Optic nerve head and nerve fiber layer in Alzheimer's disease
C. S. Tsai, R. Ritch, B. Schwartz, S. S. Lee, N. R. Miller, T. Chi and F. Y. Hsieh
Department of Ophthalmology, New York Eye and Ear Infirmary, NY 10003.
We compared (1) the differences in the retinal nerve fiber layer between 26
patients with Alzheimer's disease and 30 age- and race-matched normal
controls with use of blue-light high-resolution photography, (2) the
differences in disc pallor between 30 patients with Alzheimer's disease and
32 controls with use of a boundary-tracking program and fundus photographs,
and (3) the topographic disc variables between 26 patients with Alzheimer's
disease and 36 controls with use of an optic nerve head analyzer. A higher
proportion of patients with Alzheimer's disease had detectable nerve fiber
damage as seen by red-free photography compared with controls. Although the
pallor area-to-disc area ratio was not significantly different between
patients with Alzheimer's disease and controls, the patients with higher
pallor area-to-disc area ratios had higher Alzheimer's Disease Assessment
Scale (ADAS) scores and longer durations of disease. Patients had an
increased cup-to-disc ratio and cup volume and decreased disc rim area
compared with controls. These variables also correlated significantly with
ADAS scores and the duration of disease. The correlation among the optic
nerve head changes and the ADAS scores in patients with Alzheimer's disease
suggests a potential role for optic nerve head analysis in monitoring the
progression of Alzheimer's disease and in assessing the effectiveness of
any treatments developed.
