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by Satina Richardson 

Edmund Arthur, OD, PhD, FAAO, was awarded a National Institute of Health R21 grant from the National Institute on Aging. The $408,375 two-year pilot grant aims to develop a novel, non-invasive, and cost-effective retinal vascular biomarker for early Alzheimer’s Disease (AD) risk detection and disease monitoring.

Findings could increase access to screenings for those affected by AD by arming a greater number of clinicians with the ability to identify patients needing specialized care.

“Characterization, quantification, and validation of this novel retinal vascular metric as a non-invasive retinal biomarker for early AD risk detection will provide a low-cost screening tool for AD prevention trials, expedite enrollment and randomization, and could potentially serve as a tool for monitoring the efficacy of secondary prevention therapeutics,” says Arthur, an assistant professor at the UAB School of Optometry. “This will hopefully facilitate large-scale screening of older adults by point-of-care clinicians and referral of at-risk individuals to neurologists and neuropsychologists for detailed cognitive health assessments.”

Titled “Characterizing Retinal Tissue Oxygenation, Structure, and Function in Alzheimer's Disease”, the study aims is to validate the novel retinal vascular metric against reference-standard cerebral biomarkers (amyloid, tau positron emission tomography, and magnetic resonance imaging). It will also lead to a clinical implementation grant involving industry, academia, and clinic collaborations to evaluate the feasibility of incorporating this biomarker into routine eye care. The human retina is an extension of the brain as both are anatomically, embryologically, and physiologically linked, making optometrists important contributors to the early diagnosis of AD. 

AD is a major public health concern with no proven preventative or curative interventions. Progress in the management and treatment of AD is limited by the difficulty in detecting the disease in the preclinical phase when patients show no symptoms of cognitive impairment, but there is underlying pathology when emerging therapeutics are likely to be most effective.

“While Positron Emission Tomography and cerebrospinal fluid assessment via lumbar puncture are helpful, they are only sometimes used because they are expensive and invasive,” Arthur said. “What is needed is a biomarker-based alternative method that is non-invasive, inexpensive, and widely available in the community for the large-scale screening of older adults at high risk for developing the disease.”

This topic interests Arthur for particular reasons. According to statistics from the Alzheimer’s Association, an estimated 6.2 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent, slow or cure AD. It is in the top 10 leading causes of death in America, and when the stage of dementia sets in, there is little that the neurologist can do for the patient.

“Early detection and management of the disease are key and as optometrists or eye care professionals in general, we could help in screening large older adult population at high risk for the disease in the communities using non-invasive and comparatively low-cost retinal biomarkers,” he says.