Retinal nerve fiber layer thinning as a predictor of delirium in medical and surgical patients: a prospective cohort study

作者：Xiaoxiao Wang, Xinning Mi, Yichen Cui, Jingshu Hong, Zhuzhu Li, Zhuzhu Li, Yimei Cai, Xiangyang Guo, Zhengqian Li, Zhengqian Li, Zhengqian Li · 发表于：Anesthesiology and Perioperative Science · 年份：2025 · DOI：10.1007/s44254-025-00158-7 · 被引用次数：4 · 研究领域：Intensive Care Unit Cognitive Disorders、Traumatic Brain Injury and Neurovascular Disturbances、Intraoperative Neuromonitoring and Anesthetic Effects

Abstract Purpose Emerging evidence suggests that retinal changes may indicate brain disorders. However, the association between retinal nerve fiber layer (RNFL) thickness and delirium risk has not been investigated. This study examined whether reduced RNFL thickness could predict an increased risk of delirium. Methods A total of 42,449 participants without a history of delirium were recruited from the UK Biobank. Optical coherence tomography (OCT) was used for RNFL thickness measurement. Cox proportional hazard models were applied to calculate hazard ratios and 95% confidence intervals for incident delirium risk. Results Over a median follow-up of 13.7 years, 1.0% of participants (425) developed delirium. Each 5-μm decrease in RNFL thickness was associated with a 13.6% higher hazard of delirium. The lowest RNFL tertile was linked to a 47.7% higher hazard compared to the highest tertile. A similar correlation was observed for postoperative delirium. Conclusion Reduced RNFL thickness is associated with increased delirium risk, highlighting the potential of OCT-based RNFL measurements as a non-invasive tool to identify potential delirium patients.