Lens morphometry parameters on anterior segment optical coherence tomography and their association with chronological and biological age: a cross-sectional RussAge study

BACKGROUND: The search for noninvasive and clinically accessible biomarkers of aging remains a relevant challenge in modern medicine. The crystalline lens, whose morphometric parameters change predictably with age, serves as a convenient model for the quantitative assessment of age-related changes and the potential estimation of biological age.

AIM: To perform a correlation analysis of lens morphometric parameters measured with the CASIA2 device and chronological and biological age calculated using the PhenoAge model in healthy individuals across different age groups.

METHODS: We conducted a cross-sectional multicenter study. We included ophthalmologically and somatically healthy individuals from various age groups. All participants underwent anterior segment optical coherence tomography with assessment of the radii of curvature of the anterior (Front R, Front Rs, Front Rf) and posterior (Back R, Back Rs, Back Rf) lens surfaces, lens thickness (LT), equatorial diameter (LE-Dia), tilt (Tilt), and decentration (Decent). Biological age was estimated using the PhenoAge model. Statistical analysis included Spearman correlation coefficient (r), generalized estimating equations accounting for inter-eye correlation, and linear regression models with 10-fold cross-validation to assess predictive accuracy. Differences were considered significant at p < 0.05.

RESULTS: The study included 111 patients (222 eyes) aged 22–89 years. Statistically significant inter-eye asymmetry was found for the following parameters: Back R, Back Rf, LE-Dia, and Tilt (p < 0.05 Lens thickness (LT) demonstrated a strong positive correlation (r = 0.747–0.765, p < 0.0001), while Front R, Front Rs, and Front Rf showed a moderate negative correlation (r = −0.613 to −0.653, p < 0.0001) with both chronological and biological age. Correlations with biological age for some parameters (e.g., LT) were comparable to or slightly stronger than those with chronological age. Predictive analysis revealed moderate accuracy for individual age prediction (minimum mean absolute error > 8 years), indicating limited independent prognostic value of individual parameters.

CONCLUSION: Lens morphometric parameters, particularly its thickness and anterior surface curvature, are closely associated with the aging process. Comparable, and in some cases stronger, associations with biological age suggest that lens morphology may be sensitive to individual aging rates. These parameters may therefore be of interest as components of noninvasive multiparametric approaches to the assessment of biological aging.