Focus falls on retina as risk indicator of developing ‘old age diseases’

Begonia Ruiz (left) has her eyes tested by Dr Ashleigh Barrett-Young with an optical coherence...
Begonia Ruiz (left) has her eyes tested by Dr Ashleigh Barrett-Young with an optical coherence tomography machine as part of research to see if a simple eye test can be used to diagnose the earliest stages of diseases such as Alzheimer’s. PHOTO: PETER MCINTOSH
Determining the likely risk for developing "old age diseases" such as Alzheimer’s may soon be as simple as visiting the local optometrist.

Parts of the retina have previously been proposed as biomarkers for Alzheimer’s disease, so researchers from the University of Otago’s Dunedin multidisciplinary health and development research unit have been investigating the retina’s potential to indicate cognitive change earlier in life.

Study lead Dr Ashleigh Barrett-Young said diseases of old age, such as Alzheimer’s, were usually diagnosed when people started forgetting things or acting out of character.

"This is often when the disease is quite far along. Early detection is possible through MRI or other brain imaging, but this is expensive and impractical for most," she said.

"In the near future, it’s hoped that artificial intelligence will be able to take an image of a person’s retina and determine whether that person is at risk for Alzheimer’s, long before they begin showing symptoms and when there is a possibility of treatment to mitigate the symptoms."

The study analysed data from 865 Dunedin Study participants, looking specifically at the retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) at age 45.

Dr Barrett-Young said researchers found thicker RNFL and GCL in middle age was associated with better cognitive performance in childhood and adulthood.

Thinner RNFL was also linked to a greater decline in processing speed (the speed in which a person can understand and react to the information they receive) from childhood to adulthood.

"This highlights the potential for optical scans to aid in the diagnosis of cognitive decline.

"Given we haven’t been able to treat advanced Alzheimer’s, and that the global prevalence of the disease is increasing, being able to identify people in the pre-clinical stage, when we may still have the chance to intervene, is really important."

Further studies were required to determine if retinal thinning predicted Alzheimer’s, or just the normal cognitive decline of old age.

"In the future, these findings could result in AI being used to take a typical optical coherence tomography scan, done at an optometrist, and combine it with other health data to determine your likely risk for developing Alzheimer’s," she said.

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