Abstract
Purpose :
We have shown earlier that AMD-like pathologies on ultra-widefield images (UWFI) detect a higher prevalence of peripheral retinal changes in Alzheimer’s Disease (AD) compared to healthy controls (Ctrl) (Csincsik et al. 2018). The utility of UWFI and the application of different grading grids were further investigated using well-characterised cases of typical AD (tAD), Posterior cortical atrophy (PCA, atypical variant of AD), and Ctrl.
Methods :
UWFI were acquired of 24 tAD (MMSE<20), 25 PCA (MMSE<24) patients and 69 Ctrl (MMSE>28) using OPTOS P200Tx scanning laser ophthalmoscope. UWFI were graded for absence/presence of AMD-like abnormalities such as drusen like deposit (drusen) formation, sub-retinal drusenoid deposit like features (SDD) and peripheral reticular pigmentary degeneration (PRPD) by two independent, masked graders, using the Manchester grid. Statistical analysis was undertaken in SPSS. The study had full local Ethical Committee approval.
Results :
There was no statistically significant age difference between tAD, PCA and Crtl (63.7±7.1; 66.1±6.9, 66.2±7.6, p=0.309, respectively). There was a higher prevalence of far-peripheral drusen formation in tAD compared to Ctrl on the supero-nasal quadrant [75% vs 38%; χ2=4.281, df=1, p=0.039]. In PCA drusen was more prevalent in the infero-nasal quadrant compared to Crtl [52% vs 26.1%; χ2=8.575, df=1, p=0.018]. There was a higher prevalence of SDD in tAD compared to Ctrl in the superior retina [25% vs 5.8%; χ2=6.842, df=1, p=0.017] and lower prevalence of PRPD compared to both PCA [14% vs 33%; χ2=4.647, df=1, p=0.031] and Ctrl [14% vs 29%; χ2=3.908, df=1, p=0.048].
Conclusions :
These results obtained on well-characterised AD cases highlighted the utility of UWFI in dementia and stressed the importance of detailed, quadrant specific phenotyping. The work also shows the importance of including well-characterised cases in dementia studies for developing relevant and reliable ocular biomarkers.
This is a 2020 ARVO Annual Meeting abstract.