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Open Access 01-12-2024 | Research

Changes in choroidal thickness quantified by Optical Coherence Tomography across cognitive impairment: data from the NORFACE cohort

Authors: Luis Castilla-Martí, Ainhoa García-Sánchez, Joan Martínez, Maitée Rosende-Roca, Liliana Vargas, Juan Pablo Tartari, Federico Casales, José Nelet Rodríguez, Natali Bein, Montserrat Alegret, Gemma Ortega, Ana Espinosa, Ángela Sanabria, Alba Pérez-Cordón, Nathalia Muñoz, Fernando García-Gutiérrez, Josep Blazquez-Folch, Andrea Miguel, Itziar de Rojas, Pablo García-González, Raquel Puerta, Clàudia Olivé, Maria Capdevila, Álvaro Muñoz-Morales, Paula Bayón-Buján, Amanda Cano, Victoria Fernández, Sergi Valero, Lluís Tárraga, Agustín Ruiz, Mercè Boada, Miguel Castilla-Martí, Marta Marquié

Published in: Alzheimer's Research & Therapy | Issue 1/2024

Abstract

Background

Optical coherence tomography (OCT) enables high-resolution imaging of ocular structures in health and disease. Choroid thickness (CT) is a key vascular retinal parameter that can be assessed by OCT and might be relevant in the evaluation of the vascular component of cognitive decline. We aimed to investigate CT changes in a large cohort of individuals cognitive unimpaired (CU), with mild cognitive impairment due to Alzheimer's (MCI-AD), mild cognitive impairment due to cerebrovascular disease (MCI-Va), Alzheimer’s disease dementia (ADD), and vascular dementia (VaD).

Methods

Clinical, demographical, ophthalmological and OCT data from the Neuro-ophthalmological Research at Fundació ACE (NORFACE) project were analyzed. CT was assessed in the macula across nine Early Treatment Diabetic Retinopathy Study (ETDRS) quadrants, average thickness, total volume, and subfoveal choroidal thickness. Differences of CT among the five diagnostic groups were assessed in a multivariate regression model, adjusting for demographic and cardiovascular risk factors and OCT image quality. A comparison between manual and automatic CT measurements in a subset of participants was also performed.

Results

The study cohort comprised 1,280 participants: 301 CU, 196 MCI-AD, 112 MCI-Va, 578 ADD, and 93 VaD. CT was significantly increased in individuals with cognitive impairment compared to those CU, particularly in the VaD and MCI-Va groups and in the peripheral ETDRS regions. No significant differences were found in inner superior, center and subfoveal choroidal thickness. The interaction of sex and diagnosis had no effect in differentiating CT. Mini-Mental State Examination (MMSE) scores were not correlated to CT. Manual and automated CT measurements showed good reliability.

Discussion

Our findings indicated that peripheral choroidal thickening, especially in patients with cerebrovascular disease, may serve as a potential choroidal biomarker for cognitive decline and suggest different pathogenic pathways in AD and VaD. Further research is required to explore CT as a reliable ocular biomarker for cognitive impairment.

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Title: Changes in choroidal thickness quantified by Optical Coherence Tomography across cognitive impairment: data from the NORFACE cohort
Authors: Luis Castilla-Martí
Ainhoa García-Sánchez
Joan Martínez
Maitée Rosende-Roca
Liliana Vargas
Juan Pablo Tartari
Federico Casales
José Nelet Rodríguez
Natali Bein
Montserrat Alegret
Gemma Ortega
Ana Espinosa
Ángela Sanabria
Alba Pérez-Cordón
Nathalia Muñoz
Fernando García-Gutiérrez
Josep Blazquez-Folch
Andrea Miguel
Itziar de Rojas
Pablo García-González
Raquel Puerta
Clàudia Olivé
Maria Capdevila
Álvaro Muñoz-Morales
Paula Bayón-Buján
Amanda Cano
Victoria Fernández
Sergi Valero
Lluís Tárraga
Agustín Ruiz
Mercè Boada
Miguel Castilla-Martí
Marta Marquié
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: Alzheimer's Research & Therapy / Issue 1/2024
Electronic ISSN: 1758-9193
DOI: https://doi.org/10.1186/s13195-024-01616-3

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