Thinner changes of the retinal nerve fiber layer in patients with mild cognitive impairment and Alzheimer’s disease

Liu, Dachuan; Zhang, Lina; Li, Zhen; Zhang, Xuxiang; Wu, Yue; Yang, Huiqing; Min, Baoquan; Zhang, Xinqing; Ma, Ding; Lu, Yan

doi:10.1186/s12883-015-0268-6

Cited by 122 publications

(128 citation statements)

References 35 publications

(33 reference statements)

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“…No statistically significant differences in GC-IPL thickness between AD and MCI most affected. While some studies report preferential superior quadrant RNFL thinning in AD, which would explain the predominantly inferior visual field defects previously described in AD [40,45,47,54,[70][71][72], other authors have reported different findings; these results are presented in Table 1. A meta-analysis of TD-OCT studies in AD demonstrated that peripapillary RNFL thinning occurred in all retinal quadrants [73].…”

Section: Pathological Changes In the Retina And Optic Nervementioning

confidence: 91%

“…Whether or not a correlation exists between retinal changes and severity of dementia also remains a controversial issue. While most OCT studies did not show correlation between Minimal Mental State Examination (MMSE) and peripapillary RNFL thinning (Table 2), one TD-OCT study reported correlation between MMSE scores and macular volume [44], and more recent studies using SD-OCT have indeed reported a significant correlation between MMSE scores and RNFL thickness [50,66,72,76,77]. Studies comparing changes in RNFLT in MCI and AD (Table 2) have also yielded conflicting results, although the majority reported no statistically significant differences between MCI and AD patient groups [46,47,54,77].…”

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: 91%

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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“…Although reports of NFL thinning vary, there appears to be an overwhelming majority of evidence supporting a significant thinning of the superior quadrant of the NFL in the AD retina (Fig. 2) [19, 62, 79, 87, 104, 110, 113, 118, 121, 137, 142, 145–147, 160, 177]. …”

Section: Non-specific Ocular Abnormalities In Ad Patientsmentioning

confidence: 99%

Ocular indicators of Alzheimer’s: exploring disease in the retina

et al. 2016

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Although historically perceived as a disorder confined to the brain, our understanding of Alzheimer’s disease (AD) has expanded to include extra-cerebral manifestation, with mounting evidence of abnormalities in the eye. Among ocular tissues, the retina, a developmental outgrowth of the brain, is marked by an array of pathologies in patients suffering from AD, including nerve fiber layer thinning, degeneration of retinal ganglion cells, and changes to vascular parameters. While the hallmark pathological signs of AD, amyloid β-protein (Aβ) plaques and neurofibrillary tangles (NFT) comprising hyperphosphorylated tau (pTau) protein, have long been described in the brain, identification of these characteristic biomarkers in the retina has only recently been reported. In particular, Aβ deposits were discovered in post-mortem retinas of advanced and early stage cases of AD, in stark contrast to non-AD controls. Subsequent studies have reported elevated Aβ42/40 peptides, morphologically diverse Aβ plaques, and pTau in the retina. In line with the above findings, animal model studies have reported retinal Aβ deposits and tauopathy, often correlated with local inflammation, retinal ganglion cell degeneration, and functional deficits. This review highlights the converging evidence that AD manifests in the eye, especially in the retina, which can be imaged directly and non-invasively. Visual dysfunction in AD patients, traditionally attributed to well-documented cerebral pathology, can now be reexamined as a direct outcome of retinal abnormalities. As we continue to study the disease in the brain, the emerging field of ocular AD warrants further investigation of how the retina may faithfully reflect the neurological disease. Indeed, detection of retinal AD pathology, particularly the early presenting amyloid biomarkers, using advanced high-resolution imaging techniques may allow large-scale screening and monitoring of at-risk populations.

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“…They also found significant reduction of the macular volume in MCI patients. Other authors showed that the RNFL thickness measurements were reduced in the superior quadrant and the total mean values are gradually and significantly decreased in patients ranging from MCI to severe AD, when compared to the controls [41]. In a systematic review and meta-analysis, Thomson et al [39] identified five studies including 214 MCI eyes and 421 control eyes), demonstrating a significant reduction in the overall mean RNFL thickness and in all four quadrants (superior, nasal, temporal and inferior) in patients with MCI.…”

Section: Optical Coherence Tomography Parameters In Mild Cognitive Immentioning

confidence: 99%

The role of optical coherence tomography in Alzheimer’s disease

et al. 2016

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BackgroundAlzheimer’s disease (AD) is the most common cause of dementia and its incidence is increasing worldwide along with population aging. Previous clinical and histologic studies suggest that the neurodegenerative process, which affects the brain, may also affect the retina of AD patients.Main bodyOptical coherence tomography (OCT) is a non-invasive technology that acquires cross-sectional images of retinal structures allowing neural fundus integrity assessment. Several previous studies demonstrated that both peripapillary retinal nerve fiber layer and macular thickness measurements assessed by OCT were able to detect neuronal loss in AD. Moreover, recent advances in OCT technology, have allowed substantial enhancement in ultrastructural evaluation of the macula, enabling the assessment not only of full-thickness retinal measurements but also of inner retinal layers, which seems to be a promising approach, mainly regarding the assessment of retinal ganglion cell layer impairment in AD patients. Furthermore, retinal neuronal loss seems to correlate with cognitive impairment in AD, reinforcing the promising role of OCT in the clinical evaluation of these patients.ConclusionThe purpose of this article is to review the main findings on OCT in AD patients, to discuss the role of this important diagnostic tool in these patients and how OCT technology may be useful in understanding morphological retinal changes in AD.

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Thinner changes of the retinal nerve fiber layer in patients with mild cognitive impairment and Alzheimer’s disease

Cited by 122 publications

References 35 publications

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

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

Ocular indicators of Alzheimer’s: exploring disease in the retina

The role of optical coherence tomography in Alzheimer’s disease

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