Abstract
BackgroundRetinal imaging may serve as an alternative approach to monitor brain pathology in Alzheimer’s disease (AD). In this study, we investigated the association between retinal vascular and structural changes and cerebral amyloid-β (Aβ) plaque load in an elderly cohort.MethodsWe studied a total of 101 participants, including 73 elderly subjects (79 ± 5 years, 22 male) with no clinical diagnosis of AD but reporting some subjective memory change and an additional 28 subjects (70 ± 9 years, 16 male) with clinically established AD. Following a complete dilated ocular examination, the amplitude of retinal vascular pulsations and dynamic response, retinal nerve fibre layer thickness and retinal ganglion cell layer (RGCL) thickness were determined in all patients. Systemic blood pressure and carotid-to-femoral pulse wave velocity were measured. The elderly cohort also underwent magnetic resonance imaging and 18F-florbetaben (FBB)-positron emission tomographic amyloid imaging to measure neocortical Aβ standardised uptake value ratio (SUVR), and this was used to characterise a ‘preclinical’ group (SUVR >1.4).ResultsThe mean FBB neocortical SUVR was 1.35 ± 0.3. The amplitude of retinal venous pulsations correlated negatively with the neocortical Aβ scores (p < 0.001), whereas the amplitude of retinal arterial pulsations correlated positively with neocortical Aβ scores (p < 0.01). RGCL thickness was significantly lower in the clinical AD group (p < 0.05).ConclusionsThe correlation between retinal vascular changes and Aβ plaque load supports the possibility of a vascular component to AD. Dynamic retinal vascular parameters may provide an additional inexpensive tool to aid in the preclinical assessment of AD.
Highlights
Retinal imaging may serve as an alternative approach to monitor brain pathology in Alzheimer’s disease (AD)
In this study, we investigated the association between retinal haemodynamics and cerebral Aβ load in a cohort of elderly participants with no clinical diagnosis of AD but who had subjective memory complaints, and we subdivided these for further analysis according to positron emission tomographic (PET) scan results
This study demonstrates a significant correlation between amplitude of retinal vascular pulsatility and neocortical Aβ scores, independent of other risk factors
Summary
Retinal imaging may serve as an alternative approach to monitor brain pathology in Alzheimer’s disease (AD). Johnson and colleagues [7] devised a set of criteria that an individual must meet before PET amyloid imaging can be considered ‘appropriate’. These criteria include (1) a cognitive complaint, (2) possible AD diagnosis and (3) whether the knowledge of the presence or absence of Aβ will increase diagnostic accuracy or certainty. Besides PET amyloid imaging, cerebrospinal fluid (CSF) pathophysiological markers, including Aβ1–42, total tau and phosphorylated Tau, have shown high specificity in confirming AD pathophysiology [4]
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