Utilizing technology currently available to clinical ophthalmologists, including us at Vision Quest Medical Center, researchers are developing new ways to diagnose Alzheimer's at earlier and earlier stages, which may hopefully lead to earlier and more effective treatments of the condition.

Alzheimer's disease is a growing public health crisis, with far-reaching impacts on people afflicted with the condition, as well as their loved ones. In the coming years, the number of Alzheimer's diagnoses and deaths is expected to increase. According to the report "2015 Alzheimer's Disease Facts and Figures" from the Alzheimer's Association, an estimated 5.3 million Americans have Alzheimer's. One in nine people age 65 and older have the disease, as well as one in three people age 85 and older. At present, it is the sixth leading cause of death in the United States.

According to Dr Paul J Foster of Moorfield's Eye Hospital in London, England: "Between 2002 and 2012, 99% of clinical trials of treatments for Alzheimer's Disease failed. A probable reason for this failure rate is that treatments are being provided to those patients who already have irreparable damage to the brain. By targeting people in the very early stages of cognitive change, it should be possible to design better clinical trials for treatments that slow or stop further onset."

Optical Coherence Tomography, or OCT, is technology which has been widely adopted by eye care professionals across the world. One of the exciting things that it allows us to do is image the thickness of the retinal nerve fiber layer which tends to thin in neurologic conditions like optic neuritis and glaucoma. New research suggests that the same technology may be able to detect early "pre-clinical" signs of dementia.

In a study out of England, 30,000 U.K. residents aged 40 to 69 yearsunderwent OCT imaging, a physical examination, and cognitive testing. The research team found that worse cognitive performance was associated with a thinner RNFL at baseline, and those in the thinnest quintile of RNFLs were 11% more likely to fail at least 1 cognitive test.

Similar results emerged in a Dutch study that explored the link between retinal neurodegeneration and dementia. In the more than 5,000 study participants, thinner RNFLs were associated with an increased risk of developing dementia.

Taken together, the growing body of evidence supports using this readily available technology to look for unique preclinical biomarkers for dementia, and may hopefully allow researchers to help monitor disease progression, evaluate treatment response, and shape eligibility determination for future clinical trials.

We here at Vision Quest are trying to closely follow new developments in this exciting, burgeoning field and would be happy to participate in multi-site clinical trials in order to better evaluate how to use existing technology to help in diagnosing and treating Alzheimer's disease. We currently use our OCT machine on a regular basis for things like glaucoma screening, as part of cataract evaluations, etc.