Advances in retina imaging as potential biomarkers for early diagnosis of Alzheimer’s disease

Zhang, Ying; Wang, Yanjiang; Shi, Chaoji; Shen, Meixiao; Liu, Fan

doi:10.1186/s40035-021-00230-9

Cited by 41 publications

(36 citation statements)

References 88 publications

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“…It has to be mentioned that although our findings did not support that glaucoma is an independent risk factor for subsequent development of AD, in view of the lack of effective strategies for early screening of AD before the occurrence of memory dysfunction ( 41 ), ophthalmologic examinations remain of potential as early screening tools for AD. With the development of novel techniques such as retinal optical coherence tomography ( 42 , 43 ) and nanomaterial biosensors ( 44 ), it could be expected that eye clinics and ophthalmology facilities may play important roles in the early diagnosis of AD and subsequent reducing the burdens arising from severe dementia ( 45 ).…”

Section: Discussionmentioning

confidence: 99%

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Zhao

et al. 2021

Front. Med.

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Background: Previous studies evaluating the relationships of glaucoma with Alzheimer's disease (AD) and dementia showed inconsistent results. We performed a meta-analysis of cohort studies to evaluate the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia.Methods: Cohort studies which evaluated the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia in adult population with multivariate analyses were identified by systematic search of PubMed, Embase, and Cochrane's Library databases. A random-effects model incorporating the potential intra-study heterogeneity was used for the meta-analysis.Results: Eleven cohort studies including 4,645,925 participants were included. Results showed that compared to those without glaucoma at baseline, adult patients with glaucoma was not independently associated with increased incidence of AD [adjusted risk ratio (RR): 1.03, 95% confidence interval (CI): 0.93–1.05, P = 0.55; I2 = 83%], all-cause dementia (adjusted RR: 1.08, 95% CI: 0.97–1.19, P = 0.15; I2 = 79%), or non-AD dementia (adjusted RR: 1.05 95% CI: 0.91–1.21, P = 0.49; I2 = 82%). Sensitivity analyses by excluding one study at a time did not significantly affect the results of the meta-analyses. Moreover, subgroup analyses showed consistent results in meta-analysis of prospective or retrospective cohort studies, and in meta-analysis of patients with primary open-angle glaucoma or primary angle-closure glaucoma (P-values for subgroup difference all > 0.05).Conclusions: Current evidence from cohort studies did not support that glaucoma is an independent risk factor of AD, all-cause dementia, or non-AD dementia in adult population.

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Section: Discussionmentioning

confidence: 99%

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Zhao

et al. 2021

Front. Med.

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“…Optical coherence tomography (OCT) is a technique that allows imaging of the retina with a micrometer resolution [ 12 ]. The advanced functional extension of OCT termed OCT- angiography (OCTA) [ 13 ] can help a detailed angiographic view of the retinal vascular network [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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

Hui

Zhao

et al. 2021

PLoS ONE

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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.

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“…257 Indeed, a concerted effort has been put forth to understand how Alzheimer's disease (AD) pathology may manifest in the retina as a means to assess the state of the AD brain. [258][259][260] OCTA has also been successfully evaluated as a tool to assess retinal changes in Parkinson's disease 261 and both schizophrenia and bipolar disorder. 262…”

Section: Optical Coherence Angiographymentioning

confidence: 99%

Enhanced medical diagnosis for dOCTors: a perspective of optical coherence tomography

et al. 2021

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Significance: After three decades, more than 75,000 publications, tens of companies being involved in its commercialization, and a global market perspective of about USD 1.5 billion in 2023, optical coherence tomography (OCT) has become one of the fastest successfully translated imaging techniques with substantial clinical and economic impacts and acceptance.Aim: Our perspective focuses on disruptive forward-looking innovations and key technologies to further boost OCT performance and therefore enable significantly enhanced medical diagnosis.Approach: A comprehensive review of state-of-the-art accomplishments in OCT has been performed. Results:The most disruptive future OCT innovations include imaging resolution and speed (single-beam raster scanning versus parallelization) improvement, new implementations for dual modality or even multimodality systems, and using endogenous or exogenous contrast in these hybrid OCT systems targeting molecular and metabolic imaging. Aside from OCT angiography, no other functional or contrast enhancing OCT extension has accomplished comparable clinical and commercial impacts. Some more recently developed extensions, e.g., optical coherence elastography, dynamic contrast OCT, optoretinography, and artificial intelligence enhanced OCT are also considered with high potential for the future. In addition, OCT miniaturization for portable, compact, handheld, and/or cost-effective capsule-based OCT applications, home-OCT, and self-OCT systems based on micro-optic assemblies or photonic integrated circuits will revolutionize new applications and availability in the near future. Finally, clinical translation of OCT including medical device regulatory challenges will continue to be absolutely essential.Conclusions: With its exquisite non-invasive, micrometer resolution depth sectioning capability, OCT has especially revolutionized ophthalmic diagnosis and hence is the fastest adopted imaging technology in the history of ophthalmology. Nonetheless, OCT has not been completely exploited and has substantial growth potential-in academics as well as in industry. This applies not only to the ophthalmic application field, but also especially to the original motivation of OCT to enable optical biopsy, i.e., the in situ imaging of tissue microstructure with a resolution approaching that of histology but without the need for tissue excision.

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Advances in retina imaging as potential biomarkers for early diagnosis of Alzheimer’s disease

Cited by 41 publications

References 88 publications

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

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

Enhanced medical diagnosis for dOCTors: a perspective of optical coherence tomography

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