Retinal phenotyping of variants of Alzheimer’s disease using colour ultra-widefield laser scanning ophthalmoscopic images

Lajos Csincsik, Nicola Quinn, Keir X X Yong, Sebastian J Crutch, Tunde Peto, Imre Lengyel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
65 Downloads (Pure)


Posterior cortical atrophy (PCA) is the most common atypical variant of Alzheimer’s (AD) disease. Changes associated with PCA in the brain affect the visual cortex, but little is known whether there are retinal changes associated to with PCA. This study explored retinal phenotypic variations in typical AD (tAD) and PCA and compared these to cognitively normal controls (Ctrl).
Retinal images were taken with the OPTOS P200Tx scanning laser ophthalmoscope (SLO). Retinal phenotyping was carried out on ultra-widefield (UWF) colour images of 69 Ctrl, 24 tAD and 25 PCA participants enrolled at the Dementia Research Centre at University College London, UK. High-resolution phenotyping was carried out for hard and soft drusen, reticular pseudodrusen, geographic atrophy, coroidal neovascularisation and peripheral reticular pigmentary degeneration. The resulting data was analysed using binary logistic regression.
Individuals with tAD (OD=2.76 [CI: 1.24 to 6.10], p=.012) and PCA (OD=3.40 [CI: 1.25 to 9.22], p=.016) were more likely phenotyped as hard drusen than Ctrl in the retinal periphery. tAD (OD=0.34 [CI: 0.12 to 0.92], p=.035) were less likely to have soft drusen deposited in their retinal far-periphery compared to Ctrl. An almost three-fold increase in sub-retinal deposit (pseudodrusen) formation in tAD (OD=2.93 [CI: 1.10 to 7.76], p=.030) compared to Ctrl was detected
UWF images demostrated that the retinal periphery might show significant changes for understanding differences between controls and different variants of AD.
Original languageEnglish
Article numbere12232
Number of pages12
JournalAlzheimer's & Dementia: The Journal of the Alzheimer's Association
Issue number1
Publication statusPublished - 13 Aug 2021


  • Alzheimer's disease
  • drusen
  • peripheral reticular pigmentary degeneration
  • posterior cortical atrophy
  • reticular pseudodrusen
  • retinal imaging
  • retinal phenotype
  • sub‐retinal deposit
  • ultra‐widefield imaging


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