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Optical coherence tomography angiography in cognitively impaired patients: Vascular and neurodegenerative perspectives
Author(s) -
Lee JuYeun,
Kim Jun Pyo,
Jang Hyemin,
Kim Jaeho,
Kim Ji Sun,
Jung Young Hee,
Seo Sang Won,
Na Duk L,
Oh Sei Yeul,
Lee Jong Min,
Kang Sung Hoon,
Kim Hee Jin
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041738
Subject(s) - retinal , nerve fiber layer , medicine , neurodegeneration , ophthalmology , optical coherence tomography , optical coherence tomography angiography , magnetic resonance imaging , pathology , radiology , disease
Background Vascular and neuronal changes in the retina may reflect cerebral small vessel disease (CSVD) and neurodegeneration in the brain. We aimed to compare radial peripapillary capillary (RPC) network density and RNFL thickness between diagnostic groups using optical coherence tomography angiography (OCTA) imaging. Then, we evaluated whether the RPC network density correlated with CSVD markers and whether RNFL correlated with Aβ or brain cortical thickness. Method In this prospective, cross‐sectional, observational study, subjects were recruited from February 2018 to March 2019. Retinal vascular [Capillary density (CD) of the radial peripapillary capillary (RPC) network] and neurodegeneration markers [retinal nerve fiber layer (RNFL) thickness at four quadrants] were measured using optical coherence tomography (OCT) and OCT angiography (OCTA) imaging. Brain vascular (CSVD score), and neurodegeneration markers [brain cortical thickness] were assessed using 3D brain magnetic resonance imaging. We compared CD and RNFL thickness between ADCI, SVCI, and CN group. Then, we evaluated correlation between retinal imaging markers (CD and RNFL) and brain imaging markers (CSVD score and cortical thickness) Result The mean (SD) age of total 60 participants was 70.3 (9.0) years and 21 (35%) of them were male. The SVCI group showed lower CD in the temporal quadrant of RPC network compared to the CN group (mean (sd), 42.34 (6.29) vs 48.45 (7.08); p = 0.002), and lower CD in the superior quadrant of RPC network (mean (sd), 60.14 (6.42) vs 64.15 (6.39); p = 0.021) compared with the ADCI group. The CD was negatively correlated with CSVD score in the superior (regression coefficient, ‐0.050; 95% CI, ‐0.083 to 0.017; p=0.004) and temporal (regression coefficient, ‐0.042; 95% CI, ‐0.070 to ‐0.014; p=0.004) quadrants of the RPC network. RNFL thickness did not differ among the groups nor did it correlate with cortical thickness. Conclusion The importance of the CD of the RPC network rather than RNFL thicknesses should be highlighted in evaluating cerebral pathology. Moreover, noninvasive and rapid acquisition of OCTA images has the potential to be used as a peripheral imaging tool to screen for the degree of CSVD.