Page 53 - JCBP-3-3

Journal of Clinical and
Basic Psychosomatics Integrative neurodegenerative care

(i) In ADR, key biomarkers include progressive thinning
of the retinal nerve fiber layer, accumulation of
amyloid-beta plaques, and microvascular alterations
detected through OCT angiography. These changes
7,10
parallel cerebral amyloid pathology and are associated
with hippocampal atrophy, a hallmark of ADR.
(ii) In Parkinson’s disease, retinal changes are distinct, with
dopaminergic dysfunction affecting the inner retinal
layers. Specifically, the loss of retinal dopaminergic
amacrine cells leads to retinal thinning that is more
pronounced in the parafoveal region, rather than
widespread across retinal layers as seen in ADR. 11
(iii) Lewy body dementia is characterized by pronounced
retinal ganglion cell loss and significant disruptions
in contrast sensitivity and color discrimination,
reflecting the early involvement of the occipital lobe
in disease progression. 12
These distinctions highlight the importance of
integrating multiple biomarkers, rather than relying solely
on retinal imaging. By combining retinal imaging with
complementary assessments such as eye-tracking and
cognitive testing, clinicians may be able to refine diagnostic
accuracy and improve the differentiation of ADR from
Figure 1. Neurological and retinal biomarkers in neurodegenerative other neurodegenerative diseases.
disease progression. Healthy and neurodegenerative brain anatomy
(gray matter degradation) with corresponding retinal changes (amyloid 3. Integrated diagnostics management
beta plaques) associated with Alzheimer’s and dementia-related diseases The integration of diagnostic technologies such as eye-
(ADR) are compared. The healthy brain and retina serve as baselines,
emphasizing the pathological changes observed in ADR. tracking that measures pupillometry and gaze dynamics,
reaction-retention testing, and the SRSS enhances our
OCT and fluorescence imaging have limited accessibility, ability to evaluate and manage ADR with greater precision
high costs, and the impracticality of frequent monitoring. and efficiency. By synthesizing data on ocular activity (e.g.,
9
To address these challenges, further advancements in non- fixation duration and saccade amplitude), response times,
invasive, cost-effective technologies are needed to improve and self-reported emotional states, this approach provides
their feasibility for early cognitive impairment screening. a more comprehensive cognitive and emotional profile
for each patient. After collecting 30 days of baseline data,
These retinal imaging technologies do not simply clinicians can apply basic statistical analyses (e.g., mean,
assess structural integrity but also provide insights into standard deviation, and control limits) to detect
functional impairments, including visual processing meaningful deviations that may indicate ADR progression.
deficits that manifest early in ADR progression. When These insights enable timely, individualized adjustments to
combined with eye-tracking measurements, these treatment plans.
techniques may offer a more comprehensive assessment
of neurodegenerative changes, allowing for enhanced For example, if pupillometry and reaction-retention
diagnostic precision. testing indicate functional cognitive decline while SRSS
scores suggest elevated stress, clinicians can design
Despite their advantages, several challenges remain in interventions that address both cognitive and emotional
the implementation of retina-based biomarkers. While factors. This may include cognitive therapies to enhance
they provide valuable insights into neurodegenerative executive function, alongside physical activity and stress-
progression, distinguishing ADR from other conditions management programs tailored to the patient’s current
such as Parkinson’s disease and Lewy body dementia condition. In addition, by monitoring ADR progression in
remains critical. Each of these diseases exhibits unique real-time, clinicians may be able to detect subtle changes
retinal imaging characteristics that may aid in differential in cognitive or emotional health before they manifest as
diagnosis: severe symptoms. This proactive monitoring approach has

Volume 3 Issue 3 (2025) 47 doi: 10.36922/jcbp.8349