June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Longitudinal Retinal Findings in Individuals with Mild Cognitive Impairment over a Two Year Period
Author Affiliations & Notes
  • Angela Hemesath
    iMIND, Duke University School of Medicine, Durham, North Carolina, United States
  • Anita Kundu
    iMIND, Duke University School of Medicine, Durham, North Carolina, United States
  • Suzanna Joseph
    iMIND, Duke University School of Medicine, Durham, North Carolina, United States
  • Ariana Allen
    iMIND, Duke University School of Medicine, Durham, North Carolina, United States
  • Justin Ma
    iMIND, Duke University School of Medicine, Durham, North Carolina, United States
    University of California Santa Cruz, Santa Cruz, California, United States
  • Cason Robbins
    Duke Medicine, Durham, North Carolina, United States
  • Dilraj Singh Grewal
    Duke Medicine, Durham, North Carolina, United States
  • Sharon Fekrat
    Duke Medicine, Durham, North Carolina, United States
  • Footnotes
    Commercial Relationships   Angela Hemesath None; Anita Kundu None; Suzanna Joseph None; Ariana Allen None; Justin Ma None; Cason Robbins None; Dilraj Grewal None; Sharon Fekrat None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2534. doi:
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      Angela Hemesath, Anita Kundu, Suzanna Joseph, Ariana Allen, Justin Ma, Cason Robbins, Dilraj Singh Grewal, Sharon Fekrat; Longitudinal Retinal Findings in Individuals with Mild Cognitive Impairment over a Two Year Period. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2534.

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

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Abstract

Purpose : The diagnosis of neurodegenerative diseases is largely based on clinical suspicion with limited confirmation antemortem. However, neuropathological changes occur years prior to disease presentation. Changes in the retina, an embryologically brain-derived structure, is exemplar of measurable pre-clinical findings in neurodegenerative disease. Limited data exists on the usefulness of retinal imaging in MCI. The progression of change in the retina over time may act as a quantitative measure of disease progression.

Methods : This was a longitudinal study consisting of MCI patients and cognitively normal controls over the age of 50. Exclusion criteria included diabetes, uncontrolled hypertension, glaucoma, and retinal pathology. Zeiss Cirrus HD-5000 AngioPlex optical coherence tomography (OCT) and OCT angiography, visual acuity, and Mini Mental State Exam were performed at study entry and year 2.

Results : Eighty-seven eyes of 42 MCI patients and 83 eyes of 42 controls were analyzed. Controls were matched by age (range 58-84 years) and sex (51% male, 49% female). Average MMSE at baseline was 26.3 in MCI and 29.3 in controls (p < 0.01). There were no significant differences in rate of change (ROC) of OCT/OCTA data between controls and MCI patients at baseline. The ROC of MMSE at year 2 was -0.33 in controls vs -1.78 in MCI (p=0.12). The ROC of OCTA perfusion density (PD) was significantly different (p < 0.04) in year 2, with an ROC of 0 %/year in controls and -0.1 %/year in MCI for both 3x3 ETDRS circle and ring as well as 6x6 ETDRS circle, inner ring, and outer ring. Changes in vessel density (VD) at year 2 were significant (p <0.04) in 3x3 ETDRS circle and ring as well as the 6x6 ETDRS circle, inner ring, and outer ring.

Conclusions : At baseline, there was no significant difference in OCT and OCTA metrics between MCI patients and controls, which is consistent with previous work. However, after 2 years of follow-up, there is a significantly greater velocity of decline in OCTA PD and VD in MCI patients compared to controls prior to a significant change in MMSE scores. Longitudinal assessment of these retinal microvascular differences in MCI may be a strong marker of progressive disease prior to measurable cognitive changes.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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