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Can Eye Specialists Diagnose Alzheimer’s?

Alzheimer’s disease (AD) is a devastating condition that steals your memory, your personality, and finally, your life. It affects 1 in 10 Americans aged 65 or older, and two-thirds of its victims are women. It kills more people than breast and prostate cancer combined. And yet, after decades and billions of dollars spent on research, we still don’t have an effective treatment, or even a reliable diagnostic test for the disease.

If you’re seeking signs of hope, however, you need look no further than vision research labs, where scientists may be on the verge of producing a test that can identify active AD with an eye exam. That’s important, because if we can get a diagnosis early enough in the course of the disease, we do have treatments that can at least delay its progression. Since 80% of dementia patients are age 75 or older, delaying progression for five years may be nearly as good as a cure.
Interest in diagnosing AD through the eyes began in 2003, when a neurologist on the psychiatry faculty at Harvard University, Lee E. Goldstein, MD, PhD, published research asserting that AD patients inevitably developed an unusual ring of amyloid beta protein around lenses of their eyes, where it wouldn’t interfere with vision, before showing other symptoms.

Since then, efforts by other research groups to reproduce Goldstein’s findings have met with mixed results, and further studies continue. Goldstein himself, now an associate professor of neurology at Boston University, is developing a laser device that he believes will render an AD diagnosis accurately, quickly, and cheaply.

In the meantime, vision labs around the U.S. are developing other tests, and so far, have found that three common eye diseases, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy, all increase risk for AD. Researchers at the Department of Ophthalmology, University of Washington, recently published a retrospective cohort analysis of data from a 1993 AD study called Adult Changes in Thought. Their analysis revealed that AMD patients had a 20% greater risk for developing AD, while diabetic retinopathy increased risk by 44%, and glaucoma, a 44% increase.

Even more intriguing, scientists at Department of Ophthalmology and Vision Science, Washington University in St Louis, have discovered they can detect biomarkers for AD with a simple retinal scan in patients who otherwise haven’t yet developed symptoms. The team’s results will have to be confirmed by other investigators, but hope is high.

After many years of effort and frustration, we may be on the verge of an AD diagnostic breakthrough, and it’s all happening in vision labs.

Retinal Scan
Ophthalmic Conditions and Alzheimer’s
Scholarly Discussion of Goldstein’s Findings

Supra-nuclear Cataracts (The Lancet)
Supra-nuclear Cataracts (PLoS One)
Ophthalmic Conditions and Alzheimer’s
Retinal Scan

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