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

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
24 Downloads (Pure)


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 languageEnglish
Article number13
Number of pages10
JournalTranslational Vision Science and Technology
Issue number1
Early online date9 Jan 2023
Publication statusPublished - Jan 2023


  • 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


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