The Retinal Vessel Density Can Reflect Cognitive Function in Patients with Alzheimer’s Disease: Evidence from Optical Coherence Tomography Angiography

2021 ◽  
pp. 1-10
Author(s):  
Yibing Yan ◽  
Xingqi Wu ◽  
Xiaojing Wang ◽  
Zhi Geng ◽  
Lu Wang ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Optical Coherence Tomography ◽  
Cognitive Function ◽  
Layer Thickness ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Retinal Layer ◽  
Optical Coherence ◽  
Visual Spatial

Background: There is increasing evidence that Alzheimer’s disease (AD) patients may present decreased cerebral blood perfusion before pathological brain changes. Using the retina as a window to the brain, we can study disorders of the central nervous system through the eyes. Objective: This study aimed to investigate differences in retinal structure and vessel density (VD) between patients with mild AD and healthy controls (HCs). Furthermore, we explored the relationship between retinal VD and cognitive function. Methods: We enrolled 37 patients with AD and 29 age-matched HCs who underwent standard ophthalmic optical coherence tomography angiography (OCTA) for evaluation of the retinal layer thickness and VD parameters. Cognitive function was evaluated using a battery of neuropsychological assessments. Finally, the correlations among retinal layer thickness, VD parameters, and cognitive function were evaluated. Results: The retinal fiber layer thickness and retinal VD of patients with AD were significantly reduced compared with HCs. The retinal VD was significantly correlated with overall cognition, memory, executive, and visual-spatial perception functions. However, there was no significant between-group difference in the macular thickness. Conclusion: Our findings indicate a positive correlation between retinal VD and some, but not all, cognitive function domains. Most importantly, we demonstrated the role of OCTA in detecting early capillary changes, which could be a noninvasive biomarker for early AD.

scholarly journals Optical coherence tomography angiography in preclinical Alzheimer’s disease

2019 ◽  
Vol 104 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Jacoba Alida van de Kreeke ◽  
Hoang-Ton Nguyen ◽  
Elles Konijnenberg ◽  
Jori Tomassen ◽  
Anouk den Braber ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Binding Potential ◽  
Continuous Measure ◽  
Optical Coherence ◽  
Mz Twins ◽  
The Brain

Background/aimsAs a protrusion from the brain, the retina might reflect the status of the brain. Previous studies showed a decrease in vessel density and foveal avascular zone (FAZ) enlargement on optical coherence tomography angiography (OCTA) in individuals suffering from Alzheimer’s disease (AD). This study aims to assess whether such changes are already present in preclinical stages of AD, in a population of monozygotic (MZ) twins.Methods124 cognitively healthy individuals (MZ twins, ages 60–93 years) underwent [18F]flutemetamol amyloid positron emission tomography (PET) scanning and OCTA. PET scans were visually rated for cortical amyloid-beta (Aβ) positivity. Parametric global cortical non-displaceable binding potential (BPND) was used as a continuous measure for Aβ aggregation. FAZ size and vessel densities for the inner and outer ring of the macular ETDRS grid and in a 3–6 mm ring around the optic nerve head (ONH) were measured.OCTA measures were associated with visual Aβ score,BPNDand amyloid load estimated by twin concordance on visual Aβ score. Twin correlations were estimated as a measure of maximum heritability of OCTA measures.Results13 of 124 participants were Aβ+. Aβ+ individuals had significantly higher vessel density than Aβ– individuals in all regions but did not differ in FAZ size. Twin analyses showed a positive association between and vessel densities in all regions.BPNDtended to be associated with higher vessel density in the inner ring. Twin correlations were moderate/high for all OCTA parameters except vessel density around the ONH, which correlated weakly.ConclusionRetinal vessel density was higher in individuals with preclinical AD.

scholarly journals Quantitative assessment of retinal thickness and vessel density using optical coherence tomography angiography in patients with Alzheimer’s disease and glaucoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248284
Author(s):  
Przemyslaw Zabel ◽  
Jakub J. Kaluzny ◽  
Katarzyna Zabel ◽  
Martyna Kaluzna ◽  
Aleksander Lamkowski ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Optical Coherence Tomography ◽  
Open Angle Glaucoma ◽  
Retinal Vessel ◽  
Vessel Density ◽  
Vascular Density ◽  
Retinal Layer ◽  
Optical Coherence ◽  
Vascular Plexus

Purpose Assessment and a direct comparison of retinal vessel density with the thickness of inner retinal layer (IRL) and outer retinal layer (ORL) in the same regions of the macula in subjects with Alzheimer’s disease (AD) and primary open-angle glaucoma (POAG). Methods We analyzed data from 48 eyes of healthy control (HC) participants, 71 eyes with POAG, and 49 eyes of AD patients. Ophthalmic examination included optical coherence tomography (OCT) imaging to measure IRL and ORL thickness and OCT angiography (OCTA) in the same region for the imaging of vessel density in the superficial vascular plexus (SVP) and deep vascular plexus (DVP) of the retina. A direct comparison of vessel density and retinal layers thickness, which different dynamic ranges, was obtained by normalizing values as percentage losses. Results Patients with AD presented significantly greater losses of vascular density in the DVP and ORL thickness compared to POAG (p <0.001), but percentage losses of vessel density in SVP and IRL thickness were considerable in POAG compared to AD eyes (p<0.001). Positive associations among presence of AD were observed primarily in outer retina where a 1% decrease of ORL thickness was associated with about 24–29% increase in odds of the presence of AD. According to OCTA measurements, a 1% decrease of vessel density in DVP was positively associated with a 4–9% increase in odds of the presence of AD. In POAG positive associations among presence of disease were observed only in inner retina where 1% loss of IRL thickness and a 1% loss of vessel density in the SVP were positively associated with a 13–23% increase in risk of presence of the disease. Conclusions Analysis of ORL thickness and vessel density in DVP could potentially improve diagnostic capabilities and may provide a valuable approach for predicting of AD.

scholarly journals Quantitative Assessment of Retinal Thickness and Vessel Density Using Optical Coherence Tomography Angiography in Patients with Alzheimer’s Disease and Glaucoma

2020 ◽  
Author(s):  
Przemyslaw Zabel ◽  
Jakub J. Kaluzny ◽  
Katarzyna Zabel ◽  
Martyna Kaluzna ◽  
Aleksander Lamkowski ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Optical Coherence Tomography ◽  
Open Angle Glaucoma ◽  
Vessel Density ◽  
Vascular Density ◽  
Retinal Layer ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Vascular Plexus

Abstract Background Retinal imaging using optical coherence tomography (OCT) and OCT angiography (OCTA) may serve as an alternative approach to monitoring and diagnosing neurodegenerative diseases such as Alzheimer's disease (AD) and primary open-angle glaucoma (POAG). In this study, we performed direct comparisons of retinal vessel density with the thickness of inner retinal layer (IRL) and outer retinal layer (ORL) in patients with AD and POAG. Methods In this cross-sectional study, we analyzed data from 48 eyes of healthy control (HC) participants, 71 eyes of POAG patients, and 49 eyes of AD patients with confirmed presence of fibrillar brain amyloid on positron emission tomography (PET) imaging with florbetapir F 18. Ophthalmic examination included OCT imaging to measure IRL and ORL thickness in the macula and OCTA in the same region for the imaging of vessel density in the superficial vascular plexus (SVP) and deep vascular plexus (DVP) of the retina. A direct comparison of vessels density and retinal layers thickness, which different dynamic ranges, was obtained by normalizing values as percentage losses. Values were adjusted for inter-eye correlation, age, gender, and scan quality, where applicable. Results Patients with AD presented significantly greater losses of vascular density in the DVP and ORL thickness compared to POAG (p < 0.001), but percentage losses of vessel density in SVP and IRL thickness were considerable in POAG compared to AD eyes (p < 0.001). Positive associations among presence of AD were observed primarily in outer retina where a 1% decrease of ORL thickness was associated with about 24–29% increase in odds of the presence of AD. According to OCTA measurements, a 1% decrease of vessel density in DVP was positively associated with a 4–9% increase in odds of the presence of AD. In POAG positive associations among presence of disease were observed only in inner retina where 1% loss of IRL thickness and a 1% loss of vessel density in the SVP were positively associated with a 13–23% increase in risk of presence of the disease. Conclusions Analysis of ORL thickness and vessel density in DVP could potentially improve diagnostic capabilities and may provide a valuable approach for predicting of AD.

Evaluation of Ocular Perfusion in Alzheimer’s Disease Using Optical Coherence Tomography Angiography

2018 ◽  
Vol 66 (4) ◽  
pp. 1745-1752 ◽  
Author(s):  
Larissa Lahme ◽  
Eliane Luisa Esser ◽  
Natasa Mihailovic ◽  
Friederike Schubert ◽  
Jost Lauermann ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Ocular Perfusion

scholarly journals Detection of retinal changes with optical coherence tomography angiography in mild cognitive impairment and Alzheimer’s disease patients: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255362
Author(s):  
Jingwen Hui ◽  
Yun Zhao ◽  
Shasha Yu ◽  
Jinfeng Liu ◽  
Kin Chiu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Optical Coherence Tomography ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Optical Coherence Tomography Angiography ◽  
Meta Analysis ◽  
Optical Coherence ◽  
Retinal Microvasculature ◽  
Capillary Plexus

Objective To assess retinal microvascular network impairments in the eyes of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) patients with optical coherence tomography angiography (OCTA). Design Systematic review and meta-analysis. Methods A literature search was conducted in the PubMed and EMBASE databases to identify relevant studies detecting retinal microvascular attenuation among AD, MCI patients and cognitively healthy controls (HCs) by OCTA. Data were extracted by Review Manager V.5.4 and Stata V.14.0. Results Eight investigations were included in this meta-analysis, with 150 AD patients, 195 MCI patients and 226 HCs were eligible for meta-analysis. Evidence based on these studies demonstrated that there was a significantly decreased vessel density (VD) of the Optovue group in superficial capillary plexus (SCP): WMD = -2.26, 95% CI: -3.98 to -0.55, p = 0.01; in deep capillary plexus (DCP): WMD = -3.40, 95% CI: -5.99 to -0.81, p = 0.01, VD of the Zeiss group in SCP:WMD = -0.91, 95% CI: -1.79 to -0.02, p = 0.05 and an enlarged fovea avascular zone (FAZ):WMD = 0.06, 95% CI: 0.01 to 0.11, P = 0.02 in OCTA measurements of MCI patients. Additionally, in OCTA measurements of AD patients, there was a significantly decreased VD in the SCP: WMD = -1.88, 95% CI: -2.7 to -1.07, p<0.00001. In contrast, there was no significant decrease in DCP nor enlargement of FAZ in AD patients. Conclusion Retinal microvascular alternations could be optimally screened in MCI patients detected by OCTA, which could be a warning sign of relative changes in the MCI before progressing to AD. Retinal microvasculature changes worth further investigation in larger scale clinical trials.

scholarly journals Decreased Retinal Vascular Density in Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI): An Optical Coherence Tomography Angiography (OCTA) Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Xi Wang ◽  
Qianhua Zhao ◽  
Rui Tao ◽  
Huimeng Lu ◽  
Zhenxu Xiao ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Optical Coherence Tomography ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Patient Group ◽  
Optical Coherence Tomography Angiography ◽  
Vascular Density ◽  
Optical Coherence ◽  
Patient Groups

BackgroundTo explore the retinal vascular density changes in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients using optical coherence tomography angiography (OCTA).MethodsWe recruit 62 AD patients, 47 MCI patients, and 49 cognitively healthy controls (HC) in this study. All participants in the study received a comprehensive ophthalmological and neurological evaluation, including global cognitive screening, as well as the Mini-Mental State Examination (MMSE), and completed the following eye examinations: visual acuity (VA), intraocular pressure (IOP), examination with slit-lamp, fundus photography (Version 1.5.0.0, NIDEK CO, LTD) and Optical coherence tomography imaging (software ReVue version 2017.1.0.155, Optovue Inc., Fremont, CA, United States). The visual rating scales for atrophy and white matter lesion in MRI was evaluated for all the patients with AD and MCI.ResultsIn the AD patient group, the superficial vascular density in the superior, inferior and whole retina was 44.64 ± 3.34, 44.65 ± 3.55, and 44.66 ± 3.36, respectively. These values were 44.24 ± 3.15, 43.72 ± 3.16, and 44 ± 3.07, respectively, in the MCI patient group. After multivariate analysis of the generalized linear model, adjustments for the confounding factors of sex, age, hypertension, diabetes and the quality index of OCTA image, the superficial vascular density in the AD and MCI patient groups was significantly lower than that in the HC group (P &lt; 0.05): 46.94 ± 2.04, 46.67 ± 2.26, and 46.82 ± 2.08, respectively. No difference in the area of the FAZ among the three groups was observed (AD group: 0.34 ± 0.11 mm2; MCI group: 0.36 ± 0.12 mm2; control group: 0.33 ± 0.12 mm2, p &gt; 0.05). The ganglion cell complex (GCC) thickness, inner parafovea thickness, and peripapillary retinal nerve fiber layer (p-RNFL) thickness were associated with the superficial vascular density. We found no significant correlation between the global cognition (MMSE scores) or between the Fazekas score and retinal OCT angiogram flow density.ConclusionThe superficial vascular density in the AD and MCI patient groups was significantly lower than that in the HC group. Our findings suggest the retinal microvascular dysfunction occurred in MCI and AD.

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