Duke Eye Center faculty Sharon Fekrat, MD, FASRS, and Dilraj S. Grewal, MD, FASRS, are featured in the March 2026 issue of Retina Today in the publication’s Imaging section. Their article, “Retinal Diagnostics in Alzheimer Disease: Where Are We Now?”, highlights how advances in retinal imaging are opening new possibilities for early, noninvasive detection of Alzheimer disease (AD).
Retinal imaging is proving to be a promising, accessible way to detect Alzheimer disease early, as subtle structural and microvascular changes in the retina can appear long before symptoms. Duke’s iMIND group has identified measurable differences on OCT and OCT angiography—including ganglion cell–inner plexiform layer thinning, reduced choroidal vascularity, and decreased vessel density—even in asymptomatic APOE ε4 carriers. These retinal changes also parallel brain findings such as hippocampal atrophy on MRI, and additional imaging methods like ultra‑widefield photography and hyperspectral imaging help visualize vascular complexity and amyloid‑beta or tau aggregates. As blood‑based biomarkers gain FDA approval, the authors note that future screening strategies will likely combine retinal imaging with plasma assays to strengthen early detection and risk assessment.