Quantitative Swept-Source Optical Coherence Tomography Angiography Indicators of Neurovascular Dysfunction in Alzheimer Disease

Do optical coherence tomography angiography–based biomarkers of the retina, choroid, and choriocapillaris differ across normal cognition, mild cognitive impairment (MCI), and Alzheimer disease (AD) dementia?In this cross-sectional study of 103 older adults, choriocapillaris flow deficit (CCFD) showed a biphasic pattern (lower in MCI, higher in AD dementia). A model combining vessel skeleton density, CCFD, and ganglion cell complex thickness achieved area under the curve of 0.720.87 among 21 held-out participants (10 controls, 6 MCI, 5 AD dementia).These results demonstrate that noninvasive retinal and choroidal imaging may provide an accessible screening tool for cognitive impairment and guide referral for neurological evaluation.

Corresponding Author: Ruikang Wang, PhD, Department of Bioengineering, University of Washington, 3720 15th Ave NE, Seattle, WA 98195 (wangrk@uw.edu).

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