Introduction:To examine the clinical value of spectral-domain optical coherence tomography (Spectralis OCT) to detect retinal nerve fibre layer defects in patients with clinically defined Alzheimer‘s disease (AD).Material and Methods:This cross-sectional study included 22 patients with AD (mean age: 75.9 ± 6.1 years) and 22 healthy age- and sex-matched controls. Neuro-ophthalmologic examinations and a series of high-resolution OCT examinations of the peripapillary retinal nerve fibre layer (RNFL) thickness using the Spectralis 3.5-mm circle scan protocol with ART-Modus and eye tracking were obtained, and compared to age- and sex-matched healthy control subjects.Results:Patients with AD showed a significant decrease in RNFL thickness in the nasal superior sector compared to the control group (101.0 ± 18.18 µm vs. 122.8 ± 28.08 µm; p

The retina has been found affected in Parkinson’s disease (PD). It is unclear if this is due to neurodegeneration of local dopamine-dependent retinal cells, a result of central nervous degeneration including the optic nerve or retinal small vessel disease. This study aimed to detect changes of the retinal vasculature in PD patients compared to controls. We examined 49 PD patients and 49 age- and sex-matched healthy controls by spectral domain optical coherence tomography (SD-OCT) with a circular scan centred at the optic disc. Vessels within the retinal nerve fibre layer were identified by an automated algorithm and thereafter manually labelled as artery or vein. Layer segmentation, vessel lumen and direct surrounding tissue were marked automatically with a grey value and the contrast between both values in relation to the surrounding tissue was calculated. The differences in these grey value ratios among subjects were determined and used as an indicator for differences in vessel morphology. Furthermore, the diameters of the veins and arteries were measured and then compared between the groups. The contrast of retinal veins was significantly lower in PD patients compared to controls, which indicates changes in vessel morphology in PD. The contrast of arteries was not significantly different. Disease duration, disease stage according to Hoehn and Yahr or age did not influence the grey value ratios in PD patients. Vessel diameter in either veins or arteries did not differ between subject groups. The contrast of retinal veins contralateral to the clinically predominant and first affected side was significantly lower compared to the ipsilateral side. Our data show a potential difference of the retinal vasculature in PD patients compared to controls. Vascular changes in the retina of PD patients might contribute to vision-related complaints in PD.

Purpose: Acute central retinal artery occlusion (CRAO) induces ischaemic retinal oedema. The purpose of this study was to define sensitivity and specificity of optical coherence tomography (OCT) based retinal thickness analysis in determining ischaemia onset in CRAO.Methods: The relative retinal thickness increase (RRTI) in comparison with the fellow eye was analysed retrospectively in OCT scans of 66 patients diagnosed with CRAO between January 2010 and December 2019 within 48 hr of ischaemia onset. The natural course of RRTI and the sensitivity and specificity of OCT‐based determination of ischaemia onset in identifying CRAO within 4.5 hr using the RRTI were evaluated.Results: Relative retinal thickness increase (RRTI) in acute CRAO follows a hyperbolic curve with a steep incline within the early phase after which it reaches a plateau. Optical coherence tomography (OCT)‐based retinal thickness analysis in CRAO allows to differentiate patients with ischaemia onset within the past 4.5 hr or thereafter with a sensitivity of 100% and a specificity of 94.3%.Conclusion: Relative retinal thickness increase (RRTI) allows to identify CRAO patients that are eligible for a potentially beneficial reperfusion therapy within a therapeutic window of 4.5 hr with a high accuracy. Especially in patients with unknown ischaemia onset, this diagnostic tool could be of major importance in the future clinical management.

Introduction Alzheimer‘s disease is a long term progressive neurodegenerative disease and might affect the retinal nerve fibre layer thickness of the eye. There is increasing evidence that visual evoked potentials, which are an objective way to indicate visual field loss, might be affected by the disease as well. Material and Methods 22 patients (mean age: 75.9 ± 6.1 years; 14 women) with mild-to-moderate Alzheimer‘s disease and 22 sex-matched healthy patients were examined. We compared the use of visual evoked potentials and retinal nerve fibre layer thickness using latest high-resolution spectral domain optical coherence tomography with eye-tracking capabilities for optimised peripapillary scan centring for the first time in Alzheimer‘s disease patients. Results The mean MMSE score was 22.59 ± 5.47 in the Alzheimer‘s disease group, and did not significantly correlate with the visual evoked potentials latencies. We found no significant difference between the visual evoked potentials latencies of the Alzheimer‘s disease patients and those of the control patients. No peripapillary sector of the retina had a retinal nerve fibre layer thickness significantly correlated with the visual evoked potentials latencies. Discussion We demonstrated that pattern visual evoked potentials did not show any significant correlation despite subtle loss in retinal nerve fibre layer thickness. It remains open whether additional flash visual evoked potentials combined with retinal nerve fibre layer thickness analysis may be useful in diagnosing Alzheimer‘s disease, particularly for mild-to-moderate stages of the disease.