Nuclear Age Predictor Screens AS-OCT Images for Nucleus Degeneration

A nuclear age predictor can assess degeneration of the crystalline lens nucleus and possible detect cataracts.

A crystalline lens nuclear age predictor that relies on anterior segment optical coherence tomography (AS-OCT) imaging can effectively screen for nucleus degeneration, according to a study published in the British Journal of Ophthalmology

To develop a nuclear age prediction model from anterior segment optical coherence tomography (AS-OCT) data of noncataract (NonCata) eyes to be used to monitor abnormal nuclear aging, researchers recruited participants from 6 ophthalmology centers. Data were categorized into 2 groups: 1287 eyes (11,525 images) for training and 121 eyes (1379 images) for validation. The performance of the nuclear age predictor was also examined in nuclear cataract (NC) eyes. Participants were a mean age of 48.75 years. 

A high correlation between the nuclear age and chronological age was found with NonCata data. The model achieved the mean absolute error (MAE) of 2.570 (95% CI, 1.886-2.863) years and the Pearson correlation coefficient (r) of 0.969 (95% CI, 0.952-0.981) in the validation set. 

To test the accuracy of the nuclear age predictor, it was applied to 3 separate clinical test sets of NonCata participants. The predictor achieved MAEs of 4.261 (95% CI 3.391 to 5.094; TU-NonCata) years, 3.920 (95% CI 3.332 to 4.637; ZOM1-NonCata) years, and 4.380 (95% CI 3.730 to 5.061; SPH-NonCata) years. The correlations were strong and consistent at 0.936 (95% CI 0.895 to 0.969; TU-NonCata), 0.929 (95% CI 0.881 to 0.958; ZOM1-NonCata), and 0.915 (95% CI 0.874 to 0.945; SPH-NonCata). These results validate the generalizability of the predictor across multiple clinical test sets and sites.

Our work provides a new marker by nuclear age and may give an early warning of age-related disease onset, such as NC.

The nuclear age of NC was generally older than those of NonCata and got larger with higher NC disease grade. The optimal threshold to detect NC with the predicted nuclear age of NonCata and NC data was +5. Additionally, the binary classification outcomes outperform those of ophthalmologists.

Study limitations include data imbalance affecting the model’s precision, no specific diagnostic standard for AS-OCT images, and some measurement error when physicians judge NC.

“The nuclear age gap can be considered a new diagnostic marker for NC. In previous eye-screening tests, the disease was often detected only after some symptoms appeared. Our work provides a new marker by nuclear age and may give an early warning of age-related disease onset, such as NC,” according to the researchers.

Disclosure: Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Guo M, Higashita R, Lin C, et al. Crystalline lens nuclear age prediction as a new biomarker of nucleus degeneration. Bri J Ophthalmol. Published online July 26, 2023. doi:10.1136/bjo-2023-323176