Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 25:6:162-170.
doi: 10.1016/j.dadm.2016.12.014. eCollection 2017.

Retinal thickness in Alzheimer's disease: A systematic review and meta-analysis

Jurre den Haan  1 , Frank D Verbraak  2 , Pieter Jelle Visser  3 , Femke H Bouwman  1
Affiliations

Retinal thickness in Alzheimer's disease: A systematic review and meta-analysis

Jurre den Haan et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Retinal characteristics are increasingly recognized as biomarkers for neurodegenerative diseases. Retinal thickness measured by optical coherence tomography may reflect the presence of Alzheimer's disease (AD). We performed a meta-analysis on retinal thickness in AD and mild cognitive impairment (MCI) patients and healthy controls (HCs).

Methods: We selected 25 studies with measurements of retinal thickness including 887 AD patients, 216 MCI patients, and 864 HCs that measured retinal thickness. Outcomes were peripapillary retinal nerve fiber layer (RNFL) and macular thickness. The main outcome was the standardized mean differences (SMDs). We used STATA to perform the meta-analysis (StataCorp, Texas; version 14.0).

Results: Relative to HCs, AD and MCI patients had lower peripapillary RNFL (SMD 0.98 [CI -1.30, -0.66, P < .0001] and SMD 0.71 [CI -1.24, -0.19, P = .008]). Total macular thickness was decreased in AD patients (SMD 0.88 [CI -1.12, -0.65, P = .000]).

Discussion: Retinal thickness is decreased in AD and MCI patients compared to HC. This confirms that neurodegenerative diseases may be reflected by retinal changes.

Keywords: Alzheimer's disease (AD); Biomarkers; Eye; Meta-analysis; Mild cognitive impairment (MCI); Optical coherence tomography (OCT); Retinal thickness.

PubMed Disclaimer

Figures

Supplementary Fig. 1
Supplementary Fig. 1
Funnel plot.
Fig. 1
Fig. 1
Optical coherence tomography (Heidelberg Spectralis). OCT image of the macula (A) with an overlay of the Early Treatment Diabetic Retinopathy Study regions and transversal OCT image showing the macula (B). Image of optic disk (C) and a transversal OCT image through the optic disk (D). Abbreviations: F, Fovea; II, inferior inner; IO, inferior outer; NI, nasal inner; NO, nasal outer; OCT, optical coherence tomography; SI, superior inner; SO, superior outer; TI, temporal inner; TO, nasal inferior.
Fig. 2
Fig. 2
Flowchart of included and excluded articles.
Fig. 3
Fig. 3
Mean peripapillary RNFL in AD and HC. Forest plots of standardized mean peripapillary retinal nerve fiber layer (RNFL) in (A) all studies (n = 24), (B) studies with time domain (TD)-OCT scanners (n = 10), and (C) spectral domain (SD)-OCT studies (n = 14). Abbreviations: AD, Alzheimer's disease; HC, healthy control; OCT, optical coherence tomography.
Fig. 4
Fig. 4
Total macular thickness in AD and HC. Forest plots of standardized mean macular thickness, in the (A) fovea, (B) outer ring, and (C) inner ring. (D) Shows the ETDRS regions of the macula (inner and outer ring subdivided in four quadrants). Abbreviations: AD, Alzheimer's disease; ETDRS, Early Treatment Diabetic Retinopathy Study; HC, healthy control.
See this image and copyright information in PMC

References

    1. Sperling R.A., Aisen P.S., Beckett L.A., Bennett D.A., Craft S., Fagan A.M. Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:280–292. - PMC - PubMed
    1. McKhann G.M., Knopman D.S., Chertkow H., Hyman B.T., Jack C.R., Kawas C.H. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:263–269. - PMC - PubMed
    1. Jack C.R., Holtzman D.M. Biomarker modeling of Alzheimer's disease. Neuron. 2013;80:1347–1358. - PMC - PubMed
    1. Reardon S. Antibody drugs for Alzheimer's show glimmers of promise. Nature. 2015;523:509–510. - PubMed
    1. Petzold A., de Boer J.F., Schippling S., Vermersch P., Kardon R., Green A. Optical coherence tomography in multiple sclerosis: a systematic review and meta-analysis. Lancet Neurol. 2010;9:921–932. - PubMed