Analysis of the Retinal and Choroidal Vasculature Using Ultrawidefield Fundus Imaging in Mild Cognitive Impairment and Normal Cognition

Suzanna Joseph; Alice Haystead; Cason B Robbins; Adam Threlfall; Tom J MacGillivray; Sandra Stinnett; Dilraj S Grewal; Sharon Fekrat

doi:10.1016/j.xops.2024.100480

Analysis of the Retinal and Choroidal Vasculature Using Ultrawidefield Fundus Imaging in Mild Cognitive Impairment and Normal Cognition

Ophthalmol Sci. 2024 Feb 1;4(4):100480. doi: 10.1016/j.xops.2024.100480. eCollection 2024 Jul-Aug.

Authors

Suzanna Joseph^{1

2}, Alice Haystead², Cason B Robbins^{1

2}, Adam Threlfall³, Tom J MacGillivray³, Sandra Stinnett^{1

2}, Dilraj S Grewal^{1

2}, Sharon Fekrat^{1

2

4}

Affiliations

¹ Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
² iMIND Research Group, Duke University School of Medicine, Durham, North Carolina.
³ Centre for Clinical Brain Science, University of Edinburgh, Scotland, United Kingdom.
⁴ Department of Neurology, Duke University School of Medicine, Durham, North Carolina.

Abstract

Purpose: To utilize ultrawidefield (UWF) imaging to evaluate retinal and choroidal vasculature and structure in individuals with mild cognitive impairment (MCI) compared with that of controls with normal cognition.

Design: Prospective cross sectional study.

Participants: One hundred thirty-one eyes of 82 MCI patients and 230 eyes of 133 cognitively normal participants from the Eye Multimodal Imaging in Neurodegenerative Disease Study.

Methods: A scanning laser ophthalmoscope (California, Optos Inc) was used to obtain UWF fundus color images. Images were analyzed with the Vasculature Assessment Platform for Images of the Retina UWF (VAMPIRE-UWF 2.0, Universities of Edinburgh and Dundee) software.

Main outcome measures: Imaging parameters included vessel width gradient, vessel width intercept, large vessel choroidal vascular density, vessel tortuosity, and vessel fractal dimension.

Results: Both retinal artery and vein width gradients were less negative in MCI patients compared with controls, demonstrating decreased rates of vessel thinning at the periphery (P < 0.001; P = 0.027). Retinal artery and vein width intercepts, a metric that extrapolates the width of the vessel at the center of the optic disc, were smaller in MCI patients compared with that of controls (P < 0.001; P = 0.017). The large vessel choroidal vascular density, which quantifies the vascular area versus the total choroidal area, was greater in MCI patients compared with controls (P = 0.025).

Conclusions: When compared with controls with normal cognition, MCI patients had thinner retinal vasculature manifested in both the retinal arteries and the veins. In MCI, these thinner arteries and veins attenuated at a lower rate when traveling toward the periphery. MCI patients also had increased choroidal vascular density.

Financial disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Diagnostic imaging; MCI; Retinal vasculature; Ultrawidefield fundus imaging.