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OCT in Alzheimer’s disease: thinning of the RNFL and superior hemiretina

  • Neurophthalmology
  • Published:
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Abstract

Background

Peripapillary retinal nerve fiber layer (pRNFL) and internal macular layer thinning have been demonstrated in Alzheimer’s disease (AD) with optical coherence tomography (OCT) studies. The purpose of this study is to compare the pRNFL thickness and overall retinal thickness (RT) in AD patients with non-AD patients, using spectral domain optical coherence tomography (SD-OCT) and determine the sectors most characteristically affected in AD.

Methods

A cross-sectional study was performed to determine the pRNFL and overall macular RT thicknesses in AD and non-AD patients, attending a tertiary hospital center. For pRNFL, the global and six peripapillary quadrants were calculated, and for overall RT values, the nine Early Treatment Diabetic Retinopathy Study (ETDRS) areas were used. A multiple regression analysis was applied to assess the effects of disease, age, gender, spherical equivalent, visual acuity, intraocular pressure, axial length and blood pressure on pRNFL and overall macular RT.

Results

A total of 202 subjects, including 50 eyes of 50 patients with mild AD (mean age 73.10; SD = 5.36 years) and 152 eyes of 152 patients without AD (mean age 71.03; SD = 4.62 years). After Bonferroni correction, the pRNFL was significantly thinner for the AD group globally and in the temporal superior quadrant (10.76 μm and 20.09 μm mean decrease, respectively). The RT thickness was also decreased in superior sectors S3 and S6 (mean thinning of 9.92 μm and 11.65 μm, respectively). Spearman’s correlation coefficient showed a direct association between pRNFL in the temporal superior quadrant and RT in superior S6 and S3 sectors (rS = 0.41; p < 0.001 and rS = 0.28; p < 0.001, respectively).

Conclusions

Patients with AD showed a significant thickness reduction in global and temporal superior quadrants in pRNFL and in superior pericentral and peripheral sectors of RT. These findings may reflect a peripapillary and retinal changes characteristic of AD, suggesting the importance of SD-OCT as a potential adjuvant in early diagnosis of AD. Further studies are needed to understand which retinal layers and macular sectors are more useful as potential ocular biomarker over time in AD.

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Acknowledgements

We would like to thank Bruno Oliveira-Santos for the helpful cooperation in collecting the OCT data. We thank Dr. Paula Mota and Dr. Joana Tavares-Ferreira for the detailed reading and comments on the manuscript.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Central Lisbon Hospital Center, Lisbon, Portugal

    João Paulo Cunha, Rita Proença & Arnaldo Dias-Santos

  2. NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal

    João Paulo Cunha, Ana Luísa Papoila & Carlota Louro

  3. Department of Neuro-Ophthalmology, Central Lisbon Hospital Center, 1169-050, Lisboa, Portugal

    João Paulo Cunha

  4. Department of Neurology, Central Lisbon Hospital Center, Lisbon, Portugal

    Rita Almeida & Helena Águas

  5. Epidemiology and Statistics Unit, Research Centre, Central Lisbon Hospital Center, Lisbon, Portugal

    Marta Alves & Ana Luísa Papoila

  6. CEAUL (Center of Statistics and Applications), Lisbon University, Lisbon, Portugal

    Ana Luísa Papoila

  7. Visual Sciences Study Center, Faculty of Medicine, Lisbon University, Lisbon, Portugal

    António Castanheira-Dinis

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  1. João Paulo Cunha
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Correspondence to João Paulo Cunha.

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All authors certify that they have no affiliationswith or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving humanparticipants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Cunha, J.P., Proença, R., Dias-Santos, A. et al. OCT in Alzheimer’s disease: thinning of the RNFL and superior hemiretina. Graefes Arch Clin Exp Ophthalmol 255, 1827–1835 (2017). https://doi.org/10.1007/s00417-017-3715-9

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