发现眼球位置和视神经弯曲度影响视网膜神经纤维厚度，与青光眼和近视相关。
Impact of Optic Nerve Tortuosity, Globe Proptosis, and Size on Retinal Ganglion Cell Thickness Across General, Glaucoma, and Myopic Populations: Insights from the UK Biobank
- 用AI分析UK Biobank的3D-OCT和MRI，量化视神经弯曲度、眼球前突和大小。
- 视神经越直、眼球前突越小，视网膜神经纤维层越薄，尤其在青光眼和近视者中显著。
- 提出新指标ILPP距离，融合眼球大小与位置，或可作视神经健康生物标志物。
目的：研究视神经迂曲度（ONT）及眼球前突与眼球大小的交互作用对视网膜神经节细胞（RGC）厚度的影响，基于视网膜神经纤维层（RNFL）厚度，涵盖普通人群、青光眼患者和高度近视者。方法：分析来自英国生物银行队列（ID 76442）的17,940只眼睛，包括72例青光眼和2,475例近视眼。通过人工智能模型从3D光学相干断层扫描（OCT）和磁共振成像（MRI）中分割结构。从OCT提取RNFL厚度并校正眼内放大效应；从MRI提取ONT、眼球前突、轴向长度及一种新型复合指标——颧弓线至后极点（ILPP）距离，反映眼球前突与大小。广义估计方程（GEE）模型评估各类人群的眶部与视网膜特征关联。结果：分割模型在MRI和OCT上均取得超过0.94的Dice系数。RNFL厚度与ONT（r = 0.065, p < 0.001）和ILPP距离（r = 0.206, p < 0.001）呈正相关。该趋势在青光眼（r = 0.040, p = 0.74；r = 0.224, p = 0.059）和近视者（r = 0.069, p < 0.001；r = 0.100, p < 0.0001）中同样成立。GEE模型显示，视神经更直、ILPP距离更短是所有人群中RNFL变薄的预测因素。结论：本研究强调了视神经迂曲度、眼球大小与前突对视网膜健康的影响，提示视神经变直或前突减小可能引发轴突机械应力，导致RNFL变薄，尤以青光眼和近视为著。新型ILPP指标整合眼球大小与位置，或可作为轴突健康的潜在生物标志物。这些发现凸显眶结构在视网膜神经节细胞轴突健康中的作用，呼吁进一步探索眶部与视神经之间的生物力学关系。
原文摘要 · Abstract (English)
Purpose: To investigate the impact of optic nerve tortuosity (ONT), and the interaction of globe proptosis and globe size on retinal ganglion cell (RGC) thickness, using Retinal Nerve Fiber Layer (RNFL) thickness, across general, glaucoma, and myopic populations. Methods: We analyzed 17,940 eyes from the UKBiobank cohort (ID 76442), including 72 glaucoma and 2475 myopic eyes. AI models segmented structures from 3D optical coherence tomography (OCT) scans and magnetic resonance images (MRI). RNFL thickness was derived from OCT scans and corrected for ocular magnification, was derived from OCT. From MRIs, we extracted: ONT, globe proptosis, axial length, and a novel interzygomatic line-to-posterior pole (ILPP) distance, a composite marker of globe proptosis and size. GEE models assessed associations between orbital and retinal features across all populations. Results: Segmentation models achieved Dice coefficients over 0.94 for both MRI and OCT. RNFL thickness was positively correlated with both ONT and ILPP distance (r = 0.065, p < 0.001, and r = 0.206, p < 0.001 respectively). The same was true for glaucoma (r = 0.040, p = 0.74, and r = 0.224, p = 0.059), and for myopia (r = 0.069, p < 0.001, and r = 0.100, p < 0.0001). GEE models revealed straighter optic nerves and shorter ILPP distance as predictive of thinner RNFL in all populations. Conclusions: This study emphasizes the impact of ONT, globe size, and proptosis on retinal health, suggesting RNFL thinning may arise from biomechanical stress due to straighter optic nerves or reduced ILPP distance, particularly in glaucoma or myopia. The novel ILPP metric, integrating globe size and position, shows potential as a biomarker for axonal health. These findings highlight the role of orbit structures in RGC axonal health and warrant further exploration of the biomechanical relationship between the orbit and optic nerve.
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