differences globally and across most quadrants. Increasing age was consistently associated with thinning of all three retinal parameters. Additionally, these thickness parameters were also associated with other ocular and systemic factors, including AL, lens status, IOP, and CVD.
Song et al. (Sun,) studied this question.