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Updated: Dec 26, 2025
Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Retinal microvascular attenuation in mental cognitive impairment and Alzheimer's disease by optical coherence
Jing Wu1,2, Xiaojun Zhang3, Guliqiwaer Azhati1
1Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
Purpose:
To explore regional variation of the macular microvasculature in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), also to detect the association between retinal macular microvascular parameters and the progress of preclinical AD.
Methods:
Prospective study of healthy controls, patients with MCI and patients with AD by using Optical coherence tomography angiography (OCT-A). We quantified foveal avascular zone (FAZ) areas, densities of the superficial retinal capillary plexuses (SRCP) and deep retinal capillary plexuses (DRCP). The SRCP and DRCP were divided into inner (3 mm) and external (6 mm) annular rings, each containing four quadrants (SI, II, TI, NI, SE, IE, TE and NE). The data were analysed statistically by using SPSS 22 software.
Results:
Totally, 60 subjects including 21 HC (33 eyes), 21 patients with MCI (32 eyes) and 18 AD patients (28 eyes) were recruited. The microvascular densities of DRCP at all quadrants of the parafovea and perifovea were significantly lower in AD patients compared to HC group (p < 0.05). Compared to the HCs, MCI patients showed significant microvascular loss in most sectors of the parafovea and the SE sector of the DRCP (p < 0.05), but not in the parafovea (p = 0.829) or perifovea (p = 0.824) of the SRCP. No significant difference was found in microvascular density of SRCP among the groups, except at SI between the AD and HC groups (p = 0.048).
Conclusion:
Our findings demonstrated the macular microvascular attenuation in MCI and AD patients. Both AD and MCI patients showed retinal microvascular density loss, which is more significant in the deep retinal capillary plexuses. Optical coherence tomography angiography (OCT-A) can be used to identify early microvascular abnormalities in AD and MCI. Quantified microvascular density in the DRCP might serve as potential biomarkers of early sign of AD then contribute to forestall the progression of preclinical AD.
Insights
Macular microvascular density loss is evident in mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients, particularly in the deep retinal capillary plexuses. Optical coherence tomography angiography (OCT-A) can detect these early signs, aiding in monitoring disease progression.
Area of Science:
- Ophthalmology
- Neurology
- Medical Imaging
Background:
- Macular microvasculature changes are implicated in neurodegenerative diseases.
- Early detection of Alzheimer's disease (AD) and mild cognitive impairment (MCI) is crucial for timely intervention.
- Optical coherence tomography angiography (OCT-A) offers high-resolution imaging of retinal microvasculature.
Purpose of the Study:
- To investigate regional variations in macular microvasculature in patients with MCI and AD.
- To assess the association between retinal microvascular parameters and the progression of preclinical AD.
Main Methods:
- Prospective study involving healthy controls (HC), MCI patients, and AD patients.
- Utilized Optical coherence tomography angiography (OCT-A) to quantify foveal avascular zone (FAZ) areas and retinal capillary plexus densities.
- Analyzed superficial retinal capillary plexuses (SRCP) and deep retinal capillary plexuses (DRCP) in inner and outer annular rings, divided into four quadrants.
Main Results:
- AD patients exhibited significantly lower microvascular densities in the DRCP across all parafoveal and perifoveal quadrants compared to HC.
- MCI patients showed significant microvascular loss in most parafoveal sectors and the SE sector of the DRCP compared to HC.
- No significant differences in SRCP microvascular density were observed among groups, except for the SI quadrant between AD and HC.
Conclusions:
- Macular microvascular attenuation is evident in both MCI and AD patients, with more pronounced loss in the DRCP.
- OCT-A is effective in identifying early microvascular abnormalities associated with MCI and AD.
- Quantified microvascular density in the DRCP may serve as a potential biomarker for early AD detection and monitoring preclinical progression.
