People at risk for Alzheimer's disease could one day get their diagnosis decades earlier - at the eye doctor.
Researchers in the Tampa Bay area and Providence, Rhode Island, are enrolling people in a new clinical trial that's looking at how retinal scans could help diagnose Alzheimer's much sooner.
Alzheimer’s is usually diagnosed with positron emission tomography (PET) scanning devices, but they cost millions of dollars, and up to $5,000 per test. This means patients are not getting diagnosed early enough for drug therapies that help slow the disease’s progression.
Dr. Stuart Sinoff, a neuro-ophthalmologist and medical director of Neurosciences for BayCare Health System’s West Region in Pinellas County, said most optometrists already have machines that can do the job for under $50 a test.
“This is not some fancy, ivory tower situation,” Sinoff said. “If you're going to your optometrist, they have these machines now. They don't have them tuned up; we haven't determined the right protocols."
These optical coherence tomography machines can detect the disease as early as a PET test, but is more accessible. After all, Sinoff says, most people are already going to the eye doctor in their 30s and 40s.
“We're talking about point of care contact for Lenscrafters, Visionworks, Provision, wherever you go, or one of your local providers.”
Dr. Peter Snyder, a University of Rhode Island professor of biomedical and pharmaceutical sciences, says the cells in certain layers of the retina are the same types as cells in the brain that are attacked by Alzheimer's, so cell changes in the retina might reflect the same changes that are happening in the brain.
“We can look more easily in the retina to see the effects of disease on the way blood is carried to brain and retinal cells,” Snyder said. “We are also using a very new laser imaging technique that makes the chemical pigments in the retina fluoresce, and we think atypical changes in the amount of these chemicals might signal high risk for Alzheimer’s disease.”
When the study is finished, optometrists and ophthalmologists could screen for the retinal biomarkers associated with Alzheimer’s disease and refer their patients to specialists early on. That could lower the cost of testing, and make drug therapies - often thought of as failures because they may be used too late - more effective.
Alzheimer’s is the sixth leading cause of death in in the United States, but it’s often underreported. Recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people, according to the National Institute on Aging.
According to the Alzheimer’s Association, by 2050, this disease could cost the nation $1.1 trillion.
About the clinical trial:
The clinical trial is being run by the University of Rhode Island, in collaboration with BayCare Health System in Florida and The Memory and Aging Program at Butler Hospital, an affiliate of The Warren Alpert Medical School of Brown University.
The five-year, $5 million Atlas of Retinal Imaging in Alzheimer’s Study (ARIAS) is sponsored by BayCare Health System’s Morton Plant Hospital and St. Anthony’s Hospital and funded largely by Morton Plant Mease Health Care Foundation and St. Anthony’s Hospital Foundation in Pinellas County.
The ARIAS study will enroll 330 individuals between the ages of 55 and 80 years old, ranging from very healthy and low-risk adults, to persons with concerns about their memory, as well as patients with mild Alzheimer’s disease.
Each participant will be examined at four different points over a three-year period, and each study visit includes an eye exam, a medical history discussion, some tests of how people think and how well they remember new information, the retinal imaging that is very much like the kind done at the eye doctor’s office, and measures of mood, walking and balancing, sleep habits and other types of medical information.
If you live near Tampa, Clearwater or St. Petersburg in Florida, and are interested in finding out more about the study, call Catrina Montgomery at (727) 298-6077.
If you live near Providence, Rhode Island, contact the Butler Alzheimer’s Prevention Registry butler.org/alzregistry or call (401) 455-6402.