Outer Retinal Thinning is Associated With Brain Atrophy in Early Age-Related Macular Degeneration

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-10-05 DOI:10.1016/j.ajo.2024.09.033

Yu Jiang , Thomas Swain , Nayoon Gim , Marian Blazes , Christine Mac Donald , Ariel Rokem , Julia P. Owen , Niranjan Balu , Mark E. Clark , Lukas Goerdt , Gerald McGwin , David Hunt , Christine A. Curcio , Swati Rane Levendovszky , Emily H. Trittschuh , Cynthia Owsley , Cecilia S. Lee

{"title":"Outer Retinal Thinning is Associated With Brain Atrophy in Early Age-Related Macular Degeneration","authors":"Yu Jiang , Thomas Swain , Nayoon Gim , Marian Blazes , Christine Mac Donald , Ariel Rokem , Julia P. Owen , Niranjan Balu , Mark E. Clark , Lukas Goerdt , Gerald McGwin , David Hunt , Christine A. Curcio , Swati Rane Levendovszky , Emily H. Trittschuh , Cynthia Owsley , Cecilia S. Lee","doi":"10.1016/j.ajo.2024.09.033","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Participants with thinner outer retina had significantly smaller hippocampus (<span><math><mi>β</mi></math></span> = 0.019, <em>P</em> = .022), lower occipital cortex regions of interest (occipital ROIs) thickness (<span><math><mi>β</mi></math></span> = 5.68, <em>P</em> = .020), and lower cortical thickness in ADRD-related brain regions (<span><math><mi>β</mi></math></span> = 7.72, <em>P</em> = .006). People with thinner total retina had significantly lower occipital ROIs (<span><math><mi>β</mi></math></span> = 3.19, <em>P</em> = .009) and ADRD-related brain region (<span><math><mi>β</mi></math></span> = 3.94, <em>P</em> = .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 <em>r</em> = 0.30, <em>P</em> = .022).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"269 ","pages":"Pages 457-465"},"PeriodicalIF":4.1000,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002939424004665","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

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.

Design

Cross-sectional study.

Methods

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.

Results

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).

Conclusions

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.

查看原文本刊更多论文

视网膜外层变薄与早期老年性黄斑变性的脑萎缩有关。

目的：视网膜变化和年龄相关性黄斑变性（AMD）都被证明与阿尔茨海默病和相关痴呆症（ADRD）有关。在老年性黄斑变性中，外层视网膜受到的影响显著且较早，但人们对其与认知或大脑形态变化的关系知之甚少。本研究调查了患有早期和中期老年性黄斑变性（AMD）的老年人视网膜和大脑形态之间的关系：设计：横断面研究：方法：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 岁的正常、早期和中期 AMD 患者。参与者接受了认知测试、光学相干断层扫描（OCT）和磁共振成像（MRI）。利用多变量线性回归评估了视网膜层厚度与脑容量和特定脑区厚度的关系。利用最小绝对收缩和选择算子（LASSO）回归模型量化了视网膜厚度变量与脑容量的相关性。评估了人口统计学变量、认知评分和脑形态测量之间的相关性：结果：外层视网膜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（枕叶 ROIs）厚度较低（β = 5.68，p = 0.020），ADRD 相关脑区皮质厚度较低（β = 7.72，p = 0.006）。总视网膜较薄的人枕叶ROIs（β = 3.19，p = 0.009）和ADRD相关脑区（β = 3.94，p = 0.005）厚度明显较低。早期糖尿病视网膜病变治疗研究（ETDRS）外环的外层视网膜厚度是 LASSO 回归中最常报告的与脑形态测量相关的视网膜变量。灰质总量与教育程度呈正相关（Pearson's r = 0.30，p = 0.022）：结论：在视网膜正常老化以及早期和中期老年性视网膜病变的老年人中，较薄的外层视网膜与主要涉及视觉和认知的脑区有特定的关联，如海马体积较小、枕叶ROIs厚度较低以及已知在痴呆症中显示早期结构变化的脑区。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.