The application of optical coherence tomography angiography in Alzheimer's disease: A systematic review

Rifai, Olivia M; McGrory, Sarah; Robbins, Cason B.; Grewal, Dilraj S.; Liu, Andy; Fekrat, Sharon; MacGillivray, Thomas J.

doi:10.1002/dad2.12149

Cited by 36 publications

(67 citation statements)

References 75 publications

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“…However, the cerebral microvasculature is too small to be directly visualized in vivo . Due to the shared embryologic origin of the retina and brain, there is resemblance between blood-retinal barrier (BRB) and blood-brain barrier (BBB), and the retina is thus regarded as an extension of the CNS (London et al, 2013 ; Gupta et al, 2020 ; Rifai et al, 2021 ); retinal vascular lesions, including reduced arterial diameter, expanded venous diameter, and decreased fractional dimension, were found in patients with AD using fundus photographs (Cheung et al, 2014 ; McGrory et al, 2016 ). Moreover, accumulating evidence have reported that Aβ deposits were discovered in retinas of AD and animal studies (Hart et al, 2016 ; Doustar et al, 2017 ; den Haan et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Retinal Microvascular Features in Alzheimer's Disease

Lei

Ruoxin

et al. 2021

Front. Aging Neurosci.

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Objective: The aim of this meta-analysis was to investigate retinal microvascular features in patients with Alzheimer's disease (AD) using optical coherence tomography angiography (OCTA).Methods: PubMed, Cochrane Library, Embase, and Web of Science databases were systematically searched for published articles comparing retinal microvascular characteristics in subjects with AD and controls. The mean difference (MD) with a 95% confidence interval (CI) was used to assess continuous variables. Review Manager Version (RevMan) 5.30, was employed to analyze the data.Results: Nine studies were included in the meta-analysis. The analysis revealed that the macular whole enface superficial and deep vessel density (VD) values measured by OCTA were significantly lower in patients with AD than in controls (MD = −1.10, P < 0.0001; MD = −1.61, P = 0.0001, respectively). The value measured by OCTA for parafoveal superficial VD in patients with AD was also remarkably lower than that in the control group (MD = −1.42, P = 0.001), whereas there was no significant difference in the value for parafoveal deep VD (MD = −3.67, P = 0.19), compared to the controls. In addition, the foveal avascular zone (FAZ) was larger in patients with AD than in the control group (MD = 0.08, P = 0.07), although it did not reach statistical significance.Conclusions: The present meta-analysis indicated that the macular whole enface and parafoveal vessel densities were reduced in patients with AD. Moreover, our pooled data revealed that FAZ is larger in patients with AD. Consequently, OCTA may be utilized as a diagnostic tool to identify and monitor patients with AD.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Retinal Microvascular Features in Alzheimer's Disease

Lei

Ruoxin

et al. 2021

Front. Aging Neurosci.

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“…7 Studies of changes in neural retinal structure have been informative regarding changes in brain structure and function, and disease progression, in neurodegenerative diseases, 7 and accumulating evidence suggests that retinal microvasculature changes are also informative in cases of CNS disease. 3,[8][9][10][11] A brief and non-invasive method for assessing the state of retinal vasculature is optical coherence tomography angiography (OCTA). [12][13][14][15][16][17][18] OCT is a method based on lowcoherence interferometry that uses the difference between the power in spectral frequencies of near-infrared light reflected back from the eye, relative to the frequency composition of the original light output, to generate detailed images of retinal layers (conventional OCT) and the retinal microvasculature (OCTA), in a manner analogous to how ultrasound is used to generate biological images.…”

Section: Introductionmentioning

confidence: 99%

“…The use of OCTA in the field of neurology has generated data indicating that a wide range of neurodegenerative diseases are characterized by retinal microvasculature abnormalities, with extent of the alteration (eg, reduced density of vessels) often being correlated with disease severity. [9][10][11]19 OCTA is only now beginning to be incorporated into psychiatric studies, however. Previous studies of the retinal microvasculature in schizophrenia using conventional fundus photography have reported wider venules, 3,20 narrower arterioles, 20 and abnormal trajectories of venules and arterioles.…”

Section: Introductionmentioning

confidence: 99%

Retinal Microvasculature in Schizophrenia

Silverstein¹,

Lai²,

Green³

et al. 2021

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Purpose: Schizophrenia is associated with alterations in neural structure and function of the retina that are similar to changes seen in the retina and brain in multiple neurodegenerative disorders. Preliminary evidence suggests that retinal microvasculature may also be compromised in schizophrenia. The goal of this study was to determine, using optical coherence tomography angiography (OCTA), whether 1) schizophrenia is associated with alterations in retinal microvasculature density; and 2) microvasculature reductions are associated with retinal neural layer thinning and performance on a measure of verbal IQ. Patients and Methods: Twenty-eight outpatients with schizophrenia or schizoaffective disorder and 37 psychiatrically healthy control subjects completed OCT and OCTA exams, and the Wechsler Test of Adult Reading. Results: Schizophrenia patients were characterized by retinal microvasculature density reductions, and enlarged foveal avascular zones, in both eyes. These microvascular abnormalities were generally associated with thinning of retinal neural (macular and peripapillary nerve fiber layer) tissue (but the data were stronger for the left than the right eye) and lower scores on a proxy measure of verbal IQ. First-and later-episode patients did not differ significantly on OCTA findings. Conclusion:The retinal microvasculature impairments seen in schizophrenia appear to be a biomarker of overall brain health, as is the case for multiple neurological conditions. Additional research is needed, however, to clarify contributions of social disadvantage and medical comorbidities to the findings.

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“…Three recent review articles have summarized OCT-A findings in AD patients [ 11 , 12 , 13 ]. Essentially, OCT-A examinations of AD retinas have shown an enlarged FAZ, a decrease of the vascular density of the superficial and deep vascular plexus in the macular region ( Figure 3 ), and also in the radial peripapillary capillary layer.…”

Section: Oct-a Findings In Neurological Diseasesmentioning

confidence: 99%

The Value of Optical Coherence Tomography Angiography (OCT-A) in Neurological Diseases

Augustin

Atorf

2022

Diagnostics

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Optical coherence tomography angiography (OCT-A) was commercially introduced in 2014. OCT-A allows a fast, non-invasive, three-dimensional analysis of the retinal vasculature from the vitreoretinal interface to the choriocapillaris. The results can be evaluated separately in automated or custom-defined retinal layers. Since its introduction, OCT-A has also been used in patients with neurological diseases in order to find and characterize retinal biomarkers. Many neurological diseases have retinal manifestations, often preceding the key symptoms of the neurological disease. Anatomically and developmentally, the retina is a part of the brain. In contrast to the brain, the retina is easily accessible for imaging methods; moreover, retinal imaging is more cost-effective than brain imaging. In this review, the current knowledge about OCT-A findings and possible OCT-A biomarkers in neurological diseases is summarized and discussed regarding the value of OCT-A as a diagnostic tool in neurological diseases.

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The application of optical coherence tomography angiography in Alzheimer's disease: A systematic review

Cited by 36 publications

References 75 publications

A Systematic Review and Meta-Analysis of Retinal Microvascular Features in Alzheimer's Disease

A Systematic Review and Meta-Analysis of Retinal Microvascular Features in Alzheimer's Disease

Retinal Microvasculature in Schizophrenia

The Value of Optical Coherence Tomography Angiography (OCT-A) in Neurological Diseases

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