Aims/Purpose: Alzheimer's disease (AD), the leading cause of dementia, affects millions, underscoring the need for early diagnostic methods. The retina, which can exhibit AD‐related pathological processes, offers a promising diagnostic site. This study aims to utilize Hyperspectral Retinal Imaging (HSRI) to differentiate between positive (+) and negative (‐) PET‐amyloid beta (Aβ) status. Within this cohort, a subset is Aβ+ while remaining cognitively healthy, indicating preclinical amyloid accumulation. Unlike most research targeting later symptomatic stages, our approach could facilitate interventions before clinically apparent neurodegeneration occurs.Methods: Data was used from 37 Aβ‐ and 25 Aβ+ individuals of which 8 with mild cognitive impairment (MCI). HSRI were captured using an easy‐to‐use hyperspectral snapshot camera, covering a spectral range of 460–630 nm. Images were taken from primary, inferior, and superior views of the retina, with further regions of interest (ROI) defined in the primary view. After preprocessing, these spectra were used to train machine learning classifiers [1].Results: The best classifier performance was observed using XGBoost with the superior spectra (AUC = 0.72), and using a Linear Discriminant Analysis classifier in superior quadrants (S1 AUC = 0.74, S2 AUC = 0.68). Lower performance in other ROI underscored the variability in amyloid deposition across the retina, correlating with previous findings that retinal Aβ deposits in AD patients are frequently concentrated in the superior quadrants.Conclusions: We were able to achieve similar performance of previous research in AD patients [1], but in a preclinical cohort of cognitively normal participants up to MCI patients. Consistent with the literature, the superior retinal regions seem most discriminative for Aβ status. Further exploration of the specificity of the HSRI signal will pave the way for early AD detection, potentially improving outcomes through earlier therapeutic intervention.Reference S. Lemmens et al., ‘Combination of snapshot hyperspectral retinal imaging and optical coherence tomography to identify Alzheimer's disease patients’, Alzheimer's Research & Therapy, vol. 12, no. 1, p. 144, Nov. 2020, doi: 10.1186/s13195‐020‐00715‐1.
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