Retinal biomarkers in Alzheimer’s disease and mild cognitive impairment: A systematic review and meta-analysis |
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| Institution: | 1. Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Republic of Korea;2. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;3. Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea;4. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;5. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore;6. Department of Ophthalmology & Visual Sciences, Chinese University of Hong Kong, Hong Kong;7. Department of Pharmacology, National University of Singapore, Singapore;8. Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea;9. Department of Neurology, Chungnam National University Hospital, Daejeon, Republic of Korea;10. Department of Neurology, Kyung Hee University Hospital, Seoul, Republic of Korea;11. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;12. Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea |
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| Abstract: | BackgroundRetinal changes may reflect the pathophysiological processes in the central nervous system and can be assessed by imaging modalities non-invasively. We aim to localize candidate retinal biomarkers in Alzheimer’s disease (AD), mild cognitive impairment (MCI), and preclinical AD.MethodsWe systematically searched PubMed, EMBASE, Scopus, and Web of Science from inception to January 2021 for observational studies that investigated retinal imaging and electrophysiological markers in AD, MCI, and preclinical AD. Between-groups standardized mean differences (SMDs) with 95 % confidence intervals were computed using random-effects models.ResultsOf 19,727 citations identified, 126 articles were eligible for inclusion. Compared with healthy controls, the thickness of peripapillary retinal nerve fiber layer (pRNFL; SMD = -0.723, p < 0.001), total macular (SMD = -0.612, p < 0.001), and subfoveal choroid (SMD = -0.888, p < 0.001) were significantly reduced in patients with AD. Compared with healthy controls, patients with MCI also had lower thickness of pRNFL (SMD = -0.324, p < 0.001), total macular (SMD = -0.302, p < 0.001), and subfoveal choroid (SMD = -0.462, p = 0.020). Other candidate biomarkers included the optic nerve head morphology, retinal amyloid deposition, microvascular morphology and densities, blood flow, and electrophysiological markers.ConclusionsRetinal structural, vascular, and electrophysiological biomarkers hold great potential for the diagnosis, prognosis and risk assessment of AD and MCI. These biomarkers warrant further development in the future, especially in diagnostic test accuracy and longitudinal studies. |
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| Keywords: | Alzheimer’s disease Biomarker Mild cognitive impairment Optical coherence tomography Retina |
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