Age-Related Associations of Foveal Structural Parameters in Healthy Adults: A Comparative Analysis of Biological and Chronological Age

Background: This research was conducted to compare the relationship between a comprehensive set of optical coherence tomography (OCT) parameters of the fovea and two measures of age-biological and chronological-in healthy adults. Methods: This cross-sectional study analyzed swept-source optical coherence tomography (OCT) data from 154 healthy adults aged 22–89 years. Parameters assessed: foveal thickness, foveal pit depth and diameter, pit slope steepness, and the presence or absence of the foveal bulge. Biological age was calculated using the PhenoAge algorithm. Results: The core geometry of the foveal pit showed no significant dependence on either type of age (p > 0.1). In contrast, the prevalence of the foveal bulge declined significantly with age: from ~80% in the youngest group (17-44 years) to 0-50% in the oldest group (75-92 years) (p = 0.0014 for PhenoAge, p = 0.0208 for chronological age). The odds ratio (OR) for the loss of the bulge per year of age was 0.96 (95% CI: 0.94–0.98).Conclusion: The foveal architecture remains structurally stable throughout adulthood. The foveal bulge emerges as a sensitive biomarker of age-related changes. Biological age does not provide additional predictive value over chronological age for foveal structural parameters under physiological aging conditions.