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Abstract
Neurodegenerative disorders (NDD) such as Alzheimer's and Parkinson's diseases are significant causes of morbidity and mortality worldwide. The pathophysiology of NDD is still debated, and there is an urgent need to understand the mechanisms behind the onset and progression of these heterogenous diseases. The eye represents a unique window to the brain that can be easily assessed via non-invasive ocular imaging. As such, ocular measurements have been recently considered as potential sources of biomarkers for the early detection and management of NDD. However, the current use of ocular biomarkers in the clinical management of NDD patients is particularly challenging. Specifically, many ocular biomarkers are influenced by local and systemic factors that exhibit significant variation among individuals. In addition, there is a lack of methodology available for interpreting the outcomes of ocular examinations in NDD. Recently, mathematical modeling has emerged as an important tool capable of shedding light on the pathophysiology of multifactorial diseases and enhancing analysis and interpretation of clinical results. In this article, we review and discuss the clinical evidence of the relationship between NDD in the brain and in the eye and explore the potential use of mathematical modeling to facilitate NDD diagnosis and management based upon ocular biomarkers.
Highlights
Neurodegenerative disorders (NDD) represent a heterogeneous group of diseases characterized by progressive structural and functional degeneration of the central and peripheral nervous systems
Thanks to its special connection to the brain and its accessibility to measurements, the eye provides a unique window on the brain, thereby offering non-invasive access to a large set of potential biomarkers that might help in the early diagnosis and clinical care of NDD
Clinical measurements are influenced by many factors that vary among individuals, such as blood pressure, intraocular pressure (IOP), and cerebrospinal fluid (CSF) pressure
Summary
Neurodegenerative disorders (NDD) represent a heterogeneous group of diseases characterized by progressive structural and functional degeneration of the central and peripheral nervous systems. Clinical measurements are influenced by many factors that vary among individuals, such as blood pressure, intraocular pressure (IOP), and cerebrospinal fluid (CSF) pressure Some of these factors may be systemic (e.g., blood pressure, CSF pressure) or local to the eye (e.g., IOP), thereby making it extremely difficult to isolate their contributions to pathogenic processes in in vivo settings. Despite their accessibility to noninvasive imaging, ocular measurements remain challenging to interpret in view of NDD biomarkers due to the lack of quantitative methods to identify the most relevant pathogenic mechanisms in specific patients. The article concludes with an outlook on how to further develop this multidisciplinary approach in order to enable NDD diagnosis and monitoring via noninvasive ocular measurements (section 7)
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