Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 7
June 2024
Volume 65, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2024
Artificial Intelligence Analysis of Retinal β-Amyloid “Hot Spots” in Dry Age-Related Macular Degeneration and Alzheimer’s disease
Author Affiliations & Notes
  • Nicholas Pfahler
    Ophthalmology and Visual Sciences, University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
  • Zibute Zaparackas
    Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Stephanie Aman
    Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Nicholas J Volpe
    Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Paul A Knepper
    Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
    Ophthalmology and Visual Sciences, University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Nicholas Pfahler None; Zibute Zaparackas None; Stephanie Aman None; Nicholas Volpe None; Paul Knepper None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science June 2024, Vol.65, 5701. doi:
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      Nicholas Pfahler, Zibute Zaparackas, Stephanie Aman, Nicholas J Volpe, Paul A Knepper; Artificial Intelligence Analysis of Retinal β-Amyloid “Hot Spots” in Dry Age-Related Macular Degeneration and Alzheimer’s disease. Invest. Ophthalmol. Vis. Sci. 2024;65(7):5701.

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

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Abstract

Purpose : Retinal β-amyloid (Aβ) deposits have been identified by histological examination in both Alzheimer’s disease (AD) and age-related macular degeneration (AMD). In vivo retinal Aβ has previously been identified in AD. In this study, we identified and measured retinal Aβ “hot spots” in vivo in participants with dry AMD and Alzheimer’s disease. These deposits can be detected in vivo using oral curcumin, which binds to Aβ deposits, as a fluorescent label in conjunction with ocular coherence tomography with BluePeak autofluorescence (OCT-BAF).

Methods : AMD (n=24), AD (n=5), and control (n=6) participants were recruited from the office of Zaparackas and Knepper in Chicago, Illinois and enrolled in clinical trial NCT05062486. OCT-BAF imaging (Heidelberg Spectralis) and a customized proprietary artificial intelligence program was used to identify and visualize retinal Aβ. Images were taken before and after participants took oral curcumin for 7-14 days at a dose of 2.6 g/day. Retinal Aβ hot spots were defined as spots of retinal fluorescence after subtracting baseline images. A composite score (retinal amyloid index, RAI) was used to incorporate the number of individual spots, total spot area, and fluorescence intensity.

Results : Participants with AMD had a significantly higher number of hot spots (36.2 vs. 21.3, p=0.002) and a higher RAI (34.3 vs. 20.98, p=0.002) compared with controls. Participants with AD had a significantly higher number of hot spots (49.4) compared with both controls (p<0.01) and AMD (p<0.05) and a significantly higher RAI (63.4) compared with both controls (p<0.0001) and AMD (p<0.05).

Conclusions : Retinal Aβ hot spots are increased in AMD and AD. The detection of retinal Aβ hot spots in vivo suggests novel therapeutic targets in AMD and AD. Hot spots can be used as an endpoint measured longitudinally in clinical trials. Hot spots are a new target for the treatment of AMD and AD.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

(A) Mean number of retinal Aβ hot spots in control, intermediate AMD (iAMD), geographic atrophy (GA), and Alzheimer's disease (AD). (B) Mean retinal amyloid index (RAI) in control, AMD, and AD. **p<0.01 vs control; †p<0.05 vs AD.

(A) Mean number of retinal Aβ hot spots in control, intermediate AMD (iAMD), geographic atrophy (GA), and Alzheimer's disease (AD). (B) Mean retinal amyloid index (RAI) in control, AMD, and AD. **p<0.01 vs control; †p<0.05 vs AD.

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