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      Retinal microvascular network attenuation in Alzheimer's disease

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          Abstract

          Introduction

          Cerebral small-vessel disease has been implicated in the development of Alzheimer's disease (AD). The retinal microvasculature enables the noninvasive visualization and evaluation of the systemic microcirculation. We evaluated retinal microvascular parameters in a case-control study of AD patients and cognitively normal controls.

          Methods

          Retinal images were computationally analyzed and quantitative retinal parameters (caliber, fractal dimension, tortuosity, and bifurcation) measured. Regression models were used to compute odds ratios (OR) and confidence intervals (CI) for AD with adjustment for confounders.

          Results

          Retinal images were available in 213 AD participants and 294 cognitively normal controls. Persons with lower venular fractal dimension (OR per standard deviation [SD] increase, 0.77 [CI: 0.62–0.97]) and lower arteriolar tortuosity (OR per SD increase, 0.78 [CI: 0.63–0.97]) were more likely to have AD after appropriate adjustment.

          Discussion

          Patients with AD have a sparser retinal microvascular network and retinal microvascular variation may represent similar pathophysiological events within the cerebral microvasculature of patients with AD.

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          Most cited references55

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          The Physiological Principle of Minimum Work: I. The Vascular System and the Cost of Blood Volume.

          C. Murray (1926)
          Article 0 comments Cited 261 times – based on 0 reviews     Review now
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            The overlap between neurodegenerative and vascular factors in the pathogenesis of dementia.

            Costantino Iadecola (2010)
            There is increasing evidence that cerebrovascular dysfunction plays a role not only in vascular causes of cognitive impairment but also in Alzheimer's disease (AD). Vascular risk factors and AD impair the structure and function of cerebral blood vessels and associated cells (neurovascular unit), effects mediated by vascular oxidative stress and inflammation. Injury to the neurovascular unit alters cerebral blood flow regulation, depletes vascular reserves, disrupts the blood-brain barrier, and reduces the brain's repair potential, effects that amplify the brain dysfunction and damage exerted by incident ischemia and coexisting neurodegeneration. Clinical-pathological studies support the notion that vascular lesions aggravate the deleterious effects of AD pathology by reducing the threshold for cognitive impairment and accelerating the pace of the dementia. In the absence of mechanism-based approaches to counteract cognitive dysfunction, targeting vascular risk factors and improving cerebrovascular health offers the opportunity to mitigate the impact of one of the most disabling human afflictions.
            Article 0 comments Cited 163 times – based on 0 reviews     Review now
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              Retinal vascular image analysis as a potential screening tool for cerebrovascular disease: a rationale based on homology between cerebral and retinal microvasculatures.

              Niall Patton, Tariq Mehmood Aslam, Thomas J MacGillivray … (2005)
              The retinal and cerebral microvasculatures share many morphological and physiological properties. Assessment of the cerebral microvasculature requires highly specialized and expensive techniques. The potential for using non-invasive clinical assessment of the retinal microvasculature as a marker of the state of the cerebrovasculature offers clear advantages, owing to the ease with which the retinal vasculature can be directly visualized in vivo and photographed due to its essential two-dimensional nature. The use of retinal digital image analysis is becoming increasingly common, and offers new techniques to analyse different aspects of retinal vascular topography, including retinal vascular widths, geometrical attributes at vessel bifurcations and vessel tracking. Being predominantly automated and objective, these techniques offer an exciting opportunity to study the potential to identify retinal microvascular abnormalities as markers of cerebrovascular pathology. In this review, we describe the anatomical and physiological homology between the retinal and cerebral microvasculatures. We review the evidence that retinal microvascular changes occur in cerebrovascular disease and review current retinal image analysis tools that may allow us to use different aspects of the retinal microvasculature as potential markers for the state of the cerebral microvasculature.
              Article 0 comments Cited 162 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Gareth J. McKay
                Journal
                Journal ID (nlm-ta): Alzheimers Dement (Amst)
                Journal ID (iso-abbrev): Alzheimers Dement (Amst)
                Title: Alzheimer's & Dementia (Amsterdam, Netherlands)
                Publisher: Elsevier B.V
                ISSN (Electronic): 2352-8729
                Publication date PMC-release: 16 May 2015
                Publication date Collection: June 2015
                Publication date (Electronic): 16 May 2015
                Volume: 1
                Issue: 2
                Pages: 229-235
                Affiliations
                [a ]Centre for Medical Education, Queen's University Belfast, Belfast, UK
                [b ]Centre for Public Health, Queen's University Belfast, Belfast, UK
                [c ]Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
                [d ]Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore
                [e ]Southern Health and Social Care Trust, Craigavon Hospital, Craigavon, UK
                [f ]Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
                Author notes
                [∗ ]Corresponding author. Tel.: +44-(0)2890635232; Fax: +44-(0)2890235900. g.j.mckay@ 123456qub.ac.uk
                [1]

                Both authors have contributed equally to this work.

                Article
                Publisher ID: S2352-8729(15)00044-5
                DOI: 10.1016/j.dadm.2015.04.001
                PMC ID: 4629099
                PubMed ID: 26634224
                SO-VID: ff92b9a0-aa7d-4936-b947-4cb7103a5011
                Copyright © © 2015 The Authors
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Categories
                Subject: Retinal Imaging

                Keywords: retina,retinal vasculature,alzheimer's disease,microcirculation,small-vessel disease
                Data availability:
                Keywords: retina, retinal vasculature, alzheimer's disease, microcirculation, small-vessel disease

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