Photoreceptor layer thinning is an early biomarker for type 2 diabetes: a cohort study in UK Biobank

To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D. This prospective cohort study included 35,024 UK Biobank participants with high-quality optical coherence tomography (OCT) images, excluding individuals with neurological or ocular diseases. Cox p...

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Bibliographic Details
Published in:Eye (London) Vol. 39; no. 17; p. 3135
Main Authors: Ma, Yiyuan, Wu, Yue, Hu, Leyi, Zhang, Xinyu, Zheng, Danying, Liu, Zhenzhen, Jin, Guangming
Format: Journal Article
Language:English
Published: England 01.12.2025
Subjects:
Biomarkers - analysis
Diabetes Mellitus, Type 2 - diagnostic imaging
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - etiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Learning Models - classification
Predictive Learning Models - statistics & numerical data
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Retinal Photoreceptor Cell Outer Segment - pathology
Risk Assessment - methods
Risk Factors
Tomography, Optical Coherence - classification
Tomography, Optical Coherence - statistics & numerical data
UK Biobank
United Kingdom - epidemiology
United Kingdom
ISSN:1476-5454, 1476-5454
Online Access:Get more information
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Summary:To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D. This prospective cohort study included 35,024 UK Biobank participants with high-quality optical coherence tomography (OCT) images, excluding individuals with neurological or ocular diseases. Cox proportional hazard models were used to analyse the association between baseline POS thickness and incident T2D. Risk model improvement was assessed using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Among 35,024 participants (mean age, 55.6 years; 54.0% women), 1187 (3.39%) developed T2D during a median follow-up of 13.18 years. A decrease of 5 μm in POS thickness was linked to a 10% higher risk of T2D (HR, 1.10; 95% CI, 1.02-1.18; P = 0.010). Participants in the lowest tertile of POS thickness had a 22% higher T2D risk compared to those in the highest tertile (HR, 1.22; 95% CI, 1.06-1.42; P = 0.007). Adding POS thickness to traditional risk models significantly improved predictive accuracy (NRI, 0.0356; P = 0.010; IDI, 0.0003; P = 0.010). POS thinning detected by OCT is significantly associated with an increased risk of T2D and improves risk prediction when added to conventional models. These findings suggest that POS thickness may serve as a novel biomarker for early detection of T2D, supporting timely interventions to reduce risk.
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ISSN:1476-5454
1476-5454
DOI:10.1038/s41433-025-04068-7