Abstract
BackgroundPosterior cortical atrophy (PCA) is the most common atypical variant of Alzheimer's disease (AD). Changes associated with PCA in the brain affect the visual cortex, but little is known about retinal changes in PCA. In this study, we explored retinal phenotypic variations in typical AD (tAD) and PCA.MethodsRetinal phenotyping was carried out on ultra‐widefield (UWF) images of 69 control, 24 tAD, and 25 PCA participants.ResultsIndividuals with tAD (odds ratio [OR] = 2.76 [confidence interval (CI):1.24 to 6.10], P = .012) and PCA (OR = 3.40 [CI:1.25 to 9.22], P = .016) were more likely phenotyped as hard drusen. tAD (OR = 0.34 [CI:0.12 to 0.92], P = .035) were less likely to have soft drusen compared to control. Almost 3‐fold increase in reticular pseudodrusen formation in tAD (OR = 2.93 [CI:1.10 to 7.76], P = .030) compared to control was estimated.DiscussionStudying the peripheral retina may contribute to a better understanding of differences in retinal phenotypes of different AD variants.
Highlights
Neuropathological and structural heterogeneity enables detailed characterization of clinical variants of Alzzheimer’s disease (AD), such as typical Alzheimer’s disease (AD), logopenic variant, behavioral/dysexecutive variant,[1] corticobasal syndrome, and posterior cortical atrophy (PCA).[2,3]Posterior cortical atrophy (PCA) is a neurodegenerative syndrome, and it is considered the most common atypical variant of AD.[2]
In a subset of participants (PCA = 18; typical AD (tAD) = 14), the clinical assessment was confirmed by biomarker evidence using positron emission tomography (PET) and cerebrospinal fluid (CSF), and it fulfilled the amyloid PET and CSF AD profile criteria.[16]
Hard drusen were detected in 133 eyes of 69 control, 41 eyes of 23 tAD, and 46 eyes of 25 PCA participants (Table 2)
Summary
PCA is a neurodegenerative syndrome, and it is considered the most common atypical variant of AD.[2] In tAD, the primarily affected cortical area is the medial temporal lobe. In PCA, which is often called the visual variant of AD, the primarily affected areas are the parietal, occipital, and occipitotemporal cortices.[4,5] Little is known about retinal changes in PCA despite the significant visual anomalies accompanying the disease. We investigated retinal changes in a cohort with tAD and PCA using optical coherence tomography (OCT).[6] We found no significant differences in retinal thickness in the posterior pole (macula and optic disc) in patients compared to cognitively normal controls, despite the apparent differences observed on brain imaging.[6]. Discussion: Studying the peripheral retina may contribute to a better understanding of differences in retinal phenotypes of different AD variants
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