Abstract
Presentation Description :
Cerebrovascular disease is a leading cause of cognitive impairment, termed vascular cognitive impairment and dementia (VCID). Optical Coherence Tomography Angiography (OCTA) is a non-invasive FDA approved imaging modality that allows investigation of the retinal vascular changes that occur in subjects at risk for VCID as well as a host of other neurodegenerative diseases (Kashani AH et al .,Progress in Retinal and Eye Research 2021). A significant body of historical clinical and epidemiological evidence suggests that macroscopic vascular changes (e.g. large vessel caliber, tortuosity and retinopathy) occuring in the retina may reflect concurrent changes in the CNS. For the first time, OCTA has enabled the clinically feasible measurement of retinal capillary features such as vessel skeleton density (VSD) in living human subjects. VSD is a measure that is signficantly associated with severity of diabetic retinopathy as well as a sensitive indicator of subclinical retinopathy (Kashani AH et al., Progress in Retinal and Eye Research 2017). Over the past 5 years several studies from have demonstrated that VSD is significantly associated with risk factors for VCID including diabetes, hypertension and apolipoprotein E4 allele status. In this presentation, we describe the design, methods, results and limitations of a prospective multicenter study that evaluates the association of VSD with cognitive function in a cohort of subjects at risk for VCID. In most cases, VSD shows significant associations with at least some measures of cognition even in cognitively intact subjects. Specifically, VSD shows the strongest association with cognitive tasks that require visuospatial and executive function. Collectively, the results of this and previous studies suggest that retinal capillary changes as reliably and significantly associated with at least some aspects of cognition and may serve as a biomarker or screening tool for vascular cognitive impairment. It is important to note that OCTA imaging, while noninvasive and relatively fast, does have limitations including the need for meticulous attention to data acquisition, quality and analyses. Implementation of OCTA in a non-ophthalmic setting requires careful consideration in terms of technician training and device compatability.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.