Fundus Peripapillary Vascular Changes in Autism Spectrum Disorder: A Cross-Sectional Study

IF 5.6 2区 医学 Q1 BEHAVIORAL SCIENCES
Autism Research Pub Date : 2025-07-28 DOI:10.1002/aur.70094
Yuexuan Wang, Yonglu Wang, Zhaoqi Zhu, Zhengwang Xia, Ningyu Wang, Mingchao Li, Ziyun Jiao, Nairong Pan, Youqiang Zhang, Qiang Chen, Xiaoyan Ke, Weiwei Zhang
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引用次数: 0

Abstract

In this cross-sectional study, participants were recruited through convenience sampling from the Children's Mental Health Research Center at The Affiliated Brain Hospital of Nanjing Medical University and the Department of Ophthalmology at The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, between December 2019 and October 2024. A total of 200 eyes were ultimately enrolled in this study, sourced from 53 individuals with ASD, aged between 7 and 13 years, and an equal number of age- and sex-matched neurotypical (NT) controls. The aim of this research is to explore the changes in retinal and choroidal vasculature in children with ASD, evaluated through optical coherence tomography and its angiography, and to further investigate the potential value of retinal vascular characteristics in the auxiliary screening and diagnosis of ASD. We analyzed intergroup differences in perfusion density (PD), vessel density, flux index (FI), fractal dimension (FD), and vessel diameter (Dm) in the peripapillary region, further stratified by subquadrants and vessel types. The results show that ASD children exhibited significant differences compared to neurotypical controls, including increased PD and Dm in the supero-nasal quadrant (p < 0.01), changes in capillary FI in the nasal quadrant (p = 0.008), increased venous FD (p = 0.009), and abnormal choroidal FI in the temporal quadrant (p = 0.008). A random forest classification model constructed based on these key features demonstrated promising performance (AUC = 0.7853) in distinguishing ASD from NT individuals, highlighting the potential of retinal vascular characteristics for auxiliary ASD screening. Moreover, retinal vascular parameters were significantly correlated (p < 0.01) with blood oxygen level-dependent signals from functional magnetic resonance imaging in several brain regions, such as the amygdala (p = 0.004–0.009) and temporal lobe (p = 0.000–0.009). Further stepwise regression analysis indicates that key retinal vascular characteristics could partially predict core clinical features of ASD, such as social functioning (adjusted R 2  = 0.091–0.104, quantified by total and subscale scores of Social Responsiveness Scale) and cognitive ability (adjusted R 2  = 0.2785, quantified by total intelligence quotient scores). This study underscores the potential of retinal vascular features as biomarkers for ASD and provides a basis for future research on non-invasive retinal imaging-based approaches for ASD screening and diagnosis, while offering new perspectives for understanding the pathological mechanisms and clinical applications of ASD.

自闭症谱系障碍的眼底乳头周围血管改变:一项横断面研究。
在这项横断面研究中,参与者于2019年12月至2024年10月期间通过方便抽样从南京医科大学附属脑科医院儿童心理健康研究中心和南京医科大学第一附属医院眼科招募。这项研究总共招募了200只眼睛,来自53名年龄在7至13岁之间的ASD患者,以及相同数量的年龄和性别匹配的神经典型(NT)对照组。本研究旨在探讨ASD患儿视网膜和脉络膜血管的变化,通过光学相干断层扫描及其血管造影进行评估,进一步探讨视网膜血管特征在ASD辅助筛查和诊断中的潜在价值。我们分析了各组间乳头周围区域灌注密度(PD)、血管密度、通量指数(FI)、分形维数(FD)和血管直径(Dm)的差异,并进一步按亚象限和血管类型分层。结果显示,ASD患儿在上鼻象限PD和Dm升高(p 2 = 0.091-0.104,以社会反应量表总分和亚量表评分量化)和认知能力(调整后R2 = 0.2785,以总智商评分量化)方面与神经正常对照组存在显著差异。该研究强调了视网膜血管特征作为ASD生物标志物的潜力,为未来基于无创视网膜成像的ASD筛查和诊断方法的研究提供了基础,同时为了解ASD的病理机制和临床应用提供了新的视角。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Autism Research
Autism Research 医学-行为科学
CiteScore
8.00
自引率
8.50%
发文量
187
审稿时长
>12 weeks
期刊介绍: AUTISM RESEARCH will cover the developmental disorders known as Pervasive Developmental Disorders (or autism spectrum disorders – ASDs). The Journal focuses on basic genetic, neurobiological and psychological mechanisms and how these influence developmental processes in ASDs.
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