Ophthalmology (Eye & Ear Hospital) - Research Publications

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    A retinal imaging biomarker of Alzheimer's disease
    van Wijngaarden, P ; Hadoux, X ; Hui, F ; Lim, J ; Nguyen, C ; Bui, B ; Crowston, J (Wiley, 2019-11-01)
    Background: Amyloid-beta (Ab) deposition in the brain is a diagnostic marker for Alzheimer's disease (AD), but current tests are costly and not widely available. Evidence from transgenic rodent models and post-mortem human tissues suggest that retinal accumulation of Ab may serve as a surrogate marker of brain Ab levels. As Ab has a wavelength-dependent effect on light scatter, we investigated the potential for in vivo retinal hyperspectral imaging to serve as a biomarker of brain Ab. Purpose: To develop and validate a retinal imaging biomarker of Alzheimer's disease. Methods: We performed human retinal hyperspectral imaging on individuals with high Ab burden on brain PET imaging and mild cognitive impairment (cases; n = 15), and age-matched PET-negative controls (n = 20). Image analysis methods were developed and validated on a second group of participants with and with (n = 4) and without (n = 13) moderate-to-high brain Ab burden and on transgenic mice (5xFAD) known to accumulate retinal Ab. Results: We show significant differences in retinal reflectance spectra between cases and controls in both cohorts (AUC ROC = 0.82, P = 0.001, 95% CI: 0.67-0.97). There was a moderate positive linear correlation between retinal imaging scores and brain Abburden (r = 0.46, 95%CI: 0.13-0.69, P = 0.008).The technique also enabled discrimination of AD-model mice from wild-type controls. Conclusion: We have developed a novel retinal imaging method to distinguish people with moderate-high brain Ab load from those without. This approach may have value for the diagnostic confirmation of AD.