Approved research

The eye and the brain

Lay summary

Aims: The overall goal of this project is to develop and validate a screening test for predicting brain diseases through ocular imaging. Specific aims are: 1) To explore the associations between major eye diseases and a wide range of brain diseases. 2) To explore the associations between retinal biomarkers derived from retinal imaging, and brain diseases, as well as specific measures of brain structure and function. 3) To develop and validate the clinical application of deep learning to ocular imaging for brain diseases, and brain structure and function prediction. Scientific rationale: Aging populations have inevitably led to a substantial rise in prevalence of age-related brain disease, including dementia. Despite the heavy burden of dementia, effective pharmacological treatments are yet to be developed. Advances in such treatments have been hampered by challenges in detecting dementia at an early stage, where individuals are still asymptomatic but already have had underlying neuropathologies. As an extension of the central nervous system (CNS), the retina has been regarded as the 'window to the brain'. Extensive research has shown abnormal retinal changes are significantly associated with clinically detectable brain diseases. Nevertheless, much of the previous work has focused on a few features (e.g.,vascular caliber) explicitly detected by ophthalmic expert using the standardized reviewing systems. As a special type of deep-learning technique that has been optimized for images, deep learning approaches have achieved state-of-the-art performance in prediction models across several domains. The ability of learning the 'personalized' image features and/or patterns for the deep learning technology may improve the prediction of brain diseases based on retinal imaging. Duration of the project: 36 months. Public health impact: This project will benefit millions of people worldwide, who are at risk of brain diseases. Of note, prevention is most effective when people at high risk are identified early, allowing preventative and therapeutic interventions. Early diagnosis and intervention in major brain diseases have resulted in reducing onset, slowing the loss of function, delaying complications, improving patient quality of life, and reducing socioeconomic burden associated with the disease in the long run.