Chan Jane W, Corradetti Giulia, Wu Xiaomeng, Astraea Natalie, Arakaki Xianghong, Fonteh Alfred N, Suchy-Dicey Astrid M, Sadda SriniVas
Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Doheny Eye Institute, Pasadena, CA, USA.
Transl Vis Sci Technol. 2025 May 1;14(5):27. doi: 10.1167/tvst.14.5.27.
This study investigated the association between swept-source OCTA (SS-OCTA) choriocapillaris flow deficit percentage (CC FD%) and cerebrospinal fluid (CSF) biomarkers in presymptomatic Alzheimer's disease (AD).
Twenty-three cognitively healthy (CH) participants, including those with pathological (CH-PAT) and normal (CH-NAT) Aβ42/tau ratios, underwent lumbar puncture for CSF Aβ42/tau and ptau-181 quantification using electrochemiluminescence assays. OCTA en face images of the choriocapillaris were analyzed for flow deficits within a 6 × 6 mm macular grid and 3- and 6-mm Early Treatment of Diabetic Retinopathy Study (ETDRS) perifoveal rings. The association between CC FD% and CSF Aβ42/tau and CSF ptau-181 levels was evaluated.
Perifoveal microvascular changes in the choriocapillaris outer ring (6-mm ETDRS ring) were significantly correlated with the CSF Aβ42/tau ratio in CH-PATs compared to CH-NATs. However, linear regression analysis across all CH participants (CH-PAT + CH-NAT) revealed that only age was significantly associated with CSF ptau-181 levels.
Our findings suggest that this cohort is in an early preclinical AD stage, without ptau-181 biomarker evidence of established AD. SS-OCTA measures may complement CSF A/T (amyloid/tau) levels, helping to define transitional stages from CH-NAT to CH-PAT during presymptomatic AD.
By identifying the transition from normal aging to presymptomatic AD, SS-OCTA metrics combined with biofluid markers could enhance AD oculomics by stratifying disease risk and prioritizing treatment interventions.
本研究调查了扫频源光学相干断层扫描血管造影（SS - OCTA）脉络膜毛细血管血流缺损百分比（CC FD%）与症状前阿尔茨海默病（AD）患者脑脊液（CSF）生物标志物之间的关联。
23名认知健康（CH）参与者，包括具有病理性（CH - PAT）和正常（CH - NAT）Aβ42/τ比值的参与者，接受腰椎穿刺以使用电化学发光测定法对CSF中的Aβ42/τ和磷酸化τ蛋白181（ptau - 181）进行定量。分析脉络膜毛细血管的OCTA正面图像，以确定6×6毫米黄斑网格以及3毫米和6毫米糖尿病视网膜病变早期治疗研究（ETDRS）中心凹周围环内的血流缺损情况。评估CC FD%与CSF Aβ42/τ以及CSF ptau - 181水平之间的关联。
与CH - NAT参与者相比，CH - PAT参与者脉络膜毛细血管外环（6毫米ETDRS环）的中心凹周围微血管变化与CSF Aβ42/τ比值显著相关。然而，对所有CH参与者（CH - PAT + CH - NAT）进行的线性回归分析显示，只有年龄与CSF ptau - 181水平显著相关。
我们的研究结果表明，该队列处于临床前AD早期阶段，尚无已确诊AD的ptau - 181生物标志物证据。SS - OCTA测量可能补充CSF A/T（淀粉样蛋白/τ蛋白）水平，有助于在症状前AD期间定义从CH - NAT到CH - PAT的过渡阶段。
通过识别从正常衰老到症状前AD的转变，SS - OCTA指标与生物流体标志物相结合，可以通过对疾病风险进行分层并确定治疗干预的优先级来增强AD眼科学。
