Comparisons between retinal vessel calibers and various optic disc morphologic parameters with different optic disc appearances: The Glaucoma Stereo Analysis Study

Accelerated Biological Aging in Exfoliation Glaucoma Assessed by Fundus-Derived Predicted Age and Advanced Glycation End Products

Glaucoma is an age-related neurodegenerative disease characterized by progressive optic nerve damage. Accelerated biological aging, assessed using predicted age derived from fundus images, may serve as a biomarker for glaucoma progression. This study aimed to examine fundus-derived age acceleration among patients with primary open-angle glaucoma (POAG), exfoliation glaucoma (EXG), and controls, and to explore its biochemical basis through advanced glycation end products (AGEs). Fundus photographs from 237 participants (79 POAG, 79 EXG, and 79 age- and sex-matched controls) were analyzed using a deep learning model (EfficientNet) previously trained to predict biological age. AGE accumulation was assessed by measuring skin autofluorescence (sAF). Multivariate regression analyses were conducted to identify factors influencing predicted age acceleration, with stratification into age tertiles to control for age-related effects. EXG patients demonstrated significant accelerated biological aging compared to controls (p = 0.006), particularly evident in younger and middle-aged tertiles. AGE scores were significantly elevated in EXG relative to both POAG (p = 0.009) and control groups (p = 0.003). Predicted age and AGE scores were more strongly correlated than chronological age and AGEs, especially in the middle tertile (p = 0.002). Accelerated biological aging detected via fundus images occurs prominently in EXG, potentially reflecting underlying AGE accumulation. Fundus-derived predicted age could serve as a non-invasive biomarker for assessing glaucoma progression risk and warrants further exploration in clinical applications.

Fundus-Derived Predicted Age Acceleration in Glaucoma Patients Using Deep Learning and Propensity Score-Matched Controls

Background/Objectives: Glaucoma, a leading cause of irreversible blindness, has been associated with systemic and ocular aging processes. This study aimed to investigate the relationship between glaucoma and accelerated biological aging using fundus-derived age prediction. Additionally, the role of systemic factors and retinal vascular changes in this association was explored. Methods: A total of 6023 participants, including 547 glaucoma patients and 547 matched controls, were analyzed. Fundus-derived predicted age was assessed using a deep learning model (EfficientNet). Systemic factors such as BMI, blood pressure, lipid profiles, liver function markers, glucose levels, and retinal vascular changes (Scheie classifications) were analyzed. Statistical comparisons and multivariate regression analyses were performed to evaluate the impact of glaucoma on predicted age acceleration, adjusting for age, gender, and systemic factors. Results: Glaucoma was significantly associated with higher predicted age acceleration (prediction difference: -1.5 ± 4.5 vs. -2.1 ± 4.5 years; p = 0.040). Multivariate regression confirmed that glaucoma independently influenced predicted age (p = 0.021) and prediction difference (p = 0.021). Among systemic factors, γ-GTP was positively associated with prediction difference (p = 0.036), while other factors, such as BMI, blood pressure, and glucose levels, showed no significant association. Retinal vascular changes, including hypertensive and sclerotic changes (Scheie classifications), were significantly more prevalent in glaucoma patients and correlated with predicted age acceleration. Conclusions: Glaucoma is associated with accelerated biological aging, as indicated by fundus-derived predicted age. Systemic factors such as γ-GTP and retinal vascular changes may play contributory roles. Fundus-derived predicted age holds promise as a non-invasive biomarker for monitoring systemic aging. Further longitudinal studies are warranted to establish causal relationships and enhance clinical applications.

Plxnd1-mediated mechanosensing of blood flow controls the caliber of the Dorsal Aorta via the transcription factor Klf2

The cardiovascular system generates and responds to mechanical forces. The heartbeat pumps blood through a network of vascular tubes, which adjust their caliber in response to the hemodynamic environment. However, how endothelial cells in the developing vascular system integrate inputs from circulatory forces into signaling pathways to define vessel caliber is poorly understood. Using vertebrate embryos and in vitro-assembled microvascular networks of human endothelial cells as models, flow and genetic manipulations, and custom software, we reveal that Plexin-D1, an endothelial Semaphorin receptor critical for angiogenic guidance, employs its mechanosensing activity to serve as a crucial positive regulator of the Dorsal Aorta's (DA) caliber. We also uncover that the flow-responsive transcription factor KLF2 acts as a paramount mechanosensitive effector of Plexin-D1 that enlarges endothelial cells to widen the vessel. These findings illuminate the molecular and cellular mechanisms orchestrating the interplay between cardiovascular development and hemodynamic forces.

Value of Combining Optical Coherence Tomography with Fundus Photography in Screening Retinopathy in Patients with High Myopia

Objective

To explore the value of combining optical coherence tomography (OCT) with fundus photography in screening retinopathy in patients with high myopia.

Methods

By means of retrospective study, 40 high myopia patients with retinopathy treated in our hospital from January 2020 to January 2021 were selected as the study group, and 40 healthy individuals in the same period were included in the control group. All patients received traditional ophthalmic examination, and accepted fundus fluorescence imaging, OCT, and fundus photography examination step by step by the same operator. After that, three physicians read the slides by the double blind method, and took the results of fundus fluorescence imaging as the gold standard to analyze the diagnostic efficacy of OCT, fundus photography and their combination.

Results

The clinical data and examination results showed that no statistical differences in general data including patients' mean age, gender ratio, and educational degree between the study group and the control group were observed (P > 0.05), and the nerve thickness above/below the optic disk and temporal/nasal nerve thickness of the optic disk of the study group were significantly different from those of the control group (P < 0.001); the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rate of diagnosis of combining OCT with fundus photography were respectively 95.0%, 97.5%, 97.4%, 95.1%, and 96.3%, which were significantly higher than OCT or fundus photography alone (P < 0.05); and for combined examination, AUC (95%CI) = 0.963 (0.000–1.000).

Conclusion

Combining OCT with fundus photography can effectively identify high myopia patients with retinopathy, which is conducive to improving clinical positive ratio and providing objective basis for treatment.