Objective: This study investigated the retinal arteriolar central reflex (CR, the central reflection
observed in photographs of retinal vessels), which may provide information about micro-vascular
health in the retina and also the brain, due to the homology between these vascular networks. The study
also describes a novel computer based semi-automated technique that accurately quantifies retinal arteriolar
CR and vessel width, and calculates the CR to vessel width ratio (CRR) from digital retinal photographs.
Methods: Digital retinal photographs were collected from participants in the Australian Imaging, Biomarkers
and Lifestyle study of ageing (AIBL), including 25 participants diagnosed with Alzheimer’s
disease (AD) (age 72.4 ± 7.5 yrs, 12 male, 13 female) and 123 elderly participants without dementia
(cognitively normals: CN) (age 71.6 ± 5.6 yrs, 55 male, 68 female). Using a sub-cohort of 144 (22 AD,
122 CN) with the novel CRR measures, we identified significantly higher CRR levels in AD participants
(mean CRR 0.253 (SD 0.04)) as compared with CN’s (mean CRR 0.231 (SD 0.04), p = 0.025). Adjustment
ε4 allele status however, reduced the significance (p = 0.081). CRR was significantly
higher in APOE
ε4 allele carriers (mean CRR 0.254 (SD 0.03) as compared with non-carriers (mean
CRR 0.224 (SD 0.05), p < 0.0001).
Results: These data indicate that CRR is strongly linked to APOE
ε4 status and exhibits a weaker, independent
trend with AD diagnosis. The retina may be useful as a novel model for non-invasive monitoring
of the effects of APOE
ε4 on the central nervous system, particularly in cerebrovascular disease.