Choroidal Structural Analysis in Alzheimer's Disease, Mild Cognitive Impairment, and Cognitively Healthy Controls.
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2020-10-08
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PURPOSE: To assess choroidal structural parameters in symptomatic Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively healthy controls. DESIGN: Prospective cross-sectional study. METHODS: Setting: Outpatient neurological disorders clinic. STUDY POPULATION: One hundred and twelve eyes of 67 individuals with AD, 143 eyes of 74 individuals with MCI, and 248 eyes of 137 controls. Individuals with diabetes, glaucoma, or retinal pathology were excluded. OBSERVATION PROCEDURE: High-definition EDI foveal scans were obtained using Zeiss Cirrus HD-5000 AngioPlex (Carl Zeiss Meditec, Dublin, CA). Subfoveal choroidal thickness (SFCT) was measured by two masked graders with a third adjudicator. Total choroidal area (TCA), luminal area (LA), and choroidal vascularity index (CVI) were calculated after image binarization. MAIN OUTCOME MEASURES: Association of choroidal parameters with AD, MCI, or controls using generalized estimating equations, adjusted for age and sex. RESULTS: After adjustment for age, sex, and visual acuity, TCA was significantly greater in AD (ß 2.73, p = 0.001) and MCI (ß 4.38, p < 0.001) compared to controls, LA was significantly greater in AD (ß 1.68, p = 0.001) and MCI (ß 2.69, p < 0.001) compared to controls, and CVI was significantly lower in MCI (ß -0.58, p = 0.002) compared to controls. SFCT was similar among AD, MCI, and controls on multivariable analysis (p > 0.05). CONCLUSIONS: TCA, LA, and CVI may differ between individuals with AD, MCI, and healthy cognition, whereas SFCT may not differ between these groups. TCA, LA, and CVI deserve further study in individuals along the Alzheimer's continuum.
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Robbins, Cason B, Dilraj S Grewal, Atalie C Thompson, James H Powers, Srinath Soundararajan, Hui Yan Koo, Stephen P Yoon, Bryce W Polascik, et al. (2020). Choroidal Structural Analysis in Alzheimer's Disease, Mild Cognitive Impairment, and Cognitively Healthy Controls. Am J Ophthalmol. 10.1016/j.ajo.2020.09.049 Retrieved from https://hdl.handle.net/10161/21604.
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Dilraj Singh Grewal
Vitreoretinal and Uveitis Specialist
Dilraj Grewal, MD specializes in the medical and surgical management of patients with complex Vitreoretinal pathology and Uveitis. He joined the Duke Eye Center in December 2016 following completion of his Vitreoretinal Surgery fellowship at Duke and Uveitis fellowship training at Moorfields Eye Hospital in London. Dr. Grewal is excited about treating patients with several of the new diagnostic and therapeutic modalities available as well as several others in the pipeline to better help patients with these potentially blinding diseases.
He has been the recipient of numerous prestigious awards including the Ronald G. Michels Foundation Fellowship Award, the Heed Ophthalmic Foundation Fellowship Award, Senior Achievement Award from the American Academy of Ophthalmology and Rhett Buckler and Senior Honor Awards from American Society of Retina Specialists.
Dr. Grewal has authored over 100 publications in peer-reviewed medical journals and over 150 presentations at national and international meetings. His research interests span clinical research activities in advanced ocular imaging and clinical trials for both Retina and Uveitis. He also serves as Director of Grading at the Duke Reading Center, a comprehensive image reading center that specializes in systematic analysis of ophthalmic images captured by many different modalities in multicenter clinical trials. In addition, he participates in national and international clinical trials in retina and uveitis.
Andrew John Liu
While striving to provide excellent clinical care, I also have several research interests:
1. Investigate a neurodevelopmental disorder, Tuberous Sclerosis Complex, which has the potential to provide insight into the pathophysiological mechanism of a neurodegenerative disorders, Alzheimer's Disease.
2. In collaboration with Dr. Cathrine Hoyo, we are investigating an epigenetic mechanism to explain the racial disparities in the development of Alzheimer's disease between underrepresented minorities and European Americans.
3. I am interested in clinically characterizing the long-term cognitive and behavioral consequences in convalescent COVID-19 patients.
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