노인에서 망막층 두께와 뇌 백질 고강도 신호의 연관성 연구

Association Between Retinal Layer Thickness and Cerebral White Matter Hyperintensities in Older Adults

Objective: Retinal and cerebral small vessel changes may share common mechanisms in aging and neurodegeneration. We investigated the associations between macular retinal layer thickness and cerebral white matter hyperintensities (WMH) in older adults. Methods: We included 166 community-dwelling participants (mean age 75.2 years) from two population-based aging cohorts who underwent both spectral-domain optical coherence tomography and brain MRI. Retinal thickness was measured across six retinal layers in the macular region, the peripapillary retinal nerve fiber layers, and the subfoveal choroid. WMH volumes were classified into juxtaventricular (JVWMH), periventricular (PVWMH), and deep (DWMH) regions. Linear regression models adjusted for age, sex, hypertension, and diabetes were used to assess associations. Results: Outer macular ganglion cell layer (GCL) and inner plexiform layer (IPL) thicknesses were negatively associated with total WMH, PVWMH, and DWMH volumes. In contrast, foveal inner nuclear layer (INL) thickness showed a positive association with WMH burden. JVWMH volumes showed no significant association with most retinal layers. Conclusion: Outer GCL and IPL thickness was associated with lesser cerebral WMH volumes, while foveal INL thicknening suggests a distinct pathological process. These findings support potential retina-brain structural correlations and regional pathophysiological heterogeneity of cerebral white matter lesions.