April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Peripheral Retinal Drusen as a Potential Surrogate Marker for Alzheimer’s Dementia: A Pilot Study Using Ultra-Wide Angle Imaging
Craig W. Ritchie; Tunde Peto; Neda Barzegar-Befroei; Adrienne Csutak; Patricia Ndhlovu; Danielle Wilson; Bryan Corridan; Bharathi Goud; Nevil Cheesman; Imre Lengyel
Author Affiliations & Notes
  • Craig W. Ritchie
    Department of Medicine, Imperial College London, London, United Kingdom
    West London Mental Health Trust, London, United Kingdom
  • Tunde Peto
    Research & Development, Moorfields Eye Hospital, London, United Kingdom
  • Neda Barzegar-Befroei
    Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, London, United Kingdom
  • Adrienne Csutak
    Research & Development, Moorfields Eye Hospital, London, United Kingdom
  • Patricia Ndhlovu
    Department of Medicine, Imperial College London, London, United Kingdom
    West London Mental Health Trust, London, United Kingdom
  • Danielle Wilson
    Department of Medicine, Imperial College London, London, United Kingdom
  • Bryan Corridan
    West London Mental Health Trust, London, United Kingdom
  • Bharathi Goud
    West London Mental Health Trust, London, United Kingdom
  • Nevil Cheesman
    West London Mental Health Trust, London, United Kingdom
  • Imre Lengyel
    Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships  Craig W. Ritchie, None; Tunde Peto, None; Neda Barzegar-Befroei, None; Adrienne Csutak, Part of salary was supporter by an unrestricted grant from OPTOS PLC. (F); Patricia Ndhlovu, None; Danielle Wilson, None; Bryan Corridan, None; Bharathi Goud, None; Nevil Cheesman, None; Imre Lengyel, None
  • Footnotes
    Support  The research was supported by the Bill Brown Charitable Trust, Moorfields Eye Hospital Special Trustees and Mercer Fund.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6683. doi:
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      Craig W. Ritchie, Tunde Peto, Neda Barzegar-Befroei, Adrienne Csutak, Patricia Ndhlovu, Danielle Wilson, Bryan Corridan, Bharathi Goud, Nevil Cheesman, Imre Lengyel; Peripheral Retinal Drusen as a Potential Surrogate Marker for Alzheimer’s Dementia: A Pilot Study Using Ultra-Wide Angle Imaging. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6683.

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Abstract

Purpose: : The development of Alzheimer’s dementia (AD) and age-related macular degeneration (AMD) share similar histopathology, vascular risk factors and genetic predisposition and both are characterized by extracellular deposit formation. In this study we examined the prevalence and spatial distribution of macular and peripheral retinal pathologies in patients with AD.

Methods: : Color and autofluorescent (AF) images were taken by the Optos P200C AF ultra-wide angle laser scanning ophthalmoscope (200°) to determine phenotypic variations in 56 AD patients and 46 controls. Images were graded for the prevalence of drusen, pigmentary changes, atrophy or choroidal neovascularisation (CNV) in the macula as well as retinal periphery. The periphery was divided into two zones (zone 4 and 5) to extend the standard AMD grid and pathological distribution was recorded in four sectors within these zones. All subjects had blood taken for genotyping. Comparisons were made using the chi-squared test after adjustment for potential confounders.

Results: : There was a positive genetic association between AD and ApoE4 RS429358(p=0.09). Only one control, but 4 patients were diagnosed to have AMD based on macular pathologies. In the periphery hard drusen were present in 14/55 (25.4%) of AD patients and 2/48 (4.2%) of controls [Chi2=9.9, df=4, p=0.04]. After adjustment for age and a history of a transient ischaemic attack, this association remained strongly significant (p<0.001).

Conclusions: : Ultra-wide angle imaging revealed a potential association between AD and AMD and a highly significant association between AD and peripheral hard drusen formation. These findings suggest that monitoring for the development and progression of pathological changes in the macula and most importantly in the periphery might become a valuable tool in detecting and monitoring the progression of AD. Further work is required to develop the understanding of this association which may lead to peripheral drusen acting as a surrogate marker for plaque development in the central nervous system.

Keywords: age-related macular degeneration • drusen • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 
© 2011, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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