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Looking into the eyes for early signs of Alzheimer’s disease

The Boston Globe logo The Boston Globe 1/6/2020 Edward Fitzpatrick
a group of people walking in a park: The University of Rhode Island campus in Kingston.  (Lane Turner/Globe Staff) © Lane Turner The University of Rhode Island campus in Kingston. (Lane Turner/Globe Staff)

KINGSTON, R.I. – Imagine if you could find out, decades ahead of time, whether you are going to suffer from Alzheimer’s disease.

Now imagine if you could detect those signs through an eye scan -- rather than through the invasive, expensive tests that doctors now use.

That is the potential of a clinical trial involving the University of Rhode Island, Butler Hospital’s Clinical and Aging Program, and Florida’s BayCare Health System.

The three organizations on Monday announced the launch of a five-year, $5-million clinical trial of a retinal screening process that could help detect Alzheimer’s more than two decades before symptoms appear. The study is seeking 330 volunteers between the ages of 55 and 80.

“Given the escalating prevalence of Alzheimer’s disease in our aging population, we need a low-cost, noninvasive, minimal risk way to screen many millions of people on a regular basis,” Peter Snyder, URI’s vice president for research and economic development and professor of biomedical and pharmaceutical sciences, told the Globe.

Snyder is one of the principal investigators, along with Dr. Stuart Sinoff, medical director of neurosciences at BayCare Health System’s West Region.

“Without inexpensive and reliable biomarkers for early disease burden, we will not be able to contain spiraling costs and burden on our healthcare system and on our larger society,” Snyder said.

The problem now is that one of the main tools for diagnosing Alzheimer’s is a scanning device that costs millions, uses a dye containing radioactive tracers, and involves tests costing as much as $4,500 apiece. A big chunk of the world doesn’t have access to these positron emission tomography machines, and those scans often take place only after people are showing signs of Alzheimer’s, Snyder said.

So how could the eyes reveal signs of Alzheimer’s?

Snyder explained that the retina is actually exposed brain tissue, and special equipment can take images of the retina without any risk of harm. “We can see amazing things,” he said, “such as individual cell layers, blood vessels that are thinner than human hairs, and even measure the amount of certain chemicals that may be important markers of the disease.”

Just about everyone who lives past the age of 40 or 50 develops changes in vision, often requiring glasses or contact lenses, he said. So optometrists or ophthalmologists could become the key to screening adults who may be early stages of Alzheimer’s, he said.

But how would it help to know you might develop Alzheimer’s 20 years from now?

Snyder said this study is a follow-up to a study completed a few years ago. “In that prior study, as we discerned who was at greatest risk for Alzheimer’s disease, we found something quite encouraging,” he said. “We were initially quite concerned that once participants learned that they were in a high-risk group based on some of the imaging tests, that they would become anxious, possibly depressed, or worse.”

But the opposite was true.

“These individuals re-focused their efforts on healthy lifestyle behaviors that could slow progression, such as improving diet, exercise, reducing their weight,” Snyder said. “They took a more active stance in managing their personal financial planning, in taking trips with their families, in donating their time and energy to participation in our research, and in spending quality time with their loved ones and friends.”

Still, there is no cure for Alzheimer’s.

“There is no question that we are wrestling with a ‘chicken-and-egg’ problem here,” Snyder said. “We are trying to solve the problem of early detection before we have clearly effective therapeutics to slow the disease with. But we will not either discover an effective treatment, nor would we know who needs it, without solving the early detection problem. We need both.”

Researchers at Massachusetts General Hospital and Brigham and Women’s Hospital have begun a similar study.

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