Retinal vascular and structural changes are associated with amyloid burden in the elderly: ophthalmic biomarkers of preclinical Alzheimer's disease

S Mojtaba Golzan, Kathryn Goozee, Dana Georgevsky, Alberto Avolio, Pratishtha Chatterjee, Kaikai Shen, Vivek Gupta, Roger Chung, Greg Savage, Carolyn Orr, Ralph Martins, Stuart Graham

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38 Citations (Scopus)
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Background: Retinal imaging may serve as an alternative approach to monitor brain pathology in Alzheimer’s disease (AD). In this study, we investigated the association between retinal vascular and structural changes and cerebral amyloid-β (Aβ) plaque load in an elderly cohort.

Methods: We studied a total of 101 participants, including 73 elderly subjects (79 ± 5 years, 22 male) with no clinical diagnosis of AD but reporting some subjective memory change and an additional 28 subjects (70 ± 9 years, 16 male) with clinically established AD. Following a complete dilated ocular examination, the amplitude of retinal vascular pulsations and dynamic response, retinal nerve fibre layer thickness and retinal ganglion cell layer (RGCL) thickness were determined in all patients. Systemic blood pressure and carotid-to-femoral pulse wave velocity were measured. The elderly cohort also underwent magnetic resonance imaging and ¹⁸F-florbetaben (FBB)-positron emission tomographic amyloid imaging to measure neocortical Aβ standardised uptake value ratio (SUVR), and this was used to characterise a ‘preclinical’ group (SUVR >1.4).

Results: The mean FBB neocortical SUVR was 1.35 ± 0.3. The amplitude of retinal venous pulsations correlated negatively with the neocortical Aβ scores (p< 0.001), whereas the amplitude of retinal arterial pulsations correlated positively with neocortical Aβ scores (p < 0.01). RGCL thickness was significantly lower in the clinical AD group (p < 0.05).

Conclusions: The correlation between retinal vascular changes and Aβ plaque load supports the possibility of a vascular component to AD. Dynamic retinal vascular parameters may provide an additional inexpensive tool to aid in the preclinical assessment of AD.
Original languageEnglish
Article number13
Pages (from-to)1-9
Number of pages9
JournalAlzheimer's Research and Therapy
Issue number1
Publication statusPublished - 1 Mar 2017

Bibliographical note

Copyright the Author(s) 2017. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • retinal imaging
  • vascular biomarkers
  • Alzheimer's disease
  • early diagnosis

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