Preop Macular Thickness May Be Marker of Postop Delirium in Seniors
FRIDAY, April 4, 2025 -- In older patients undergoing surgery, preoperative macular thickness may be a marker for vulnerability to developing postoperative delirium, according to a study published online April 1 in General Psychiatry.
Zhongyong Shi, M.D., from Shanghai Jiao Tong University School of Medicine, and colleagues examined the relationship between retinal layer thickness and postoperative delirium in a cross-sectional study involving participants aged 65 years and older undergoing elective surgery under general anesthesia. Optical coherence tomography (OCT) was used to measure preoperative macular thickness and peripapillary retinal nerve fiber layer (RNFL) thickness. The incidence and severity of postoperative delirium were measured on the first, second, and third days after surgery using the Confusion Assessment Method (CAM) algorithm and CAM-Severity.
Overall, 24 percent of the 169 participants developed postoperative delirium. The researchers found that individuals who developed versus did not develop postoperative delirium exhibited thicker preoperative macular thickness in the right eye (mean, 283.35 versus 273.84 µm). After adjustment for age, sex, and Mini-Mental State Examination scores, there were also associations observed for thicker preoperative macular thickness of the right eye with a higher incidence of postoperative delirium (adjusted odds ratio, 1.593) and greater severity (adjusted mean difference [β], 0.256). There was no such difference or association seen in the left macular or bilateral peripapillary RNFL thickness.
"Our findings suggest that macular thickness measured by OCT may serve as a noninvasive marker and identify individuals vulnerable to developing postoperative delirium after anesthesia and surgery among geriatric patients," the authors write.
One author disclosed ties to Baxter and NanoMosaic.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
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