Optic Nerve Head and Nerve Fiber Layer in Alzheimer's Disease

Ritch, Robert; Schwartz, Bernard; Lee, Shami S.; Miller, Neil R.; Chi, Thomas; Hsieh, F. Y.

doi:10.1001/archopht.1991.01080020045040

Cited by 150 publications

(117 citation statements)

References 36 publications

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“…Initial in-vivo non-invasive studies of optical neuropathy in patients with Alzheimer's disease using fundus photographs showed retinal nerve fibre layer (RNFL) abnormalities, as well as macular changes and ONH abnormalities (increased cup-to-disc ratio and decreased neurorretinal rim) [37][38][39]. Increased cup-to-disc ratio has been reported to correlate with RNFL thinning in AD [40][41][42], and cup-to-disc ratio may be correlated with duration of disease [37].…”

Section: Pathological Changes In the Retina And Optic Nervementioning

confidence: 99%

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Alzheimer’s disease: A review of its visual system neuropathology. Optical coherence tomography—a potential role as a study tool in vivo

Cunha

Moura-Coelho

Proença

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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Alzheimer's disease (AD) is a prevalent, long-term progressive degenerative disorder with great social impact. It is currently thought that, in addition to neurodegeneration, vascular changes also play a role in the pathophysiology of the disease. Visual symptoms are frequent and are an early clinical manifestation; a number of psychophysiologic changes occur in visual function, including visual field defects, abnormal contrast sensitivity, abnormalities in color vision, depth perception deficits, and motion detection abnormalities. These visual changes were initially believed to be solely due to neurodegeneration in the posterior visual pathway. However, evidence from pathology studies in both animal models of AD and humans has demonstrated that neurodegeneration also takes place in the anterior visual pathway, with involvement of the retinal ganglion cells' (RGCs) dendrites, somata, and axons in the optic nerve. These studies additionally showed that patients with AD have changes in retinal and choroidal microvasculature. Pathology findings have been corroborated in in-vivo assessment of the retina and optic nerve head (ONH), as well as the retinal and choroidal vasculature. Optical coherence tomography (OCT) in particular has shown great utility in the assessment of these changes, and it may become a useful tool for early detection and monitoring disease progression in AD. The authors make a review of the current understanding of retinal and choroidal pathological changes in patients with AD, with particular focus on invivo evidence of retinal and choroidal neurodegenerative and microvascular changes using OCT technology.

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Section: Pathological Changes In the Retina And Optic Nervementioning

confidence: 99%

“…Increased cup-to-disc ratio has been reported to correlate with RNFL thinning in AD [40][41][42], and cup-to-disc ratio may be correlated with duration of disease [37]. This method, however, has certain disadvantages, as it is manual and highly subjective to each individual observer [41].…”

Section: Pathological Changes In the Retina And Optic Nervementioning

confidence: 99%

Alzheimer’s disease: A review of its visual system neuropathology. Optical coherence tomography—a potential role as a study tool in vivo

Cunha

Moura-Coelho

Proença

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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“…This change in protein levels is similar to that observed in the CSF in AD. Given the retinal degeneration observed in AD [119][120][121][122][123] and the recently reported common features between AD and glaucoma [61,107,[121][122][123][124][125][126][127][128][129][130], the vitreous humor is an interesting focus for future research into ocular protein changes in AD.…”

Section: (Figure 3)mentioning

confidence: 99%

“…4) has also been used to identify RNFL abnormalities (nerve fiber loss) in AD [121][122], although one study indicated practical difficulties in using this approach for AD screening. The retinal nerve fibers are thick enough in the inner retina to make them visible in retinal photographs (Fig.…”

Section: (Figure 7)mentioning

confidence: 99%

“…Retinal photography and Scanning Laser Ophthalmoscopy (SLO) have both been used to demonstrate optic disc changes in AD, including optic disc pallor, pathologic disc cupping (hollowing-out), and thinning of the neuro-retinal rim [122][123]. Some of the ocular morphologies found in AD are also found in the eye disease glaucoma, specifically RNFL thinning, optic disc cupping and visual field loss.…”

Section: (Figure 7)mentioning

confidence: 99%

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Ocular Biomarkers for Early Detection of Alzheimer's Disease

Frost

Martins

Kanagasingam

2010

JAD

100

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Alzheimer's disease (AD) is the most common form of dementia and is characterized clinically by a progressive decline in memory, learning and executive function and neuropathologically by the presence of cerebral amyloid deposits. Despite a century of research, there is still no cure or conclusive pre-mortem diagnosis for the disease. A number of symptom-modifying drugs for AD have been developed, but their efficacy is minimal and short-lived. AD cognitive symptoms arise only after significant, irreversible neural deterioration has occurred, hence there is an urgent need to detect AD early, before the onset of cognitive symptoms. An accurate, early diagnostic test for AD would enable current and future treatments to be more effective, as well as contribute to the development of new treatments.While most AD related pathology occurs in the brain, the disease has also been reported to affect the eye, which is more accessible for imaging than the brain. AD-related proteins exist in the normal human eye and may produce ocular pathology in AD. There is some homology between the retinal and cerebral vasculatures and the retina also contains nerve cells and fibers that form a sensory extension of the brain. The eye is the only place in the body where vasculature or neural tissue is available for non-invasive optical imaging. This article presents a review of current literature on ocular morphology in AD and discusses the potential for an ocular based screening test for AD.

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