Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.

<h4>Background</h4>Biomarkers are widely recognized as crucial breakthroughs in tackling amyotrophic lateral sclerosis (ALS). Among them, retina markers may hold promise due to the close retina-brain connection and non-invasive, portable detection methods. Thus, using optical coherence t...

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Main Authors: Chunyang Pang, Yaojia Li, Wenhua Jiang, Haobo Xie, Wen Cao, Huan Yu, Zhiyang Lin, Yifan Cheng, Dongsheng Fan, Binbin Deng
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-06-01
Series:PLoS Medicine
Online Access:https://doi.org/10.1371/journal.pmed.1004545
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author Chunyang Pang
Yaojia Li
Wenhua Jiang
Haobo Xie
Wen Cao
Huan Yu
Zhiyang Lin
Yifan Cheng
Dongsheng Fan
Binbin Deng
author_facet Chunyang Pang
Yaojia Li
Wenhua Jiang
Haobo Xie
Wen Cao
Huan Yu
Zhiyang Lin
Yifan Cheng
Dongsheng Fan
Binbin Deng
author_sort Chunyang Pang
collection DOAJ
description <h4>Background</h4>Biomarkers are widely recognized as crucial breakthroughs in tackling amyotrophic lateral sclerosis (ALS). Among them, retina markers may hold promise due to the close retina-brain connection and non-invasive, portable detection methods. Thus, using optical coherence tomography (OCT), we investigated the link between baseline cell-level retinal features and future ALS risk.<h4>Methods and findings</h4>Participants from the UK Biobank underwent OCT scans to assess retinal layers, macula, and optic disc parameters. Follow-up commenced two years after the baseline period (2006-2010), during which ALS cases were identified using International Classification of Diseases (ICD) codes from medical and assessment records. Cox proportional hazards models were applied to examine the relationship between retinal markers and incident ALS. Over a median follow-up of 14.11 years, 70 ALS cases occurred among 53,824 participants (incidence 10.58 per 100,000 person-years). Most participants were White (94.6%), 44.8% male, with a median age of 58 years. After adjusting for demographics and comorbidities affecting the retina, a standard deviation (SD) decrease of 15.19 µm in photoreceptor layer (PRL) thickness was associated with a 19% (95% confidence interval [7, 29]; p = 0.002) increased risk of ALS, while a SD increase of 26.11 µm in retinal pigment epithelium (RPE) thickness corresponded to a 20% (95% CI [7, 34]; p = 0.002) higher risk. Sensitivity analyses excluding follow-ups of less than 4 and 6 years yielded consistent results. Subgroup analyses showed these findings were more pronounced in smokers. The main limitation of this study is its single time point observational design.<h4>Conclusion</h4>A thinner PRL and thicker RPE may precede the clinical diagnosis of ALS, offering potential clues for early diagnosis and insights into the disease's pathogenesis.
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spelling doaj-art-d4489120261c4e1e8827d171663c01532025-08-20T02:37:39ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762025-06-01226e100454510.1371/journal.pmed.1004545Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.Chunyang PangYaojia LiWenhua JiangHaobo XieWen CaoHuan YuZhiyang LinYifan ChengDongsheng FanBinbin Deng<h4>Background</h4>Biomarkers are widely recognized as crucial breakthroughs in tackling amyotrophic lateral sclerosis (ALS). Among them, retina markers may hold promise due to the close retina-brain connection and non-invasive, portable detection methods. Thus, using optical coherence tomography (OCT), we investigated the link between baseline cell-level retinal features and future ALS risk.<h4>Methods and findings</h4>Participants from the UK Biobank underwent OCT scans to assess retinal layers, macula, and optic disc parameters. Follow-up commenced two years after the baseline period (2006-2010), during which ALS cases were identified using International Classification of Diseases (ICD) codes from medical and assessment records. Cox proportional hazards models were applied to examine the relationship between retinal markers and incident ALS. Over a median follow-up of 14.11 years, 70 ALS cases occurred among 53,824 participants (incidence 10.58 per 100,000 person-years). Most participants were White (94.6%), 44.8% male, with a median age of 58 years. After adjusting for demographics and comorbidities affecting the retina, a standard deviation (SD) decrease of 15.19 µm in photoreceptor layer (PRL) thickness was associated with a 19% (95% confidence interval [7, 29]; p = 0.002) increased risk of ALS, while a SD increase of 26.11 µm in retinal pigment epithelium (RPE) thickness corresponded to a 20% (95% CI [7, 34]; p = 0.002) higher risk. Sensitivity analyses excluding follow-ups of less than 4 and 6 years yielded consistent results. Subgroup analyses showed these findings were more pronounced in smokers. The main limitation of this study is its single time point observational design.<h4>Conclusion</h4>A thinner PRL and thicker RPE may precede the clinical diagnosis of ALS, offering potential clues for early diagnosis and insights into the disease's pathogenesis.https://doi.org/10.1371/journal.pmed.1004545
spellingShingle Chunyang Pang
Yaojia Li
Wenhua Jiang
Haobo Xie
Wen Cao
Huan Yu
Zhiyang Lin
Yifan Cheng
Dongsheng Fan
Binbin Deng
Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.
PLoS Medicine
title Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.
title_full Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.
title_fullStr Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.
title_full_unstemmed Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.
title_short Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study.
title_sort analysis of retinal markers and incident amyotrophic lateral sclerosis an optical coherence tomography based cohort study
url https://doi.org/10.1371/journal.pmed.1004545
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