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Longitudinal Multimodal Retinal Imaging in Cognitively Normal Apolipoprotein E4 Carriers and Noncarriers
Alex Choi, Alice Haystead, Rachel D'Cunha, John Hsu, Michael Zhu, Kim G Johnson, Heather Whitson, Dilraj S Grewal et al.. Translational vision science & technology, 2026-10-05
Topic: Genetics and APOE
This study analyzed 871 eyes from 439 participants (230 APOE ε4 noncarriers and 209 carriers). Baseline retinal parameters did not differ significantly between groups. Carriers demonstrated nominally slower annual RNFL decline (β = 0.334; P = 0.023) and attenuated peripapillary CPD decline (β = 0.0010; P = 0.014) versus noncarriers; neither survived false discovery rate (FDR) correction (P = 0.18). In the ≥5-year subgroup (n = 58), carriers demonstrated nominally higher peripapillary CPD than noncarriers (P = 0.011; FDR-adjusted P = 0.17), although rates of change did not differ significantly between groups. Cognitively normal APOE ε4 carriers demonstrated nominally slower peripapillary CPD and RNFL decline over longitudinal follow-up, with carriers maintaining higher CPD at ≥5 years despite comparable baseline imaging. TRANSLATIONAL RELEVANCE: Longitudinal peripapillary and RNFL changes may reflect early retinal findings associated with APOE ε4 carrier status prior to cognitive decline, supporting further investigation of longitudinal retinal imaging as a potential noninvasive biomarker in preclinical Alzheimer's disease.
Key findings
- This study analyzed 871 eyes from 439 participants (230 APOE ε4 noncarriers and 209 carriers).
- Baseline retinal parameters did not differ significantly between groups.
- Carriers demonstrated nominally slower annual RNFL decline (β = 0.334; P = 0.023) and attenuated peripapillary CPD decline (β = 0.0010; P = 0.014) versus noncarriers; neither survived false discovery rate (FDR) correction (P = 0.18).
- In the ≥5-year subgroup (n = 58), carriers demonstrated nominally higher peripapillary CPD than noncarriers (P = 0.011; FDR-adjusted P = 0.17), although rates of change did not differ significantly between groups.
- Cognitively normal APOE ε4 carriers demonstrated nominally slower peripapillary CPD and RNFL decline over longitudinal follow-up, with carriers maintaining higher CPD at ≥5 years despite comparable baseline imaging.
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Study details
- Study designlongitudinal study
- Participants58
- Evidence strengthModerate
How this study scored 68/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 38 of the 56 points we could judge it on, which is 68 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Translational vision science & technology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 58 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42937433) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 38 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 38 of the 56 points we could judge it on is 68 out of 100. |
| Total | 68 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Choi, A., Haystead, A., D'Cunha, R., Hsu, J., Zhu, M., Johnson, K. G., et al. (2026). Longitudinal Multimodal Retinal Imaging in Cognitively Normal Apolipoprotein E4 Carriers and Noncarriers. Translational vision science & technology. https://doi.org/10.1167/tvst.15.10.45
Vancouver
Choi A, Haystead A, D'Cunha R, Hsu J, Zhu M, Johnson KG, et al. Longitudinal Multimodal Retinal Imaging in Cognitively Normal Apolipoprotein E4 Carriers and Noncarriers. Translational vision science & technology. 2026. doi:10.1167/tvst.15.10.45. PMID: 42937433.
BibTeX
@article{choi2026-42937433,
author = {Choi, Alex and Haystead, Alice and D'Cunha, Rachel and Hsu, John and Zhu, Michael and Johnson, Kim G and Whitson, Heather and Grewal, Dilraj S and others},
title = {{Longitudinal Multimodal Retinal Imaging in Cognitively Normal Apolipoprotein E4 Carriers and Noncarriers}},
journal = {Translational vision science \& technology},
year = {2026},
doi = {10.1167/tvst.15.10.45},
pmid = {42937433},
url = {https://doi.org/10.1167/tvst.15.10.45}
}