July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Optical Coherence Tomography Angiography in Preclinical Alzheimer’s Disease
Author Affiliations & Notes
  • Aleid van de Kreeke
    Ophthalmology, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
  • H Ton Nguyen
    Ophthalmology, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
  • Elles Konijnenberg
    Alzheimer Center, Neurology, Amsterdam UMC, location VUmc, Netherlands
  • Jori Tomassen
    Alzheimer Center, Neurology, Amsterdam UMC, location VUmc, Netherlands
  • Anouk den Braber
    Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
    Alzheimer Center, Neurology, Amsterdam UMC, location VUmc, Netherlands
  • Mara ten Kate
    Alzheimer Center, Neurology, Amsterdam UMC, location VUmc, Netherlands
  • Maqsood Yaqub
    Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Netherlands
  • Bart van Berckel
    Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Netherlands
  • Dorret I Boomsma
    Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
  • H Stevie Tan
    Ophthalmology, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
  • Pieter Jelle Visser
    Alzheimer Center, Neurology, Amsterdam UMC, location VUmc, Netherlands
  • Frank D Verbraak
    Ophthalmology, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships   Aleid van de Kreeke, None; H Nguyen, None; Elles Konijnenberg, None; Jori Tomassen, None; Anouk den Braber, None; Mara ten Kate, None; Maqsood Yaqub, None; Bart van Berckel, None; Dorret Boomsma, None; H Tan, None; Pieter Jelle Visser, None; Frank Verbraak, None
  • Footnotes
    Support  EMIF grant number 115372
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5233. doi:https://doi.org/
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      Aleid van de Kreeke, H Ton Nguyen, Elles Konijnenberg, Jori Tomassen, Anouk den Braber, Mara ten Kate, Maqsood Yaqub, Bart van Berckel, Dorret I Boomsma, H Stevie Tan, Pieter Jelle Visser, Frank D Verbraak; Optical Coherence Tomography Angiography in Preclinical Alzheimer’s Disease. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5233. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : As a protrusion from the brain, the retina might reflect (pathological) changes in the brain. Some studies have shown decrease in vessel density and foveal avascular zone (FAZ) enlargement on OCTA in individuals suffering from Alzheimer’s disease (AD). This study aims to see if these changes are already present in the preclinical stages of AD, using a population of monozygotic twins.

Methods : 124 cognitively healthy individuals (ages 60-93) underwent [18F]flutemetamol amyloid PET scanning and OCTA (Cirrus 5000 angioplex). PET scans were visually rated for cortical amyloid positivity and volume weighted global cortical non-displaceable binding potential (BPND) was calculated as a continuous measure for amyloid beta (Aβ). Vessel densities for the inner and outer ring in the macular area were obtained, as well as FAZ size. OCTA data were averaged over both eyes. Differences between Aβ+ and Aβ- individuals with regards to OCTA data, as well as the relation between BPND and OCTA data, were investigated using Generalized Estimating Equations (GEE), corrected for age, gender, scan quality and diagnosis of diabetes. Twin correlations were obtained for OCTA data using Pearson correlation coefficients.

Results : 13 of 124 participants (10.5%) had a positive visual rating score for cortical Aβ on PET. Aβ+ individuals had significantly higher vessel density in both the inner (Δ=0.81, p<0.001) and outer (Δ=0.50, p=0.012) ring of the macular area than Aβ- individuals. There was no significant difference in FAZ size between Aβ+ and Aβ- individuals (Δ=-0.02mm3, p=0.387). None of the OCTA measures were significantly associated with BPND. Twin correlations were moderate to high for all OCTA parameters (r=0.50 - 0.85, p<0.001).

Conclusions : Contrary to what was expected based on earlier studies, retinal vessel density seems to be increased in individuals suffering from preclinical AD, while FAZ size is unchanged. The increase in vessel density may be a compensatory mechanism as early manifestation of microvascular damage in the retina. Further studies should elucidate the nature of this change, as well as its diagnostic abilities for preclinical AD.
Moderate to high twin correlations suggest OCTA measures to be mainly determined by shared factors, likely of a genetic origin in this elderly population.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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