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. 2023 Nov 10;12(22):7035.
doi: 10.3390/jcm12227035.

Structural and Functional Retinal Changes in Patients with Mild Cognitive Impairment with and without Diabetes

Álvaro Santos-Ortega  1 , Carmen Alba-Linero  2   3 , Facundo Urbinati  4 , Carlos Rocha-de-Lossada  4   5   6   7 , Rafael Orti  3 , José Antonio Reyes-Bueno  8 , Francisco Javier Garzón-Maldonado  9   10 , Vicente Serrano  9 , Carmen de Rojas-Leal  9   10 , Carlos de la Cruz-Cosme  9   10 , Manuela España-Contreras  4 , Marina Rodríguez-Calvo-de-Mora  4   5   6 , Natalia García-Casares  10   11   12
Affiliations

Structural and Functional Retinal Changes in Patients with Mild Cognitive Impairment with and without Diabetes

Álvaro Santos-Ortega et al. J Clin Med. .

Abstract

Our objective is to analyze retinal changes using optical coherence tomography angiography (OCT-A) in patients with mild cognitive impairment (MCI) to characterize structural and vascular alterations. This cross-sectional study involved 117 eyes: 39 eyes from patients with MCI plus diabetes (DM-MCI), 39 eyes from patients with MCI but no diabetes (MCI); and 39 healthy control eyes (C). All patients underwent a visual acuity measurement, a structural OCT, an OCT-A, and a neuropsychological examination. Our study showed a thinning of retinal nerve fiber layer thickness (RNFL) and a decrease in macular thickness when comparing the MCI-DM group to the C group (p = 0.008 and p = 0.016, respectively). In addition, an increase in arteriolar thickness (p = 0.016), a reduction in superficial capillary plexus density (p = 0.002), and a decrease in ganglion cell thickness (p = 0.027) were found when comparing the MCI-DM group with the MCI group. Diabetes may exacerbate retinal vascular changes when combined with mild cognitive impairment.

Keywords: Alzheimer’s disease; diabetes; mild cognitive impairment; optical coherence tomography angiography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Optical coherence tomography angiography (3 × 3 mm images). Superficial capillary plexus analysis using Angioplex OCTA software 11.5.2.54532 (Carl Zeiss Meditec, Dublin, CA) from a DM-MCI patient (A), MCI patient (B), and control (C) and their corresponding quantitative color maps of vessel density (D–F) and perfusion density (G–I) with the scale on the right. MCI group = patients with mild cognitive impairment without diabetes. C group = healthy patients.
Figure 2
Figure 2
RNFL thickness analysis. RNFL thickness (expressed in µm) in nasal inferior (A), inferior (B), temporal inferior (C), and temporal superior (D) quadrants. RNFL = retinal nerve fiber layer. DM-MCI group = patients with mild cognitive impairment and diabetes. MCI group = patients with mild cognitive impairment without diabetes. C group = healthy patients.
Figure 3
Figure 3
Comparison of macular thickness in DM-MCI, MCI, and C groups. A generalized decrease is observed in the DM-MCI group compared to the C group. Inner ring = 1 × 1. Inner ring = 3 × 3. Outer ring = 6 × 6. DM-MCI group = patients with mild cognitive impairment and diabetes. MCI group = patients with mild cognitive impairment without diabetes. C group = healthy patients.
Figure 4
Figure 4
Examples of structural optical coherence tomography and fundus images. Macular OCT of a patient from the DM-MCI group, MCI group, and C group (A–C) and their corresponding fundus images (D–F). DM-MCI group = patients with mild cognitive impairment and diabetes. MCI group = patients with mild cognitive impairment without diabetes. C group = healthy patients.
See this image and copyright information in PMC

References

    1. Ashraf G.M., Chibber S., Mohammad Zaidi S.K., Tabrez S., Ahmad A., Shakil S., Mushtaq G., Baeesa S.S., Kamal M.A. Recent Updates on the Association between Alzheimer’s Disease and Vascular Dementia. Med. Chem. 2016;12:226–237. doi: 10.2174/1573406411666151030111820. - DOI - PubMed
    1. Atri A. The Alzheimer’s Disease Clinical Spectrum: Diagnosis and Management. Med. Clin. N. Am. 2019;103:263–293. doi: 10.1016/j.mcna.2018.10.009. - DOI - PubMed
    1. Sperling R.A., Aisen P.S., Beckett L.A., Bennett D.A., Craft S., Fagan A.M., Iwatsubo T., Jack C.R.J., Kaye J., Montine T.J., et al. 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. Alzheimer’s Dement. J. Alzheimer’s Assoc. 2011;7:280–292. doi: 10.1016/j.jalz.2011.03.003. - DOI - PMC - PubMed
    1. Song A., Johnson N., Ayala A., Thompson A.C. Optical Coherence Tomography in Patients with Alzheimer’s Disease: What Can It Tell Us? Eye Brain. 2021;13:1–20. doi: 10.2147/EB.S235238. - DOI - PMC - PubMed
    1. Langa K.M., Levine D.A. The diagnosis and management of mild cognitive impairment: A clinical review. JAMA. 2014;312:2551–2561. doi: 10.1001/jama.2014.13806. - DOI - PMC - PubMed

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