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Abstract

Alzheimers Disease (AD) is a type of dementia that causes problems with memory
thinking, and behavior. The global cost of dementia have increased from US$ 604
billion in 2010 to US$ 818 billion in 2015 [2]. AD animal models present devastating
amyloidopathy not only in the brain but also in the eye [4]. An early and accurate
diagnosis of AD is important in developing strategies for managing symptoms and
helping patients and their families to plan for the future. From the research of the
following literature database, we found that we can use Retinal Examination has the
potential to be a tool to make early diagnosis of Alzheimer.

Background

Alzheimers disease (AD) is a type of dementia that causes problems with memory
thinking, and behavior. Alzheimers is the most common form of dementia, which is
60 to 80 percent of dementia disease [1]. Based on World Report 2015 by Alzheimers
Disease International, it is estimated that 46.8 million people worldwide are living with
dementia in 2015, this number will almost double every 20 years, reaching 74.7
million in 2030 and 131.5 million in 2050, meanwhile 58% of all people with dementia
live in countries with low or middle income. Over 9.9 million incidence dementia in
the worldwide, 49% of the total is in Asia. The global cost of dementia have
increased from US$ 604 billion in 2010 to US$ 818 billion in 2015 [2]. Alzheimer was
identified by amyloid plaques and NFTs (Neurofibrillary Tangles) in autopsied
brains[3]. Over the past decade, researches have been utilizing mouse models to
investigate the underlying mechanisms of human disorders. Intriguingly, AD animal
models present devastating amyloidopathy not only in the brain but also in the eye [4].
According to the study, it has the potential to detect Alzheimer disease earlier in
human patient.

Objective

This literature review objective is to review the early detection of Alzheimer disease
through retinal examination.

Material and Method

We systematically searched the following literature databases published since 2011


to 2017 from: PubMed, WHO Data, PMC, ScienceDirect, Wiley Online Library, which
total are thirteen. Searches were carried out using the following keywords:
Alzheimers, Alzheimers disease, Alzheimers early detection by Retinal
Examination
Result and Discussion

The diagnosis of AD begins with a thorough physical exam and complete medical
history[6]. The use of Magnetic Resonance maging (MRI) and Positron Emission
Tomography (PET), have been limited in sensitivity and resolution[8]. Likewise,
cerebro spinal fluid analysis is invasive, while neuropsychological testing can be
imprecise. But, since the optic nerve and the retina are extensions of the brain,
imaging of the eye can be a simple and accessible alternative [9].

Abnormal Amyloid
protein precursor Neurodegenarati
clevage on

Accumulation of -amyloid
strand in extracellular space Forms
plaque

Iseri et al. demonstrated macular thinning in AD to be related to the severity of


cognitive impairment. The loss of RNFL thickness in AD is linked to a loss of Retinal
Ganglion Cells (RGC) and optic nerve axons. A post mortem study by Blanks et al.
demonstrated a 25% decrease in RGC at the level of the foveal and parafoveal
retina. Retinal photography has also been used to identify RNFL defects (nerve fiber
loss) in AD.

Conclusion

The early detection of AD is of paramount importance. The retina is an excellent


model for neurodegenerative diseases. If the plaques start in the retina first, as it has
been studied, this will give us more times to manage the symptoms and helping
patients and their families to plan for the future and pursuing care options while the
patient can still take part in the decision-making process.

Reference
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2 Azheimers Disease International. World Alzheimer report 2015: The global
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