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Abstract #99102 Published in IGR 22-4
Longitudinal analysis of the retina and choroid in cognitively normal individuals at higher genetic risk for Alzheimer disease
Ma JP; Robbins CB; Robbins CB; Lee JM; Soundararajan S; Stinnett SS; Agrawal R; Plassman BL; Lad EM; Whitson H; Grewal DS; Fekrat SOphthalmology. Retina 2022; 6: 607-619
PURPOSE: To assess baseline differences and longitudinal rate of change in retinal and choroidal imaging parameters between APOE ε4 carriers and non-carriers with normal cognition. DESIGN: Prospective study. SUBJECTS: 413 eyes of 218 individuals with normal cognition aged ≥55 years with known APOE status (98 ε4 carriers, 120 non-carriers). Exclusion criteria included diabetes mellitus, uncontrolled hypertension, glaucoma, and vitreoretinal or neurodegenerative disease. METHODS: Optical coherence tomography (OCT) and OCT angiography (OCTA) was performed at baseline and at 2 years [Zeiss Cirrus HD-OCT 5000 with AngioPlex (Zeiss Meditec, Dublin, CA)]. Groups were compared using sex- and age-adjusted generalized estimating equations. MAIN OUTCOME MEASURES: OCT: retinal nerve fiber layer thickness, macular ganglion cell-inner plexiform layer thickness, central subfield thickness (CST), choroidal vascularity index. OCTA: foveal avascular zone area, perfusion density (PD), vessel density, peripapillary capillary perfusion density and capillary flux index (CFI). Rate of change per year was calculated. RESULTS: At baseline, ε4 carriers demonstrated decreased CST (p=0.018), PD in the 6mm Early Treatment Diabetic Retinopathy Study (ETDRS) circle (p=0.049), and temporal CFI (p=0.047). Seventy-one ε4 carriers and 78 non-carriers returned at 2 years; at follow-up, the 6mm ETDRS circle (p=0.05) and outer ring (p=0.049) showed decreased PD in ε4 carriers, with no differences in rates of change between groups (all p>0.05). CONCLUSIONS: There were measured differences in CST, PD, and peripapillary CFI between APOE ε4 carriers and non-carriers with normal cognition. Larger and longer-term studies may further elucidate the potential prognostic value of these findings.
iMIND Research Group, Duke University School of Medicine, Durham, NC, USA; Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA.
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