Ophthalmology in China ›› 2026, Vol. 35 ›› Issue (3): 203-208.doi: 10.13281/j.cnki.issn.1004-4469.2026.03.004.

Previous Articles     Next Articles

Peripapillary retinal nerve fiber layer thickness and myopia progression: a cohort study of mongolian adolescents in Hinggan League, Inner Mongolia

Wang Ziyao1, Wu Xusheng2, Pan Zhe3, Chen Luxiao3, Yuan Jixuan3, Chen Xiaodong3, Zhang Chun3, Wang Yaxing3, Zhu Dan2, LiXuemin1   

  1. 1 Department of Ophthalmology, Peking University Third Hospital, Beijing100191, China; 2 Department of Ophthalmology,Affiliated Hospital of Inner Mongolia Medical University, Huhehaote 010030, China; 3 Beijing Visual Science and Translational Eye Research Institute(BERI); Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing 102218, China.
  • Received:2025-12-22 Online:2026-05-25 Published:2026-05-25
  • Contact: Li Xuemin, Email: lxmlxm66@sina.com
  • Supported by:
    National Natural Science Foundation of China (81860178)

Abstract:  Objective  To evaluate the association between baseline peripapillary retinal nerve fiber layer (pRNFL) thickness and axial length (AL) elongation over a subsequent one-year period in adolescents. Design A prospective cohort study.  Participants  353 adolescents from Bayan Hushu, Hinggan League, Inner Mongolia. Methods  Standardized ophthalmological examinations were performed in May 2023 and September 2024. Participants were categorized into a rapid progression group (AL increase≥0.2 mm/year) and a non-rapid progression group. A robust linear regression model was employed to evaluate the longitudinal relationship between baseline pRNFL thickness and annual AL elongation. Analysis of covariance (ANCOVA) with estimated marginal means (EMMs) was used to compare the baseline pRNFL differences between the two groups. Additionally, stratified analysis was performed based on baseline spherical equivalent (SE≤-3.0 D) to verify the robustness of these associations. Main Outcome Measures Independent associations between baseline global and sectoral pRNFL thickness and rapid AL growth over the following year. Results Among 353 participants, 93 were in the rapid progression group and 260 were in the non-rapid progression group. After adjusting for age, sex, baseline AL, and height, multivariate robust linear regression indicated that baseline pRNFL thickness in the temporal-inferior (TI) (β=-0.016, P=0.003) and temporal (T) (β=-0.014, P=0.009) sectors was significantly and negatively associated with annual AL growth. After adjusting for covariates, baseline pRNFL in the TI (146.97μm vs. 155.34 μm, P=0.001) and T (86.69 μm vs. 92.59 μm, P=0.009) sectors were significantly thinner in the rapid progression group. Stratified analysis confirmed that this predictive effect remained robust in the moderate-to-high myopia group. Conclusion Thinner baseline pRNFL in the TI and T sectors is independently associated with rapid axial elongation over the following year in adolescents, with this longitudinal association being more robust among those with moderate-to-high myopia. These findings provide new insights into the potential of pRNFL thickness as an imaging biomarker for identifying individuals at high risk of rapid myopia progression.

Key words:  Myopia progression, Retinal nerve fiber layer (RNFL), Cohort study