ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2025
Retinal microvascular alterations in Alzheimer's disease: Linking blood plasma biomarkers and cerebral small vessel pathology.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Mendelian randomization evidence refines retinal alterations in Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Retinal microvascular changes are related to indicators of glymphatic dysfunction and small vessel disease in frontotemporal dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- The Visual System in Alzheimer's Disease: A Multilevel Review of Pathology, Monitoring, and Intervention.Vision (Basel, Switzerland) · 2026Review
- Retinal Microvascular Dysfunction Reflects Vascular and Alzheimer's-Related Pathology in Dementia With Lewy Bodies.CNS neuroscience & therapeutics · 2026Article
- Retinal microvascular dysfunction in mild cognitive impairment: Associations with cerebral small vessel disease, plasma biomarkers, and cognitive decline.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Interactive effect of retinal microvascular impairment and larger lesion diameter on cognitive impairment in lacunar infarction.Alzheimer's research & therapy · 2026Article
- Synergistic effects of cerebral small vessel disease burden and plasma phosphorylated tau 181 on white matter microstructure and cognition in a Chinese cohort.Brain communications · 2026Article
- Retinal microvascular alterations reflect cerebral small vessel disease burden in frontotemporal dementia: a multimodal OCTA-MRI Study.Alzheimer's research & therapy · 2025Article
- Apolipoprotein E ε4 homozygosity exacerbates retinal and cerebral microvascular dysfunction in Alzheimer's disease: A mediation analysis of vascular contributions to cognitive decline.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Retinal microvascular alterations in Alzheimer's disease: Linking blood plasma biomarkers and cerebral small vessel pathology.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- A fovea-centered retinal signature linked to plasma biomarkers in prodromal Alzheimer's disease.Alzheimer's & dementia (Amsterdam, Netherlands)Article
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Authors and funding
17 authors.
Funding
Abstract
backgroundRetinal microvascular alterations, detectable via color fundus photography (CFP), may reflect cerebral microvascular pathology in Alzheimer's disease (AD). However, their associations with blood-based biomarkers and cerebral small vessel disease (SVD) remain unclear.
methodsThis cross-sectional study included 72 AD patients and 82 cognitively unimpaired (CU) controls. Participants underwent CFP, plasma biomarker analysis (amyloid beta [Aβ]42, Aβ42/40, phosphorylated tau [p-tau]181, p-tau217), and 3T magnetic resonance imaging. Retinal microvascular metrics (vessel density [VD], fractal dimension [FD]) were analyzed alongside SVD markers (white matter hyperintensities [WMHs], SVD burden) and medial temporal lobe atrophy (MTA).
resultsAD patients exhibited significantly reduced VD and FD compared to CU (all p < 0.001), with strong diagnostic accuracy (area under the curve: 0.969 for VD; 0.904 for FD). Retinal microvascular impairment correlated with plasma biomarkers (lower Aβ42, Aβ42/40; elevated p-tau181, p-tau217; all p < 0.05) and neuroimaging markers of SVD (WMHs, MTA; all p < 0.05). Apolipoprotein E ε4 carriers showed more severe retinal microvascular damage (p < 0.001). DISCUSSION: Retinal microvascular alterations, assayed via CFP, are linked to AD-specific proteinopathy and cerebrovascular pathology, supporting CFP as a scalable, non-invasive tool for AD biomarker discovery. HIGHLIGHTS: Retinal microvasculature assayed via color fundus photography (CFP) is sensitive to microvascular damage and can differentiate Alzheimer's disease (AD) from cognitively unimpaired controls. Retinal microvascular damage in AD is associated with phosphorylated tau [p-tau]181, p-tau217, p-tau217/amyloid beta (Aβ)42, and increased amyloid burden (lower Aβ42 and Aβ42/40). Retinal microvascular damage in AD is associated with increased cerebral small vessel burden.
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