Session Title: Free Paper Session 21: Imaging III
Session Date/Time: Sunday 10/09/2017 | 08:00-09:30
Paper Time: 09:00
Venue: Room 113
First Author: : M.Castilla Marti SPAIN
Co Author(s): : D. Sanchez Ruiz O. Rodriguez-Gomez A. Ruiz Laza S. Valero Llorens L. Tarraga Mestre M. Boada Rovira
Early markers are needed for experimental and clinical diagnosis and follow-up of Alzheimer disease (AD) and earlier stages as Mild Cognitive Impairment (MCI). Retinal Nerve Fiber Layer (RNFL) thinning have been observed in AD and MCI patients. We performed a prospective, observational clinical study to ascertain how RNFL thickness, as measured by Optical Coherence Tomography (OCT), can be correlated with different grades of cognitive impairment.
All patients visited in our centre between September 2014 and June 2016 underwent a complete neurologic and neuropsychological examination, as well as a complete ophthalmological examination that included measurements of RNFL and macular thickness by OCT Model 3D OCT-1 Maestro (Topcon, Japan). Individuals were then sorted between three different diagnostic groups: Healthy controls (HC), MCI and AD. Only right eyes were taken in account for analytical purposes. Inclusion criteria were: absence of ophthalmological pathology involving posterior segment of the eye, an age between 50 and 95 years, having a neurological diagnosis assigned and assessable OCT images on a time lapse not greater than 6 months. All statistical analyses were performed using the Statistical Package for the Social Sciences (version 20.0; SPSS, Inc., Chicago, IL, USA)
3274 patients were evaluated, from whom 1593 were finally included for analysis, according to inclusion and exclusion criteria mentioned above. The sample included 340 HC, 550 MCI and 703 AD patients. From all analyzed covariants related with RNFL macular thickness (scholarity, sex, age, device’s OCT image quality and neurologic diagnosis), only age and device OCT image quality showed to be statistically significant (p<0.000). RNFL macular thickness for the hole sample was 97.5μm (SD=15.5), descending from 100.3μm (SD=15.4) for HC group, to 98.7μm (SD=14.8) for MCI, and 95μm (SD 15.7) for AD, resulting those differences not statistically significant. Mean age for the whole sample was 75 years and 64 years for HC group, 74 for MCI and 80 for AD. Those differences showed to be statistically significant with a p value <0.000.
Despite published data suggests a tendency to RNFL thinning on AD patients, we were not able to confirm this statement regarding our data. Other factors seems to play a role on progressive RNFL thinning, being the age a major player. If OCT is an appropriate method for AD and MCI assessment, capable to discriminate between disease and normal age related changes on retinal thickness layers, need to be further evaluated.