Abstract
Purpose :
Both cerebrovascular accident (CVA) and Alzheimer’s disease (AD) are disorders of aging, which can lead to cognitive decline. They often occur concurrently, yet their relationship is not yet fully understood. It is thought that their association stems from an underlying vascular disease process, hence they both share common vascular risk factors. By performing a case-control imaging study involving analyzing both neural and vascular tissue of the retina and brain, we aim to provide a better understanding of how CVA and AD presents amongst patients and define features on imaging that can help us distinguish the presentation of each condition.
Methods :
Our study aims to utilize 45 subjects divided equally amongst 3 separate groups: subjects that sustained a CVA within the past 1 year, subjects that suffer from AD, and controls who have neither had a CVA nor been diagnosed with AD. Montreal Cognitive Assessment (MoCA) is being utilized during recruitment; subjects that score less than 26 for mild cognitive impairment in the experimental groups are enrolled. SD OCT / (OCTA) and MRI/MRA images are being obtained for each subject. The images are being analyzed using ImageJ software to extract measurable features from both neural tissue and vasculature as well as STATA software for statistical analysis.
Results :
Initial preliminary results from 5 MRA scans and 10 OCTA images (2 per subject) demonstrate alterations in vascular structure. Parameters such as foveal avascular zone (FAZ), vessel diameter, vessel density, and tortuosity show changes compared to our control group. The vascular changes observed in imaging of AD and CVA show evidence of shared vascular risk factors. Further SD OCT and MRI results will be obtained as we continue to actively recruit patients to assess and analyze neural tissue.
Conclusions :
Preliminary data show that both CVA and AD share similar vascular changes that correlate with the severity of risk factors. Early findings suggest that specific features on imaging may be able to distinguish CVA from AD on both OCTA and MRI. We hope to use these results in subsequent studies to better understand the differentiating features of CVA and AD, which may help improve future imaging techniques screening for CVA recurrence.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.