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源自光学相干断层扫描的视网膜中央体积作为老年人群死亡率的潜在预测指标——德国AugUR研究结果

Central retinal volume derived from optical coherence tomography as a potential predictor of mortality in the old-aged population- results from the German AugUR study.

作者信息

Stark Klaus J, Zimmermann Martina E, Helbig Horst, Heid Iris M, Brandl Caroline

机构信息

Department of Genetic Epidemiology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.

Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2025 Aug 5. doi: 10.1007/s00417-025-06924-4.

Abstract

PURPOSE

To estimate mortality risk depending on central retinal volume (CRV) from optical coherence tomography (OCT) in a German cohort of the old-aged population.

METHODS

In the AugUR study, a prospective population-based cohort study in individuals aged 70-95 years at baseline, we conducted multimodal retinal imaging, including spectral-domain OCT. Heidelberg Spectralis-derived CRV measurements from first examinations of 2,166 participants were included in the analyses. Within the observation period (median 5.9-years), 374 participants died. Association between CRV at baseline and mortality was analysed with Kaplan-Meier curves and Cox proportional hazard regression.

RESULTS

Decrease in CRV was associated with increased all-cause mortality risk. In a full model with age, sex, body weight, body size, OCT scan focus, age-related macular degeneration, smoking, cardiovascular disease, diabetes, and hypertension, hazard ratio per standard deviation lower CRV was 1.17. Cardiovascular death was not associated with CRV in the full model. However, other causes for death except cardiovascular reasons showed association with lower CRV (hazard ratio 1.25). In addition, the association was significant in those who had already exceeded their expected life expectancy (hazard ratio 1.21) but not in women below 83 years and men below 78 years, respectively.

CONCLUSION

This study indicates that lower CRV, which can be easily and automatically derived from OCT images, is a potential predictor for mortality in the old-aged population. This effect occurs independently of cardiovascular disease.

摘要

目的

在德国老年人群队列中,根据光学相干断层扫描(OCT)测量的中央视网膜体积(CRV)评估死亡风险。

方法

在AugUR研究中,这是一项基于人群的前瞻性队列研究,研究对象为基线时年龄在70 - 95岁的个体,我们进行了多模态视网膜成像,包括光谱域OCT。分析纳入了2166名参与者首次检查时使用海德堡Spectralis获得的CRV测量值。在观察期(中位时间5.9年)内,374名参与者死亡。使用Kaplan - Meier曲线和Cox比例风险回归分析基线时CRV与死亡率之间的关联。

结果

CRV降低与全因死亡风险增加相关。在一个包含年龄、性别、体重、体型、OCT扫描焦点、年龄相关性黄斑变性、吸烟、心血管疾病、糖尿病和高血压的完整模型中,CRV每降低一个标准差的风险比为1.17。在完整模型中,心血管死亡与CRV无关。然而,除心血管原因外的其他死亡原因与较低的CRV相关(风险比1.25)。此外,这种关联在那些已经超过预期寿命的人群中显著(风险比1.21),但分别在83岁以下的女性和78岁以下的男性中不显著。

结论

本研究表明,可从OCT图像轻松自动得出的较低CRV是老年人群死亡率的一个潜在预测指标。这种效应独立于心血管疾病发生。

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