Choriocapillaris reduction accurately discriminates against early‐onset Alzheimer's disease
William Robert Kwapong, Fei Tang, Peng Liu, Ziyi Zhang, Le Cao, Zijuan Feng, Shiyun Yang, Yang Shu, Heng Xu, Ying Lu, Xinjun Zhao, Baochen Chong, Bo Wu, Ming Liu, Peng Lei, Shuting ZhangAbstract
INTRODUCTION
This study addresses the urgent need for non‐invasive early‐onset Alzheimer's disease (EOAD) prediction. Using optical coherence tomography angiography (OCTA), we present a choriocapillaris model sensitive to EOAD, correlating with serum biomarkers.
METHODS
Eighty‐four EOAD patients and 73 controls were assigned to swept‐source OCTA (SS‐OCTA) or the spectral domain OCTA (SD‐OCTA) cohorts. Our hypothesis on choriocapillaris predictive potential in EOAD was tested and validated in these two cohorts.
RESULTS
Both cohorts revealed diminished choriocapillaris signals, demonstrating the highest discriminatory capability (area under the receiver operating characteristic curve: SS‐OCTA 0.913, SD‐OCTA 0.991; P < 0.001). A sparser SS‐OCTA choriocapillaris correlated with increased serum amyloid beta (Aβ)42, Aβ42/40, and phosphorylated tau (p‐tau)181 levels (all P < 0.05). Apolipoprotein E status did not affect choriocapillaris measurement.
DISCUSSION
The choriocapillaris, observed in both cohorts, proves sensitive to EOAD diagnosis, and correlates with serum Aβ and p‐tau181 levels, suggesting its potential as a diagnostic tool for identifying and tracking microvascular changes in EOAD.
Highlights
Optical coherence tomography angiography may be applied for non‐invasive screening of Alzheimer's disease (AD). Choriocapillaris demonstrates high sensitivity and specificity for early‐onset AD diagnosis. Microvascular dynamics abnormalities are associated with AD.