Decreased Vessel Density in Retinal Capillary Plexus and Thinner Ganglion Cell Complex Associated With Cognitive Impairment

Abstract

BackgroundTo determine the association of the retinal capillary plexus (RCP) and ganglion cell complex (GCC) with cognitive impairment using optical coherence tomography angiography (OCTA).MethodsA cross-sectional, community-based study utilizing data from the participants enrolled between August 2019 and January 2020 in the Jidong Eye Cohort Study. We assessed the vessel density in RCP and GCC thickness using OCTA, and cognitive testing using the Montreal Cognitive Assessment (MoCA). Cognitive impairment in this study was defined as MoCA score < 24. We used multivariable analysis to evaluate the association of RCP and GCC with cognitive impairment after adjusting for confounders.ResultsThis study analyzed 1555 participants. The mean age of participants was 52.3 (8.4) years, and 861 (55.4%) were women. Cognitive impairment was observed in 268 (17.2%) participants. The adjusted odds ratio (OR) with 95% confidence interval (95% CI) for parafovea vessel density in the deep RCP with cognitive impairment was 1.20 (1.03–1.39). For vessel area and length density surrounding foveal avascular zone with cognitive impairment, the ORs with 95% CIs were 1.23 (1.07–1.41) and 1.30 (1.13–1.49), respectively. For thickness in the superior GCC with cognitive impairment, the OR with 95% CI was 1.16 (1.01–1.32).ConclusionLower vessel density in the RCP and thinner GCC were associated with cognitive impairment. Our results suggest that alterations in the RCP and GCC could provide further evidence when assessing the cognitive function and may even be potentially useful biomarkers in the detection of cognitive impairment.

Retinal microvasculature and incident dementia over 10 years: The Three‐City‐Alienor cohort

“…Yet, understanding the most important lesions/parameters should continue through studies with extensive phenotyping of participants. Future tools could also arise from more precise techniques such as Optical Coherence Tomographie‐Angiography (OCT‐A) 48–50 . However, to date previous studies using OCT‐A had small sample sizes or were cross‐sectional and employed different types of image analysis methods and metrics definition, making it difficult to compare their results.…”

“…Future tools could also arise from more precise techniques such as Optical Coherence Tomographie‐Angiography (OCT‐A). 48 , 49 , 50 However, to date previous studies using OCT‐A had small sample sizes or were cross‐sectional and employed different types of image analysis methods and metrics definition, making it difficult to compare their results. Whatever the technique, the way is long and more work is still needed to obtain accurate, reliable, and reproducible tools that could help identify persons at risk of future dementia at an early stage when monitoring vascular risk factors may help slow brain damage.…”

The Eye as a Diagnostic Tool for Alzheimer’s Disease

“…Subsequent studies by Zhang in 2022 demonstrated FAZ changes were also related to medial temporal lobe atrophy (MTA) scores in individuals with early-onset dementia (EOD), whereas retinal microvasculature was correlated with white-matter hyperintensity [ 61 ]. Additionally, patients with AD and cognitive impairment have been found to have lower retinal capillary vessel density as well as flow density compared to controls [ 62 , 63 , 64 , 65 , 66 , 67 , 68 ] ( Figure 4 ).…”