Retinal vascular alterations in cognitive impairment: A multicenter study in China

IF 13 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's & Dementia Pub Date : 2025-02-23 DOI:10.1002/alz.14593

Qin Shi, Andrew Ni, Kexin Li, Wenxin Su, Wenbin Xie, Hao Zheng, Mingxuan Wang, Zhenxu Xiao, Wanqing Wu, Kaiwen Shi, Peijun Zhang, Biao Yan, Ding Ding, Timothy Kwok, Qianhua Zhao, Jiayi Zhang

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Abstract

INTRODUCTION

Foundational models suggest Alzheimer's disease (AD) can be diagnosed using retinal images, but the specific structural features remain poorly understood. This study investigates retinal vascular changes in individuals with cognitive impairment in three East Asian regions.

METHODS

A multicenter study was conducted in Shanghai, Hong Kong, and Ningxia, collecting retinal images from 176 patients with mild cognitive impairment (MCI) or AD and 264 controls. The VC-Net deep learning model segmented arterial/venous networks, extracting 36 vascular features.

RESULTS

Significant reductions in vessel length, segment number, and vascular density were observed in cognitively impaired patients, while venous structure and complexity were correlated with the level of cognitive function.

DISCUSSION

Retinal vascular changes may serve as indicators of cognitive impairment, requiring validation in larger cohorts and exploration of the underlying mechanisms.

Highlights

A deep learning segmentation model extracted diverse retinal vascular features.
Significant alterations in the structure of retinal arterial/venous networks were identified.
Partitioning vessel-rich retinal zones improved detection of vascular changes.
Decreases in vessel length, segment number, and vascular density were found in CI individuals.

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引言基本模型表明，阿尔茨海默病（AD）可通过视网膜图像进行诊断，但对其具体的结构特征仍知之甚少。本研究调查了东亚三个地区认知障碍患者的视网膜血管变化。方法在上海、香港和宁夏开展了一项多中心研究，收集了 176 名轻度认知障碍（MCI）或注意力缺失症（AD）患者和 264 名对照者的视网膜图像。VC-Net 深度学习模型对动脉/静脉网络进行了分割，提取了 36 个血管特征。结果在认知障碍患者中观察到血管长度、段数和血管密度显著减少，而静脉结构和复杂性与认知功能水平相关。讨论视网膜血管变化可作为认知障碍的指标，需要在更大的群体中进行验证并探索其潜在机制。亮点深度学习分割模型提取了多种视网膜血管特征。确定了视网膜动/静脉网络结构的重大改变。分割血管丰富的视网膜区域提高了对血管变化的检测能力。发现 CI 患者的血管长度、节段数量和血管密度均有所下降。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.