The Eye and Screening for Alzheimer’s Disease

The Eye and Screening for Alzheimer’s Disease

Medical school and residency training brings people together in a unique way as we work together closely and intensely. I will never forget the tears of an ophthalmology colleague as she shared with me the difficulty of dealing with her mother’s illness. It turns out her mother had suffered from mood swings and personality changes that were ultimately diagnosed as Alzheimer’s disease. Her battle with this relentless disease was lost when my colleague was pregnant with her first child. One wonders if better screening tests and treatment would have allowed her mom to live to meet her grandson. On that note, I want to share some exciting research about how examination of the eye can help screen for the early stages of Alzheimer’s disease.

Alzheimer’s disease is the most common form of dementia. It causes a progressive decline in memory, learning, and executive functions. Abnormal deposits of amyloid in the brain cause the symptoms of Alzheimer’s. Although there is no cure for the disease, a number of drugs have been developed that modify the symptoms and delay the progression of Alzheimer’s. Unfortunately, the symptoms of Alzheimer’s are only apparent after the disease has been present for many years, which means that the treatments are not very effective because they are typically started late, after irreversible brain changes have occurred.

Scientists are searching for an accurate, early diagnostic test for Alzheimer’s disease so that current and future treatments will be more effective. A newly released study examined photographs of the retina (the thin tissue that lines the back of the eye) in people with Alzheimer’s and compared them to those of healthy participants. The study found that the width of certain blood vessels in the back of the eye was significantly different in people with Alzheimer’s vs. the healthy controls. This correlated with brain imaging that demonstrated the deposition of amyloid plaque in the brain.

This study demonstrated that through a simple dilated eye examination, potential exists to identify patients at risk for Alzheimer’s disease much earlier. More research is needed before this examination will become a widespread recommendation. Once again, we confirm the importance of routine screening eye examinations in detecting not just disorders of the eye but disorders that affect other organs in the body as well.

By: Michelle Akler, MD

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