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Is retinal vasculature a biomarker in amyloid proven Alzheimer's disease?
Jurre den Haan1, Jacoba A van de Kreeke2, Bart N van Berckel3
1Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
Introduction:
The retina is a potential source of noninvasive vascular biomarkers for Alzheimer's disease (AD). We assessed retinal microvasculature in well-characterized AD cases, taking ophthalmological confounders into account.
Methods:
We included 48 amyloid-positive AD patients and 38 amyloid-negative cognitively normal control subjects. All participants underwent ophthalmological screening to exclude interfering ocular disease. Using a multimodal approach, we measured retinal vascular parameters, choroidal thickness, macular vascular density, and foveal avascular zone size.
Results:
We found no disease effects on retinal vascular measures (all β's < |0.15|, all P > .2), adjusted for confounders. Venular tortuosity was inversely associated with Fazekas score in control subjects (β -0.56, P < .01), while vessel density in the outer ring of the macula was inversely associated with Fazekas score in AD cases (β -0.64, P < .01).
Discussion:
In conclusion, retinal vasculature did not discriminate patients with AD from control subjects, despite evident changes on clinical, neuroimaging, and cerebrospinal fluid biomarkers, challenging the use of retinal vasculature measurements as AD biomarker.
Insights
Retinal vasculature did not distinguish Alzheimer's disease (AD) patients from controls. This study challenges the utility of retinal vascular measurements as a noninvasive biomarker for AD diagnosis.
Area of Science:
- Ophthalmology
- Neurology
- Biomarker Discovery
Background:
- The retina offers potential for noninvasive Alzheimer's disease (AD) vascular biomarkers.
- Assessing retinal microvasculature in AD patients requires accounting for ophthalmological confounders.
Purpose of the Study:
- To evaluate retinal microvasculature as a potential biomarker for Alzheimer's disease (AD).
- To investigate retinal vascular parameters, choroidal thickness, macular vascular density, and foveal avascular zone size in AD patients and controls.
Main Methods:
- Included 48 amyloid-positive AD patients and 38 amyloid-negative cognitively normal controls.
- Conducted ophthalmological screening to exclude ocular disease.
- Employed a multimodal approach to measure retinal vascular parameters.
Main Results:
- No significant disease effects on overall retinal vascular measures were found.
- Venular tortuosity correlated with Fazekas score in controls.
- Macular vessel density correlated with Fazekas score in AD patients.
Conclusions:
- Retinal vasculature did not differentiate AD patients from controls.
- Findings challenge the use of retinal vasculature measurements as a reliable AD biomarker.
- Further research is needed to explore potential retinal biomarkers for AD.