INTRODUCTIONThis study addresses the urgent need for non‐invasive early‐onset Alzheimer's disease (EOAD) prediction. Using optical coherence tomography angiography (OCTA), we present a choriocapillaris model sensitive to EOAD, correlating with serum biomarkers.METHODSEighty‐four EOAD patients and 73 controls were assigned to swept‐source OCTA (SS‐OCTA) or the spectral domain OCTA (SD‐OCTA) cohorts. Our hypothesis on choriocapillaris predictive potential in EOAD was tested and validated in these two cohorts.RESULTSBoth cohorts revealed diminished choriocapillaris signals, demonstrating the highest discriminatory capability (area under the receiver operating characteristic curve: SS‐OCTA 0.913, SD‐OCTA 0.991; P < 0.001). A sparser SS‐OCTA choriocapillaris correlated with increased serum amyloid beta (Aβ)42, Aβ42/40, and phosphorylated tau (p‐tau)181 levels (all P < 0.05). Apolipoprotein E status did not affect choriocapillaris measurement.DISCUSSIONThe choriocapillaris, observed in both cohorts, proves sensitive to EOAD diagnosis, and correlates with serum Aβ and p‐tau181 levels, suggesting its potential as a diagnostic tool for identifying and tracking microvascular changes in EOAD.Highlights Optical coherence tomography angiography may be applied for non‐invasive screening of Alzheimer's disease (AD). Choriocapillaris demonstrates high sensitivity and specificity for early‐onset AD diagnosis. Microvascular dynamics abnormalities are associated with AD.

中文翻译：

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脉络膜毛细血管减少可准确区分早发性阿尔茨海默病


简介本研究解决了对非侵入性早发性阿尔茨海默病 (EOAD) 预测的迫切需求。使用光学相干断层扫描血管造影 (OCTA)，我们提出了对 EOAD 敏感的脉络膜毛细血管模型，并与血清生物标志物相关。 ‐OCTA）队列。我们关于 EOAD 中脉络膜毛细血管预测潜力的假设在这两个队列中得到了测试和验证。 结果两个队列均显示脉络膜毛细血管信号减弱，表现出最高的辨别能力（受试者工作特征曲线下面积：SS-OCTA 0.913，SD-OCTA 0.991；P < 0.001）。稀疏的 SS-OCTA 脉络膜毛细血管与血清淀粉样蛋白 β (Aβ)42、Aβ42/40 和磷酸化 tau (p-tau)181 水平升高相关（所有 P < 0.05）。载脂蛋白 E 状态不影响脉络膜毛细血管测量。讨论 在两个队列中观察到的脉络膜毛细血管被证明对 EOAD 诊断敏感，并且与血清 Aβ 和 p-tau181 水平相关，表明其作为识别和跟踪 EOAD 微血管变化的诊断工具的潜力。亮点光学相干断层扫描血管造影可用于阿尔茨海默病（AD）的无创筛查。脉络膜毛细血管对于早发性 AD 诊断表现出高敏感性和特异性。微血管动力学异常与 AD 相关。