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 is a tenured Associate Professor of Ophthalmology at the Duke Eye Center. He specializes in the medical and surgical management of patients with complex Vitreoretinal pathology and Uveitis. He joined the Duke Eye Center 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 new diagnostic and therapeutic modalities available as well as investigating 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 Presidential Awards from American Society of Retina Specialists. He is an elected member of Retina Society, Clubs Jules Gonin and serves on the executive committee of the Macula Society.
Dr. Grewal has authored over 190 publications in peer-reviewed medical journals and over 250 presentations at national and international meetings. His research interests span assessment of retinal changes in neurodegenerative diseases, clinical research activities in advanced ocular imaging, surgical techniques and clinical trials for both Retina and Uveitis. Dr Grewal also serves as the Associate Director of the Duke Reading Center, a comprehensive image reading center that specializes in systematic analysis of ophthalmic images in multi-center clinical trials.
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