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Peripheral Retinal Imaging Biomarkers for Alzheimer's Disease: A Pilot Study

Csincsik, L; MacGillivray, TJ; Flynn, E; Pellegrini, E; Papanastasiou, G; Barzegar-Befroei, N; Csutak, A; ... Lengyel, I; + view all (2018) Peripheral Retinal Imaging Biomarkers for Alzheimer's Disease: A Pilot Study. Ophthalmic Research , 59 (4) pp. 182-192. 10.1159/000487053. Green open access

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Abstract

Purpose: To examine whether ultra-widefield (UWF) retinal imaging can identify biomarkers for Alzheimer’s disease (AD) and its progression. Methods: Images were taken using a UWF scanning laser ophthalmoscope (Optos P200C AF) to determine phenotypic variations in 59 patients with AD and 48 healthy controls at baseline (BL). All living participants were invited for a follow-up (FU) after 2 years and imaged again (if still able to participate). All participants had blood taken for genotyping at BL. Images were graded for the prevalence of age-related macular degeneration-like pathologies and retinal vascular parameters. Comparison between AD patients and controls was made using the Student t test and the χ2 test. Results: Analysis at BL revealed a significantly higher prevalence of a hard drusen phenotype in the periphery of AD patients (14/55; 25.4%) compared to controls (2/48; 4.2%) [χ2 = 9.9, df = 4, p = 0.04]. A markedly increased drusen number was observed at the 2-year FU in patients with AD compared to controls. There was a significant increase in venular width gradient at BL (zone C: 8.425 × 10–3 ± 2.865 × 10–3 vs. 6.375 × 10–3 ± 1.532 × 10–3, p = 0.008; entire image: 8.235 × 10–3 ± 2.839 × 10–3 vs. 6.050 × 10–3 ± 1.414 × 10–3, p = 0.004) and a significant decrease in arterial fractal dimension in AD at BL (entire image: 1.250 ± 0.086 vs. 1.304 ± 0.089, p = 0.049) with a trend for both at FU. Conclusions: UWF retinal imaging revealed a significant association between AD and peripheral hard drusen formation and changes to the vasculature beyond the posterior pole, at BL and after clinical progression over 2 years, suggesting that monitoring pathological changes in the peripheral retina might become a valuable tool in AD monitoring.

Type: Article
Title: Peripheral Retinal Imaging Biomarkers for Alzheimer's Disease: A Pilot Study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1159/000487053
Publisher version: https://doi.org/10.1159/000487053
Language: English
Additional information: This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.
Keywords: Science & Technology, Life Sciences & Biomedicine, Ophthalmology, Alzheimer's disease, Age-related macular degeneration, Drusen, Vascular biomarker, Image grading, Imaging, Peripheral retina, Fractal dimension, Tortuosity, AGE-RELATED MACULOPATHY, GANGLION-CELL LOSS, MACULAR DEGENERATION, APOLIPOPROTEIN-E, LESIONS, RISK, ASSOCIATION, PATHOLOGY, DEMENTIA, VOLUME
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10052576
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