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Prog Retin Eye Res. 2017 Mar;57:89-107. doi: 10.1016/j.preteyeres.2017.01.001. Epub 2017 Jan 3.

Imaging retina to study dementia and stroke.

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Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong. Electronic address:
Duke-NUS Graduate Medical School, National University of Singapore, Singapore; Departments of Neurology & Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, National University of Singapore, Singapore.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Graduate Medical School, National University of Singapore, Singapore.


With increase in life expectancy, the number of persons suffering from common age-related brain diseases, including neurodegenerative (e.g., dementia) and cerebrovascular (e.g., stroke) disease is expected to rise substantially. As current neuro-imaging modalities such as magnetic resonance imaging may not be able to detect subtle subclinical changes (resolution <100-500 μm) in dementia and stroke, there is an urgent need for other complementary techniques to probe the pathophysiology of these diseases. The retina - due to its anatomical, embryological and physiological similarities with the brain - offers a unique and accessible "window" to study correlates and consequences of subclinical pathology in the brain. Retinal components such as the microvasculature and retinal ganglion cell axons can now be visualized non-invasively using different retinal imaging techniques e.g., ocular fundus photography and optical coherence tomography. Advances in retinal imaging may provide new and potentially important insights into cerebrovascular neurodegenerative processes in addition to what is currently possible with neuro-imaging. In this review, we present an overview of the current literature on the application of retinal imaging in the study of dementia and stroke. We discuss clinical implications of these studies, novel state-of-the-art retinal imaging techniques and future directions aimed at evaluating whether retinal imaging can be an additional investigation tool in the study of dementia and stroke.


Alzheimer's disease; Cerebrovascular disease; Dementia; Retinal ganglion cell; Retinal imaging; Retinal microvasculature; Stroke

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