Highlights
- •No cost-effective, widely accessible biomarkers of cerebral amyloid angiopathy (CAA)
- •Retina holds potential as neurodegenerative disease biomarker
- •Trend level correlations between cerebral and retinal microbleeds in CAA
- •No group differences between CAA/controls on structural or angiographic retinal imaging
- •Results complicated by small N, systolic hypertension in CAA group
Abstract
Background
The standard in vivo diagnostic imaging technique for cerebral amyloid angiopathy
(CAA) is costly and thereby of limited utility for point-of-care diagnosis and monitoring
of treatment efficacy. Recent recognition that retinal changes may reflect cerebral
changes in neurodegenerative disease provides an ideal opportunity for development
of accessible and cost-effective biomarkers for point-of-care use in the detection
and monitoring of CAA. In this pilot study, we examined structural and angiographic
retinal changes in CAA patients relative to a control group, and compared retinal
and cerebral pathology in a group of CAA patients.
Methods
We used spectral domain optical coherence tomography (SD-OCT) to image the retina
and compared retinal microbleeds to both cerebral microbleeds and white matter hyperintensities
(WMH) in CAA patients, as seen on MRI. We compared retinal angiographic changes, along
with structural retinal neuronal layer changes in CAA patients and cognitively normal
older adults, and examined the relationship between retinal and cerebral microbleeds
and cognition in CAA patients.
Results
We found a trend level correlation between retinal and cerebral microbleeds in CAA
patients. Moreover, we found a significant correlation between retinal microbleeds
and episodic memory performance in CAA patients. There were no significant group differences
between CAA patients and cognitively normal older adults on retinal angiographic or
structural measurements.
Conclusion
Retinal microbleeds may reflect degree of cerebral microbleed burden in CAA. This
picture was complicated by systolic hypertension in the CAA group, which is a confounding
factor for the interpretation of these data. Our results stimulate motivation for
pursuit of a more comprehensive prospective study to determine the feasibility of
retinal biomarkers in CAA.
Keywords
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Article info
Publication history
Published online: March 01, 2021
Accepted:
February 26,
2021
Received in revised form:
January 26,
2021
Received:
June 28,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
