The Relationship Between Retinal Nerve Fiber Layer Thickness and Clinical Symptoms of Alzheimer's Disease

Abstract

Background/Aim: Retinal nerve fiber layer (RNFL) thickness (RT), which can reflect the status of the retinal optic nerve cells, may be affected in patients with Alzheimer's disease (AD). There are few studies on the correlation of RT of patients with AD (AD-RT) with clinical symptoms of various cognitive domains, neuropsychiatric symptoms, and activities of daily living (ADL). This study is to investigate the relationships between RT and the abovementioned clinical symptoms of AD.Methods: A total of 96 patients with AD were included in this study. RT was measured in these patients using optical coherence tomography (OCT). Demographic variables, RT, and clinical symptoms were compared between the normal and the abnormal AD-RT groups. Clinical symptoms, including cognitive symptoms, neuropsychiatric symptoms, and ADL, were evaluated using a series of rating scales.Results: The relationships between RT and cognitive symptoms scores were analyzed in patients with AD. Reduced RT was found in 54.4% of patients with AD. The average RT, RT of the superior 1/2 quadrant, and RT of the inferior 1/2 quadrant of both eyes were all significantly decreased in the abnormal AD-RT group (p < 0.001). Overall cognitive function and performance in multiple cognitive domains, including memory, language, attention, and executive function, were also significantly impaired in the abnormal AD-RT group (p < 0.05). For lower RT value, the global cognitive function and the performance in multiple cognitive domains were worse. ADL was significantly compromised in patients with AD having lower RT values (p < 0.05).Conclusions: Lower RT value appear to be correlated with cognitive impairment, and RT may be an indicator of cognitive decline in patients with AD. Further studies are required to confirm our findings.

Differences in Retinal and Choroidal Microvasculature and Structure in Dementia With Lewy Bodies Compared With Normal Cognition

“…45,46 When attenuation of the RNFL was found in Alzheimer disease, it was noted primarily in the superior and inferior quadrants. [47][48][49] Similarly, when analyzing the quadrant data of our cohort, we found thinning of the inferior quadrant in the DLB group. The decreased GC-IPL thickness in our study mirrors findings in previous studies of DLB and prodromal Lewy body dementia.…”

“…45,46 When attenuation of the RNFL was found in Alzheimer disease, it was noted primarily in the superior and inferior quadrants. 47 –49 Similarly, when analyzing the quadrant data of our cohort, we found thinning of the inferior quadrant in the DLB group.…”

The Progress of Label-Free Optical Imaging in Alzheimer’s Disease Screening and Diagnosis

“…After that, other relevant studies appeared successively to confirm this discovery (Bayhan et al, 2015;Bulut et al, 2016;Cunha et al, 2017b). Lian et al (2020) performed a comparative experiment between AD patients with abnormal and normal retinas. 96 AD patients were divided into 52 (54.17%) AD patients with an abnormal RNFL thickness and 44 (45.83%) AD patients with a normal RNFL thickness.…”

“… Lian et al (2020) performed a comparative experiment between AD patients with abnormal and normal retinas. 96 AD patients were divided into 52 (54.17%) AD patients with an abnormal RNFL thickness and 44 (45.83%) AD patients with a normal RNFL thickness.…”

Application of Deep Learning to Retinal-Image-Based Oculomics for Evaluation of Systemic Health: A Review

“…For example, retinal thickness measurements based on OCT have been used to diagnose and monitor multiple sclerosis (MS) [22][23][24]. Other studies have demonstrated an association between a thinner retinal nerve fiber layer (RNFL) and the diagnosis of Alzheimer's disease (AD) [25][26][27][28][29], which accounts for more than 60% of clinical dementia. A major area of OCT-based oculomics is the early detection of pre-clinical NDDs.…”