Analysing Optical Coherence Tomography Angiography of Mid-Life Persons at Risk of Developing Alzheimer’s Disease Later in Life

Cerebrovascular changes associated with Alzheimer’s disease (AD) can occur years before the onset of symptoms. Studies have suggested that changes in the retina may act as a surrogate for cerebrovascular changes in the brain, hence the retina might be a source of biomarkers for declining vascular brain health. Optical Coherence Tomography Angiography (OCTA) is a promising retinal imaging modality that has been increasingly used to investigate cerebrovascular diseases in this context. However, the potential clinical translation of advances for early AD detection is still being explored. In this study, we used OCTA retinal phenotypes to investigate differences between participants with and without a high genetic risk characterization of Apoliproprotein E4 (APOE4), and between participants with and without a family history of dementia. Furthermore, we investigated whether there is a difference in OCTA retinal phenotypes between participants with and without a high CAIDE (Cardiovascular Risk Factors, Aging, and Dementia score). This investigation explored retinal phenotypes (from OCTA) both cross-sectionally and longitudinally (2 years follow-up) using participants at mid-life from the PREVENT cohort and our findings suggest that there are retinal vascular changes captured in OCTA images between control and participants at risk of developing AD.