Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging

Emma Pead; Atalie C. Thompson; Dilraj S. Grewal; Sarah McGrory; Cason B. Robbins; Justin P. Ma; Kim G. Johnson; Andy J. Liu; Charlene Hamid; Emanuele Trucco; Craig W. Ritchie; Graciela Muniz; Imre Lengyel; Baljean Dhillon; Tom MacGillivray; Sharon Fekrat

doi:10.1167/tvst.12.1.13

Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging

Emma Pead (Lead / Corresponding author), Atalie C. Thompson, Dilraj S. Grewal, Sarah McGrory, Cason B. Robbins, Justin P. Ma, Kim G. Johnson, Andy J. Liu, Charlene Hamid, Emanuele Trucco, Craig W. Ritchie, Graciela Muniz, Imre Lengyel, Baljean Dhillon, Tom MacGillivray, Sharon Fekrat

Computing

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

113 Downloads (Pure)

Abstract

Purpose: Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging.

Methods: UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity.

Results: Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching.

Conclusions: Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease.

Translational Relevance: This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.

Original language	English
Article number	13
Number of pages	10
Journal	Translational Vision Science and Technology
Volume	12
Issue number	1
Early online date	9 Jan 2023
DOIs	https://doi.org/10.1167/tvst.12.1.13
Publication status	Published - Jan 2023

Keywords

Alzheimer’s dementia
Alzheimer’s disease
mild cognitive impairment
microvascular
normal cognition
ultra-widefield retinal imaging
peripheral retina
retinal image analysis
retinal biomarkers

ASJC Scopus subject areas

Ophthalmology
Biomedical Engineering

Access to Document

10.1167/tvst.12.1.13Licence: CC BY

Final Published VersionFinal published version, 1.26 MBLicence: CC BY

Cite this

Pead, E., Thompson, A. C., Grewal, D. S., McGrory, S., Robbins, C. B., Ma, J. P., Johnson, K. G., Liu, A. J., Hamid, C., Trucco, E., Ritchie, C. W., Muniz, G., Lengyel, I., Dhillon, B., MacGillivray, T., & Fekrat, S. (2023). Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging. Translational Vision Science and Technology, 12(1), Article 13. https://doi.org/10.1167/tvst.12.1.13

@article{8b92e7536ce94e6fa2a1c65a0a6a2cdd,

title = "Retinal vascular changes in Alzheimer{\textquoteright}s dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging",

abstract = "Purpose: Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging. Methods: UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity. Results: Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching. Conclusions: Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease.Translational Relevance: This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.",

keywords = "Alzheimer{\textquoteright}s dementia, Alzheimer{\textquoteright}s disease, mild cognitive impairment, microvascular, normal cognition, ultra-widefield retinal imaging, peripheral retina, retinal image analysis, retinal biomarkers",

author = "Emma Pead and Thompson, {Atalie C.} and Grewal, {Dilraj S.} and Sarah McGrory and Robbins, {Cason B.} and Ma, {Justin P.} and Johnson, {Kim G.} and Liu, {Andy J.} and Charlene Hamid and Emanuele Trucco and Ritchie, {Craig W.} and Graciela Muniz and Imre Lengyel and Baljean Dhillon and Tom MacGillivray and Sharon Fekrat",

note = "Funding Information: This work was supported in part by the Alzheimer{\textquoteright}s Drug Discovery Foundation (ADDF), GDAPB-201808-2016196 “Delivering novel neuro-retinal biomarkers for the early diagnosis of Alzheimer{\textquoteright}s disease”. Support from NHS Lothian R&D, and Edinburgh Imaging and Edinburgh Clinical Research Facility at the University of Edinburgh is acknowledged along with the support of the British Heart Foundation Centre for Research Excellence Award III (RE/18/5/34216). This work was also supported by a grant (MR/N029941/1) from the National Institute for Health Research (NIHR) and the Medical Research Council (MRC). The funding sources were not involved in designing, conducting, or submitting this work. The authors would like to thank Adam Threlfall for help in providing the neural network for the automatic vessel segmentation and Michael Verhoek for assisting in the generation of Supplementary Figure S1. The authors do not have any conflicts of interest. Copyright: {\textcopyright} 2023 The Authors. This work is licensed under a Creative Commons Attribution 4.0 International License.",

year = "2023",

month = jan,

doi = "10.1167/tvst.12.1.13",

language = "English",

volume = "12",

journal = "Translational Vision Science and Technology",

issn = "2164-2591",

publisher = "Association for Research in Vision and Ophthalmology",

number = "1",

}

Pead, E, Thompson, AC, Grewal, DS, McGrory, S, Robbins, CB, Ma, JP, Johnson, KG, Liu, AJ, Hamid, C, Trucco, E, Ritchie, CW, Muniz, G, Lengyel, I, Dhillon, B, MacGillivray, T & Fekrat, S 2023, 'Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging', Translational Vision Science and Technology, vol. 12, no. 1, 13. https://doi.org/10.1167/tvst.12.1.13

TY - JOUR

T1 - Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment

T2 - a pilot study using ultra-widefield imaging

AU - Pead, Emma

AU - Thompson, Atalie C.

AU - Grewal, Dilraj S.

AU - McGrory, Sarah

AU - Robbins, Cason B.

AU - Ma, Justin P.

AU - Johnson, Kim G.

AU - Liu, Andy J.

AU - Hamid, Charlene

AU - Trucco, Emanuele

AU - Ritchie, Craig W.

AU - Muniz, Graciela

AU - Lengyel, Imre

AU - Dhillon, Baljean

AU - MacGillivray, Tom

AU - Fekrat, Sharon

N1 - Funding Information: This work was supported in part by the Alzheimer’s Drug Discovery Foundation (ADDF), GDAPB-201808-2016196 “Delivering novel neuro-retinal biomarkers for the early diagnosis of Alzheimer’s disease”. Support from NHS Lothian R&D, and Edinburgh Imaging and Edinburgh Clinical Research Facility at the University of Edinburgh is acknowledged along with the support of the British Heart Foundation Centre for Research Excellence Award III (RE/18/5/34216). This work was also supported by a grant (MR/N029941/1) from the National Institute for Health Research (NIHR) and the Medical Research Council (MRC). The funding sources were not involved in designing, conducting, or submitting this work. The authors would like to thank Adam Threlfall for help in providing the neural network for the automatic vessel segmentation and Michael Verhoek for assisting in the generation of Supplementary Figure S1. The authors do not have any conflicts of interest. Copyright: © 2023 The Authors. This work is licensed under a Creative Commons Attribution 4.0 International License.

PY - 2023/1

Y1 - 2023/1

N2 - Purpose: Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging. Methods: UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity. Results: Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching. Conclusions: Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease.Translational Relevance: This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.

AB - Purpose: Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging. Methods: UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity. Results: Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching. Conclusions: Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease.Translational Relevance: This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.

KW - Alzheimer’s dementia

KW - Alzheimer’s disease

KW - mild cognitive impairment

KW - microvascular

KW - normal cognition

KW - ultra-widefield retinal imaging

KW - peripheral retina

KW - retinal image analysis

KW - retinal biomarkers

UR - http://www.scopus.com/inward/record.url?scp=85145956725&partnerID=8YFLogxK

U2 - 10.1167/tvst.12.1.13

DO - 10.1167/tvst.12.1.13

M3 - Article

C2 - 36622689

SN - 2164-2591

VL - 12

JO - Translational Vision Science and Technology

JF - Translational Vision Science and Technology

IS - 1

M1 - 13

ER -

Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Multi-modal Retinal Biomarkers for Vascular Dementia; Developing and Enabling Image Analysis Tools (Joint with University of Edinburgh)

Cite this

Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment: a pilot study using ultra-widefield imaging

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Projects

Multi-modal Retinal Biomarkers for Vascular Dementia; Developing and Enabling Image Analysis Tools (Joint with University of Edinburgh)

Cite this