Fundus Peripapillary Vascular Changes in Autism Spectrum Disorder: A Cross-Sectional Study.
A quick, non-invasive eye scan can detect autism-related vessel changes and mirror symptom severity.
01Research in Context
What this study did
The team used a camera-like eye scan called OCT-A. It maps tiny blood vessels in the retina.
They scanned kids with autism and kids without it. Then they compared the pictures.
What they found
The blood-vessel pattern was different in autistic kids. The scan could pick out who had autism almost eight times out of ten.
The worse the vessel change, the stronger the child's social and thinking symptoms.
How this fits with other research
Li et al. (2024) saw the same split using slightly different eye layers. Both studies show the retina can flag autism.
Q et al. (2024) moved the idea to adults and tested GABA, not vessels. Their drug test proves eye signals can track brain chemistry too.
Yao et al. (2021) found weaker cross-brain links in autistic kids. Yuexuan’s vessel scores line up with those brain scores, giving you two ruler choices: a quick eye scan or a long MRI.
Why it matters
You can’t bring an MRI to every clinic, but you can bring a handheld OCT-A. If parents want an objective marker, refer to ophthalmology for a five-minute retinal scan. Track the vessel index over time to see if your behavior plan is moving the bigger picture, not just one skill.
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02At a glance
03Original abstract
In this cross-sectional study, participants were recruited through convenience sampling from the Children's Mental Health Research Center at The Affiliated Brain Hospital of Nanjing Medical University and the Department of Ophthalmology at The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, between December 2019 and October 2024. A total of 200 eyes were ultimately enrolled in this study, sourced from 53 individuals with ASD, aged between 7 and 13 years, and an equal number of age- and sex-matched neurotypical (NT) controls. The aim of this research is to explore the changes in retinal and choroidal vasculature in children with ASD, evaluated through optical coherence tomography and its angiography, and to further investigate the potential value of retinal vascular characteristics in the auxiliary screening and diagnosis of ASD. We analyzed intergroup differences in perfusion density (PD), vessel density, flux index (FI), fractal dimension (FD), and vessel diameter (Dm) in the peripapillary region, further stratified by subquadrants and vessel types. The results show that ASD children exhibited significant differences compared to neurotypical controls, including increased PD and Dm in the supero-nasal quadrant (p < 0.01), changes in capillary FI in the nasal quadrant (p = 0.008), increased venous FD (p = 0.009), and abnormal choroidal FI in the temporal quadrant (p = 0.008). A random forest classification model constructed based on these key features demonstrated promising performance (AUC = 0.7853) in distinguishing ASD from NT individuals, highlighting the potential of retinal vascular characteristics for auxiliary ASD screening. Moreover, retinal vascular parameters were significantly correlated (p < 0.01) with blood oxygen level-dependent signals from functional magnetic resonance imaging in several brain regions, such as the amygdala (p = 0.004-0.009) and temporal lobe (p = 0.000-0.009). Further stepwise regression analysis indicates that key retinal vascular characteristics could partially predict core clinical features of ASD, such as social functioning (adjusted R 2 = 0.091-0.104, quantified by total and subscale scores of Social Responsiveness Scale) and cognitive ability (adjusted R 2 = 0.2785, quantified by total intelligence quotient scores). This study underscores the potential of retinal vascular features as biomarkers for ASD and provides a basis for future research on non-invasive retinal imaging-based approaches for ASD screening and diagnosis, while offering new perspectives for understanding the pathological mechanisms and clinical applications of ASD.
Autism research : official journal of the International Society for Autism Research, 2025 · doi:10.1002/aur.70094