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The neural retina is a key organ for vision and visual processing. As a direct extension of the brain, it emerges as a prominent site impacted by Alzheimer’s disease (AD).  The retina is the only CNS tissue not shielded by bone that can be easily accessible for noninvasive, affordable, ultra-high-resolution imaging in the clinical setting. Data from recent years strongly suggest it can serve as a window to assess AD. Early studies described retinal nerve fiber layer and ganglion cell degeneration. Our team revealed the accumulation of core AD hallmarks—amyloid β-protein (Aβ) plaques and neurofibrillary tangles—in the retina of AD and mild cognitive impairment (MCI) patients. Subsequent studies confirmed these findings, and further reported visual and electroretinography abnormalities, retinal tauopathy, Aβ oligomers, inflammation, and cell-specific degeneration in AD patients. Data from our group and others suggest that the brain and retina follow a similar trajectory during AD progression, potentially due to their shared embryonic origin and anatomical proximity. Moreover, retinal vascular irregularities—vessel density and fractal dimensions, blood flow, foveal avascular zone, curvature tortuosity, arteriole-to-venule ratio—are present in AD patients, including early-stage cases. A tight association between cerebral and retinal vasculopathy to cognitive deficits was reported in AD patients and animal models. More recently, we identified early and progressive retinal vascular platelet-derived growth factor receptor-β (PDGFRβ) deficiency and pericyte loss, as well as retinal endothelial tight junction losses in MCI and AD patients. These retinal vasculopathies strongly link to vascular amyloid accumulation as well as could predict the severity of cerebral amyloid angiopathy. Currently, we explore the complex landscape of Alzheimer’s in the retina, including AD-related molecular signatures and processes, new forms of proteinopathies, vascular and inflammatory abnormalities, synaptic loss, as well as cell-specific vulnerability and resilience. Establishing how early retinal biomarkers can be detected during AD continuum and what do they mean for brain pathology and functional decline, should guide the development of future retinal imaging technologies to improve early, noninvasive AD diagnosis and monitoring.



September 15, 2023
11:00 am - 12:00 pm


Rudy North Lecture Theatre, Djavad Mowafaghian Centre for Brain Health
2215 Wesbrook Mall
Vancouver, British Columbia V6T 1Z3 Canada

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