Jiang Yu, Swain Thomas, Gim Nayoon, Blazes Marian, Donald Christine Mac, Rokem Ariel, Owen Julia P, Balu Niranjan, Clark Mark E, Goerdt Lukas, McGwin Gerald, Hunt David, Curcio Christine A, Levendovszky Swati Rane, Trittschuh Emily H, Owsley Cynthia, Lee Cecilia S
From the Department of Ophthalmology (Y.J., N.G., M.B., J.P.O., and C.S.L.), University of Washington, Seattle, Washington, USA.
Department of Ophthalmology and Visual Sciences (T.S., M.E.C., L.G., G.M., C.A.C., and C.O.), University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Epidemiology (T.S. and G.M.), School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Am J Ophthalmol. 2025 Jan;269:457-465. doi: 10.1016/j.ajo.2024.09.033. Epub 2024 Oct 5.
Both retinal changes and age-related macular degeneration (AMD) have been shown to be associated with Alzheimer's disease and related dementias (ADRD). In AMD, the outer retina is impacted significantly and early, but little is known about its association with cognition or changes in brain morphometry. This study investigates the relationship between retinal and brain morphometry in older adults with early and intermediate AMD.
Cross-sectional study.
Adults ≥70 years with normal, early, and intermediate AMD were recruited from Callahan Eye Hospital Clinics at the University of Alabama at Birmingham. Participants underwent cognitive testing, optical coherence tomography, and magnetic resonance imaging. Associations of retinal layer thickness with brain volume and thickness of specific brain regions were evaluated utilizing multivariable linear regression. The relevance of retinal thickness variables in brain volumetrics was quantified using least absolute shrinkage and selection operator regression models. Correlations between demographic variables, cognitive scores, and brain morphometry were evaluated.
Participants with thinner outer retina had significantly smaller hippocampus (β = 0.019, P = .022), lower occipital cortex regions of interest (occipital ROIs) thickness (β = 5.68, P = .020), and lower cortical thickness in ADRD-related brain regions (β = 7.72, P = .006). People with thinner total retina had significantly lower occipital ROIs (β = 3.19, P = .009) and ADRD-related brain region (β = 3.94, P = .005) thickness. Outer retinal thickness in the outer Early Treatment of Diabetic Retinopathy Study ring was the most frequently reported retinal variable associated with brain morphometry on least absolute shrinkage and selection operator regression. Total gray matter volume showed positive correlations with education (Pearson's r = 0.30, P = .022).
In older adults with normal retinal aging and early and intermediate AMD, thinner outer retina had specific associations with brain regions primarily involved in vision and cognition, such as lower hippocampal volume and lower thickness of the occipital ROIs and brain regions known to show early structural changes in dementia.
视网膜变化和年龄相关性黄斑变性（AMD）均已被证明与阿尔茨海默病及相关痴呆症（ADRD）有关。在AMD中，视网膜外层会在早期受到显著影响，但关于其与认知或脑形态测量变化之间的关联却知之甚少。本研究调查了患有早期和中期AMD的老年人视网膜与脑形态测量之间的关系。
横断面研究。
从阿拉巴马大学伯明翰分校卡拉汉眼科医院诊所招募年龄≥70岁、患有正常、早期和中期AMD的成年人。参与者接受了认知测试、光学相干断层扫描和磁共振成像。利用多变量线性回归评估视网膜层厚度与脑容量及特定脑区厚度之间的关联。使用最小绝对收缩和选择算子回归模型量化视网膜厚度变量在脑容量测量中的相关性。评估人口统计学变量、认知分数和脑形态测量之间的相关性。
视网膜外层较薄的参与者海马体明显较小（β = 0.019，P = 0.022），枕叶皮质感兴趣区域（枕叶ROIs）厚度较低（β = 5.68，P = 0.020），且ADRD相关脑区的皮质厚度较低（β = 7.72，P = 0.006）。视网膜总厚度较薄的人枕叶ROIs（β = 3.19，P = 0.009）和ADRD相关脑区（β = 3.94，P = 0.005）的厚度明显较低。在最小绝对收缩和选择算子回归中，糖尿病视网膜病变早期治疗研究外环的视网膜外层厚度是最常报告的与脑形态测量相关的视网膜变量。总灰质体积与教育程度呈正相关（Pearson相关系数r = 0.30，P = 0.022）。
在视网膜正常老化以及患有早期和中期AMD的老年人中，较薄的视网膜外层与主要参与视觉和认知的脑区存在特定关联，如海马体体积较小以及枕叶ROIs和已知在痴呆症中显示早期结构变化的脑区厚度较低。
