{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:05:34Z","timestamp":1784721934346,"version":"3.55.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study is to evaluate the relationship between retinal nerve fiber layer (RNFL) thickness and the onset as well as progression of chronic obstructive pulmonary disease (COPD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Database searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP Database, and CBM, covering the period from each database's inception to March 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This meta\u2010analysis included 15 studies from 2016 to 2023, comprising a total of 1455 participants (801 in the COPD group and 654 in the health group). The results showed a significant reduction in RNFL thickness across all quadrants (average, inferior, nasal, superior, and temporal) in the COPD group compared to the health group (MD: \u22124.46; 95%CI: \u22127.77 to \u22121.14; <jats:italic>p<\/jats:italic>\u2009=\u20090.008; MD: \u22128.17; 95%CI: \u221211.36 to \u22124.99; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00001; MD: \u22124.69; 95%CI: \u22127.22 to \u22122.16; <jats:italic>p<\/jats:italic>\u2009=\u20090.0003; MD: \u22124.83; 95%CI: \u22128.45 to \u22121.21; <jats:italic>p<\/jats:italic>\u2009=\u20090.009; MD: \u22122.89; 95%CI: \u22125.35 to \u22120.43; <jats:italic>p<\/jats:italic>\u2009=\u20090.02). In the mild\/moderate COPD group, only the inferior RNFL (MD: \u22122.32; 95%CI: \u22124.40 to \u22120.24; <jats:italic>p<\/jats:italic>\u2009=\u20090.03) showed a significant reduction. However, in the severe COPD group, all quadrants were significantly reduced (MD: \u22125.89; 95%CI: \u22127.40 to \u22124.38; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; MD: \u22126.74; 95%CI: \u221210.71 to \u22122.77; <jats:italic>p<\/jats:italic>\u2009=\u20090.0009; MD: \u22124.29; 95%CI: \u22125.95 to \u22122.64; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; MD: \u22122.34; 95%CI: \u22124.30 to \u22120.37; <jats:italic>p<\/jats:italic>\u2009=\u20090.02; MD: \u22124.84; 95%CI: \u22128.82 to \u22120.86; <jats:italic>p<\/jats:italic>\u2009=\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on current evidence, the average RNFL thickness and the thicknesses of various RNFL regions in COPD patients are significantly lower than those in healthy subjects, and these reductions are closely associated with disease severity. The inferior RNFL may be the first to show changes with the onset and progression of COPD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.70065","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T16:14:29Z","timestamp":1741709669000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changes in Retinal Nerve Fiber Layer Thickness in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4693-0222","authenticated-orcid":false,"given":"Yunpeng","family":"Xu","sequence":"first","affiliation":[{"name":"The First Clinical Medical College of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peidong","family":"Shi","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Liu","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyi","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical School of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanru","family":"Chen","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College of Lanzhou University  Lanzhou China"},{"name":"Gansu Province Maternity and Child\u2010Care Hospital (Gansu Provincial Central Hospital)  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunwen","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology The First Hospital of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine The First Hospital of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanqi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine The Second Hospital of Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1404615"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0173-2022"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11010-022-04559-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000527835"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00132.2022"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0174026"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2298\/VSP1412132A"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12523"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0161734613514391"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2005.06.010"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41551-021-00813-x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000504717"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/08820538.2024.2343049"},{"issue":"5","key":"e_1_2_10_15_1","article-title":"Role of Optical Coherence Tomography to Measure Retinal Nerve Fiber Layer Thickness in Patient With Chronic Obstructive Pulmonary Disease","volume":"14","author":"Wagh V.","year":"2022","journal-title":"Cureus Journal of Medical Science"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1201976"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00484-019-01717-x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.03.003"},{"key":"e_1_2_10_19_1","first-page":"151","article-title":"Retinal Nerve fiber Layer Thickness in Chronic Obstructive Pulmonary Disease: An Optical Coherence Tomography Study","volume":"15","author":"Ghee Y. T.","year":"2017","journal-title":"Asian Journal of Ophthalmology"},{"issue":"45","key":"e_1_2_10_20_1","first-page":"2","article-title":"Evaluation of the Impact of COPD Severity Grading and Oxygen Saturation on the Retinal Nerve Fiber Layer Thickness and Subfoveal Choroidal Thickness in COPD Patients","volume":"15","author":"Ahmed N. O.","year":"2021","journal-title":"Egyptian Journal of Bronchology"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.64.11.24"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2022.10.001"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_2338_21"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/crj.13349"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/crj.13140"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-019-0613-x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/7463815"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2017.1373824"},{"issue":"25","key":"e_1_2_10_29_1","first-page":"46","article-title":"Study of Retinal Nerve Fiber Layer Thickness in Patients With Chronic Obstructive Pulmonary Disease","volume":"15","author":"Li L.","year":"2018","journal-title":"Chinese Medical Innovations"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.3109\/15569527.2015.1004079"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-023-06069-2"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-21225-0"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.517"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0084\u20102023"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00983-2020"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2023.2176845"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.18-25369"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-15401-5"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.1.30"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1159\/000196349"},{"issue":"9","key":"e_1_2_10_41_1","first-page":"699","article-title":"Change of Retinal Nerve Fiber Layer Thickness in Obstructive Sleep Apnea: A Meta\u2010Analysis","volume":"42","author":"Fang Y.","year":"2022","journal-title":"International Journal of Respiration"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2014.11.009"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00424-023-02805-z"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S51226"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2023.103578"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.3928\/23258160-20240220-01"}],"container-title":["The Clinical Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/crj.70065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T06:14:10Z","timestamp":1743142450000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/crj.70065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/crj.70065"],"URL":"https:\/\/doi.org\/10.1111\/crj.70065","archive":["Portico"],"relation":{},"ISSN":["1752-6981","1752-699X"],"issn-type":[{"value":"1752-6981","type":"print"},{"value":"1752-699X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-08-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70065"}}