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OCT in Alzheimer's disease: thinning of the RNFL and superior hemiretina.
Graefes Arch Clin Exp Ophthalmol. 2017 Sep; 255(9):1827-1835.GA

Abstract

BACKGROUND

Peripapillary retinal nerve fiber layer (pRNFL) and internal macular layer thinning have been demonstrated in Alzheimer's disease (AD) with optical coherence tomography (OCT) studies. The purpose of this study is to compare the pRNFL thickness and overall retinal thickness (RT) in AD patients with non-AD patients, using spectral domain optical coherence tomography (SD-OCT) and determine the sectors most characteristically affected in AD.

METHODS

A cross-sectional study was performed to determine the pRNFL and overall macular RT thicknesses in AD and non-AD patients, attending a tertiary hospital center. For pRNFL, the global and six peripapillary quadrants were calculated, and for overall RT values, the nine Early Treatment Diabetic Retinopathy Study (ETDRS) areas were used. A multiple regression analysis was applied to assess the effects of disease, age, gender, spherical equivalent, visual acuity, intraocular pressure, axial length and blood pressure on pRNFL and overall macular RT.

RESULTS

A total of 202 subjects, including 50 eyes of 50 patients with mild AD (mean age 73.10; SD = 5.36 years) and 152 eyes of 152 patients without AD (mean age 71.03; SD = 4.62 years). After Bonferroni correction, the pRNFL was significantly thinner for the AD group globally and in the temporal superior quadrant (10.76 μm and 20.09 μm mean decrease, respectively). The RT thickness was also decreased in superior sectors S3 and S6 (mean thinning of 9.92 μm and 11.65 μm, respectively). Spearman's correlation coefficient showed a direct association between pRNFL in the temporal superior quadrant and RT in superior S6 and S3 sectors (rS = 0.41; p < 0.001 and rS = 0.28; p < 0.001, respectively).

CONCLUSIONS

Patients with AD showed a significant thickness reduction in global and temporal superior quadrants in pRNFL and in superior pericentral and peripheral sectors of RT. These findings may reflect a peripapillary and retinal changes characteristic of AD, suggesting the importance of SD-OCT as a potential adjuvant in early diagnosis of AD. Further studies are needed to understand which retinal layers and macular sectors are more useful as potential ocular biomarker over time in AD.

Authors+Show Affiliations

Department of Ophthalmology, Central Lisbon Hospital Center, Lisbon, Portugal. cunha.oft@gmail.com. NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal. cunha.oft@gmail.com. Department of Neuro-Ophthalmology, Central Lisbon Hospital Center, 1169-050, Lisboa, Portugal. cunha.oft@gmail.com.Department of Ophthalmology, Central Lisbon Hospital Center, Lisbon, Portugal.Department of Ophthalmology, Central Lisbon Hospital Center, Lisbon, Portugal.Department of Neurology, Central Lisbon Hospital Center, Lisbon, Portugal.Department of Neurology, Central Lisbon Hospital Center, Lisbon, Portugal.Epidemiology and Statistics Unit, Research Centre, Central Lisbon Hospital Center, Lisbon, Portugal.NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal. Epidemiology and Statistics Unit, Research Centre, Central Lisbon Hospital Center, Lisbon, Portugal. CEAUL (Center of Statistics and Applications), Lisbon University, Lisbon, Portugal.NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal.Visual Sciences Study Center, Faculty of Medicine, Lisbon University, Lisbon, Portugal.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28643042

Citation

Cunha, João Paulo, et al. "OCT in Alzheimer's Disease: Thinning of the RNFL and Superior Hemiretina." Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, vol. 255, no. 9, 2017, pp. 1827-1835.
Cunha JP, Proença R, Dias-Santos A, et al. OCT in Alzheimer's disease: thinning of the RNFL and superior hemiretina. Graefes Arch Clin Exp Ophthalmol. 2017;255(9):1827-1835.
Cunha, J. P., Proença, R., Dias-Santos, A., Almeida, R., Águas, H., Alves, M., Papoila, A. L., Louro, C., & Castanheira-Dinis, A. (2017). OCT in Alzheimer's disease: thinning of the RNFL and superior hemiretina. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, 255(9), 1827-1835. https://doi.org/10.1007/s00417-017-3715-9
Cunha JP, et al. OCT in Alzheimer's Disease: Thinning of the RNFL and Superior Hemiretina. Graefes Arch Clin Exp Ophthalmol. 2017;255(9):1827-1835. PubMed PMID: 28643042.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - OCT in Alzheimer's disease: thinning of the RNFL and superior hemiretina. AU - Cunha,João Paulo, AU - Proença,Rita, AU - Dias-Santos,Arnaldo, AU - Almeida,Rita, AU - Águas,Helena, AU - Alves,Marta, AU - Papoila,Ana Luísa, AU - Louro,Carlota, AU - Castanheira-Dinis,António, Y1 - 2017/06/22/ PY - 2017/02/07/received PY - 2017/06/05/accepted PY - 2017/05/30/revised PY - 2017/6/24/pubmed PY - 2018/4/28/medline PY - 2017/6/24/entrez KW - Alzheimer’s disease KW - Macula KW - RNFL KW - Retina KW - Spectral domain optical coherence tomography SP - 1827 EP - 1835 JF - Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie JO - Graefes Arch Clin Exp Ophthalmol VL - 255 IS - 9 N2 - BACKGROUND: Peripapillary retinal nerve fiber layer (pRNFL) and internal macular layer thinning have been demonstrated in Alzheimer's disease (AD) with optical coherence tomography (OCT) studies. The purpose of this study is to compare the pRNFL thickness and overall retinal thickness (RT) in AD patients with non-AD patients, using spectral domain optical coherence tomography (SD-OCT) and determine the sectors most characteristically affected in AD. METHODS: A cross-sectional study was performed to determine the pRNFL and overall macular RT thicknesses in AD and non-AD patients, attending a tertiary hospital center. For pRNFL, the global and six peripapillary quadrants were calculated, and for overall RT values, the nine Early Treatment Diabetic Retinopathy Study (ETDRS) areas were used. A multiple regression analysis was applied to assess the effects of disease, age, gender, spherical equivalent, visual acuity, intraocular pressure, axial length and blood pressure on pRNFL and overall macular RT. RESULTS: A total of 202 subjects, including 50 eyes of 50 patients with mild AD (mean age 73.10; SD = 5.36 years) and 152 eyes of 152 patients without AD (mean age 71.03; SD = 4.62 years). After Bonferroni correction, the pRNFL was significantly thinner for the AD group globally and in the temporal superior quadrant (10.76 μm and 20.09 μm mean decrease, respectively). The RT thickness was also decreased in superior sectors S3 and S6 (mean thinning of 9.92 μm and 11.65 μm, respectively). Spearman's correlation coefficient showed a direct association between pRNFL in the temporal superior quadrant and RT in superior S6 and S3 sectors (rS = 0.41; p < 0.001 and rS = 0.28; p < 0.001, respectively). CONCLUSIONS: Patients with AD showed a significant thickness reduction in global and temporal superior quadrants in pRNFL and in superior pericentral and peripheral sectors of RT. These findings may reflect a peripapillary and retinal changes characteristic of AD, suggesting the importance of SD-OCT as a potential adjuvant in early diagnosis of AD. Further studies are needed to understand which retinal layers and macular sectors are more useful as potential ocular biomarker over time in AD. SN - 1435-702X UR - https://www.unboundmedicine.com/medline/citation/28643042/OCT_in_Alzheimer's_disease:_thinning_of_the_RNFL_and_superior_hemiretina_ L2 - https://dx.doi.org/10.1007/s00417-017-3715-9 DB - PRIME DP - Unbound Medicine ER -