Liermann Yannick N, Behning Charlotte, Isselmann Ben, Schmid Matthias, Dunbar Hannah M P, Luhmann Ulrich F O, Finger Robert P, Schmitz-Valckenberg Steffen, Holz Frank G, Pfau Maximilian, Luu Chi D, Saßmannshausen Marlene, Thiele Sarah
Department of Ophthalmology, University of Bonn, Bonn, Germany.
Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany.
Sci Rep. 2025 Jun 20;15(1):20093. doi: 10.1038/s41598-025-00735-7.
This study evaluated the functional relevance of relative ellipsoid zone reflectivity (rEZR) on spectral-domain optical coherence tomography as a structural biomarker for retinal integrity, focusing on its association with retinal function. Participants with age-related macular degeneration (AMD) and controls from the MACUSTAR study underwent functional testing, including mesopic fundus-controlled perimetry, best-corrected visual acuity, low-luminance visual acuity, low-luminance deficit, Moorfields Acuity Test, and Pelli-Robson contrast sensitivity, along with spectral-domain optical coherence tomography imaging. Structural and functional data were analyzed globally and spatially aligned for topographic analysis. Linear-mixed effects models, adjusted for age, sex, and eccentricity of the rEZR, assessed associations between rEZR and functional metrics. A total of 275 eyes (early AMD, n = 34; intermediate AMD, n = 152; late AMD, n = 36; controls, n = 53) from 275 participants (mean ± standard deviation age: 71.1 ± 7.2 years; 63.3% female) were included. In global analyses, rEZR was associated with the mean average threshold in mesopic fundus-controlled perimetry (coefficient estimate 0.0492, 95% confidence interval 0.0190-0.0794, p = 0.0015), low-luminance visual acuity (coefficient estimate - 0.0015, 95% confidence interval - 0.0026 to - 0.0004, p = 0.0092), Moorfields Acuity Test (coefficient estimate 0.0092, 95% confidence interval - 0.0022 to - 0.0001, p = 0.0285), and Pelli-Robson contrast sensitivity (coefficient estimate 0.0030, 95% confidence interval 0.0015-0.0045, p = 0.0001). Topographic analysis further revealed an association of rEZR with mesopic retinal sensitivity (coefficient estimate 0.0065, 95% confidence interval 0.0026-0.0104, p < 0.0001). Higher outer retinal reflectivity is linked to better retinal function in AMD and controls, supporting its potential as a biomarker for retinal integrity and function.
本研究评估了光谱域光学相干断层扫描中相对椭圆体区反射率（rEZR）作为视网膜完整性结构生物标志物的功能相关性，重点关注其与视网膜功能的关联。来自MACUSTAR研究的年龄相关性黄斑变性（AMD）患者和对照组接受了功能测试，包括中视眼底控制视野检查、最佳矫正视力、低亮度视力、低亮度缺陷、摩尔菲尔德视力测试和佩利-罗布森对比敏感度测试，同时还进行了光谱域光学相干断层扫描成像。对结构和功能数据进行全局分析，并进行空间对齐以进行地形分析。采用线性混合效应模型，对年龄、性别和rEZR的偏心率进行调整，评估rEZR与功能指标之间的关联。共纳入了275名参与者的275只眼睛（早期AMD，n = 34；中期AMD，n = 152；晚期AMD，n = 36；对照组，n = 53）（平均±标准差年龄：71.1±7.2岁；63.3%为女性）。在全局分析中，rEZR与中视眼底控制视野检查中的平均阈值（系数估计值0.0492，95%置信区间0.0190 - 0.0794，p = 0.0015）、低亮度视力（系数估计值 - 0.0015，95%置信区间 - 0.0026至 - 0.0004，p = 0.0092）、摩尔菲尔德视力测试（系数估计值0.0092，95%置信区间 - 0.0022至 - 0.0001，p = 0.0285）和佩利-罗布森对比敏感度（系数估计值0.0030，95%置信区间0.0015 - 0.0045，p = 0.0001）相关。地形分析进一步揭示了rEZR与中视视网膜敏感度之间的关联（系数估计值0.0065，95%置信区间0.0026 - 0.0104，p < 0.0001）。在AMD患者和对照组中，较高的外层视网膜反射率与较好的视网膜功能相关，支持其作为视网膜完整性和功能生物标志物的潜力。
