Runhart, E. (Esmee) (2016) Retinal biomarkers for early Alzheimer’s disease. thesis, Medicine.
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Abstract
Characteristics of early Alzheimer’s disease (AD) include amyloid-beta (Aβ) pathology and hippocampal atrophy. A curative treatment for AD is not available at this moment. An explanation might be that patients in a late disease stage already have too much brain damage. Therefore, easy accessible AD biomarkers are necessary to identify cognitively healthy persons in the earliest stage of AD. There is increasing evidence of changing retinal vasculature and retinal nerve fiber layer (RNFL) thickness in AD patients. Here, the potential of retinal vasculature and RNFL as biomarkers for early AD was studied in cognitively healthy elderly persons. Dynamic amyloid PET scans were acquired using [18F]Flutemetamol, to assess amyloid-beta non-displaceable binding potential (Aβ BPND) in the posterior cingulate. MRI scans were acquired to assess hippocampal volume and intracranial volume. Fundus images of 129 individuals were analyzed and retinal vascular parameters (RVPs), including calibers, tortuosity and fractal dimension, were measured using Singapore I Vessel Assessment software. Peripapillary RNFL thickness of 120 individuals was measured using optical coherence tomography. Firstly, it is investigated whether RVPs can predict Aβ pathology. Secondly, it is investigated whether RNFL thickness is associated with hippocampal volume. Retinal venular changes were associated with Aβ BPND, after adjusting for age, gender and cardiovascular risk factors. Higher Aβ BPND was associated with a smaller central retinal vein equivalent (β=0.004, p=0.049), a higher venular branching coefficient (β=0.342, p=0.024), and a higher venular asymmetry factor (β=0.590, p=0.014). Additionally, a thinner RNFL in the superior (β=8.60, p=0.002) and temporal superior (β=5.62, p=0.005) segment was associated with smaller left hippocampal volume, after adjusting for age, gender and intracranial volume. Cognitively healthy individuals with retinal venular changes and thinner RNFL show more cerebral Aβ pathology and decreased hippocampal volume respectively, suggesting these characteristics are potential biomarkers for early AD.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Ponsioen, dr. T.L. |
| Supervisor name: | Second supervisor: and Visser, dr. P.J. and Daily supervisors: and Konijnenberg, drs. E. and Nguyen, drs. H.T. and Institution: VU University Medical Center and Department of Neurology & Alzheimer Center and Department of Ophthalmology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2141 |
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