Jiang noted that this technology might also be used to monitor the progression of disease or the efficacy of treatments for cerebral small vessel disease. “This indicates that altered retinal blood flow may be a biomarker of early changes in cognition resulting from cerebral small vessel disease,” said Jiang, noting that of the two associated measures, the rate of blood flow in the retinal capillaries was a more sensitive measure of changes in the brain. They were also associated with three MRI measures which are also known to be related to cerebral small vessel disease. Certain early structural changes in the brain are known biomarkers of cerebral small vessel disease.Īfter analyzing the information collected during the exams, the team found that lower rates of blood flow through the retinal capillaries and lower density of blood vessels are both connected to functional and structural changes in the brain associated with cerebral small vessel disease.Īmong people in the study who underwent cognitive testing, lower rates of blood flow and blood vessel density were connected to worse information processing speed and executive function. Some of them also underwent magnetic resonance imaging (MRI) of the brain which allowed the team to take measurements of the participants’ brain structures. Participants were put through a series of examinations to evaluate their cognitive function. Jiang noted that OCTA can capture changes in retinal capillaries before patients have clinical symptoms. Using these images, the team was able to calculate the density of these blood vessels within the retina, the amount of blood that is flowing through those vessels and how quickly the blood was moving. OCTA, a relatively new type of imaging that is increasingly incorporated in clinical practice in ophthalmology, captures detailed images of tiny retinal capillaries without needing to inject a dye into the patient. Study participants underwent a type of retinal imaging called optical coherence tomography angiography, or OCTA, which was carried out at the USC Roski Eye Institute. Recruited from the African American Eye Disease Study, a population-based study of more than 6,000 African Americans from Inglewood, California, the research participants were all over 40 and had no history of cognitive impairment. Using a new type of device that looks at the blood vessels in the retina, the team was able to connect certain characteristics in the vasculature of the eye to early signs of cognitive decline and structural changes commonly found in the brains of people with cerebral small vessel disease. “This exam might help identify those people who are at high risk of developing cerebral small vessel disease early, while they can still get help.” Damage to the brain cells is not reversible.” said Xuejuan Jiang, PhD, associate professor of ophthalmology at the Keck School of Medicine and lead author of the study that was published in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. “Most people with cerebral small vessel disease are not diagnosed until significant brain damage has occurred. After Alzheimer’s disease, vascular dementia, associated with impaired blood flow to the brain, is the second most common dementia diagnosis. A research team led by the Keck School of Medicine of USC has discovered that a non-invasive eye exam may be a possible tool for screening Black Americans and other people from underdiagnosed and high-risk populations for cerebral small vessel disease, a major contributor to cognitive impairment and dementia.
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