Optical Coherence Tomography (OCT) as a Retinal Biomarker for Brain Neurodegeneration: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.54.70115Keywords
RNFL thickness, Optical Coherence Tomography, Optical Coherence Tomography Angiography, Neurodegenerative disease, Alzheimer's Disease, Parkinson's Disease, Retina, CNSAbstract
Background. Optical coherence tomography is a rapidly developing imaging technique being increasingly used for the diagnosis of neurodegenerative diseases. It has brought forth new innovations for these diseases. Measurements of the retinal layers, macular and separate layer thicknesses, ganglion cell complex and choroidal thickness etc, have proven to be an excellent indication in differentiating these diseases using non-invasive and minimally invasive procedures.
Aim. To summarize available information and studies about the usage of OCT in neurodegenerative diseases which might create a new path for their diagnosis and treatment.
Materials and Methods. A literary search was done using the PubMed database to identify relevant studies published in English within the last 10 years. The selected studies were analysed to summarize current evidence regarding the potential role of OCT and OCTa in neurodegenerative diseases.
Results. Various studies have proven significant correlation between OCT measurements and neurodegenerative diseases. This increasingly developing correlation may help in the diagnosis and clinical treatment of these illnesses. However, there is a need for further studies and research to be conducted as non-specificity of OCT findings across the diseases remain a significant factor to be considered before mainstream usage.
Conclusions. OCT usage has proved to be a field which deserves more gravity towards it. The anatomical origin as well as similarity of the eye and brain in function may help us understand and diagnose these diseases better in the foreseeable future.
References
1. Tsokolas G , Tsaousis KT , Diakonis VF , Matsou A , Tyradellis S. Optical Coherence Tomography Angiography in Neurodegenerative Diseases: A Review. Eye Brain. 2020;12:73–87. https://doi.org/10.2147/EB.S193026
2. Cunha LP, Pires LA , Cruzeiro MM, Almeida ALM, Martins LC, Martins PN, Shigaeff N, Vale TC. Arq Neuropsiquiatr. 2022;80(2):180-191. https://doi.org/10.1590/0004-282X-ANP-2021-0134
3. Katsimpris A, Karamaounas A, Sideri AM, Katsimpris J, Georgalas I, Petrou P. Optical coherence tomography angiography in Alzheimer's disease: a systematic review and meta-analysis. Eye (Lond). 2022;36(7):1419-1426. https://doi.org/10.1038/s41433-021-01648-1
4. Britze J, Frederiksen JL. Optical coherence tomography in multiple sclerosis. Eye (Lond). 2018;32(5):884-888. https://doi.org/10.1038/s41433-017-0010-2
5. Lampert EJ, Andorra M, Torres-Torres R, Ortiz-Pérez S, Llufriu S, Sepúlveda M, Sola N, Saiz A, Sánchez-Dalmau B, Villoslada P, Martínez-Lapiscina EH. Color vision impairment in multiple sclerosis points to retinal ganglion cell damage. J Neurol. 2015;262(11):2491-7. https://doi.org/10.1007/s00415-015-7876-3
6. Katsimpris A, Papadopoulos I, Voulgari N, Kandarakis S, Petrou P, Karampitsakos T, Dimitropoulou AN, Katsimpras M, Karamaounas A, Sideri AM, Katsimpris J, Georgalas I, Kymionis G. Optical coherence tomography angiography in Parkinson's disease: a systematic review and meta-analysis. Eye (Lond). 2023;37(14):2847-2854. https://doi.org/10.1038/s41433-023-02438-7
7. Nepal G, Kharel S, Coghlan MA, Yadav JK, Parajuli P, Pandit K, Shing YK, Ojha R. Amyotrophic lateral sclerosis and retinal changes in optical coherence tomography: A systematic review and meta-analysis. Brain Behav. 2022;12(9):e2741. https://doi.org/10.1002/brb3.2741
8. Bogdanova-Mihaylova P, Plapp HM, Chen H, Early A, Cassidy L, Walsh RA, Murphy SM. Longitudinal Assessment Using Optical Coherence Tomography in Patients with Friedreich's Ataxia. Tomography. 2021;7(4):915-931. https://doi.org/10.3390/tomography7040076
9. Bianchi-Marzoli S, Fenu S, Melzi L, Benzoni C, Antonazzo F, Tomas Roldan E, Farina L, Tremolada G, Mauro E, Pensato V, Gellera C, Pareyson D, Salsano E. Optical coherence tomography in adult adrenoleukodystrophy: a cross-sectional and longitudinal study. Neurol Sci. 2021;42(1):235-241. https://doi.org/10.1007/s10072-020-04576-2
10. van Ballegoij WJC, Kuijpers SC, Huffnagel IC, Weinstein HC, Poll-The BT, Engelen M, Bennebroek CAM, Verbraak FD. Optical coherence tomography shows neuroretinal thinning in myelopathy of adrenoleukodystrophy. J Neurol. 2020;267(3):679-687.https://doi.org/10.1007/s00415-019-09627-z
11. Fang XJ, Yu M, Wu Y, Zhang ZH, Wang WW, Wang ZX, Yuan Y. Study of Enhanced Depth Imaging Optical Coherence Tomography in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy. Chin Med J (Engl). 2017;130(9):1042-1048. https://doi.org/10.4103/0366-6999.204935
12. Pandya BU, Grinton M, Mandelcorn ED, Felfeli T. RETINAL OPTICAL COHERENCE TOMOGRAPHY IMAGING BIOMARKERS: A Review of the Literature. Retina. 2024;44(3):369-380. https://doi.org/10.1097/IAE.0000000000003974
13. López-Cuenca I, de Hoz R, Alcántara-Rey C, Salobrar-García E, Elvira-Hurtado L, Fernández-Albarral JA, Barabash A, Ramírez-Toraño F, de Frutos-Lucas J, Salazar JJ, Ramírez AI, Ramírez JM. Foveal Avascular Zone and Choroidal Thickness Are Decreased in Subjects with Hard Drusen and without High Genetic Risk of Developing Alzheimer's Disease. Biomedicines. 2021;9(6):638. https://doi.org/10.3390/biomedicines9060638
14. Chalkias E, Chalkias IN, Bakirtzis C, Messinis L, Nasios G, Ioannidis P, Pirounides D. Differentiating Degenerative from Vascular Dementia with the Help of Optical Coherence Tomography Angiography Biomarkers. Healthcare (Basel). 2022;10(3):539. https://doi.org/10.3390/healthcare10030539
15. Yoon JM, Lim CY, Noh H, Nam SW, Jun SY, Kim MJ, Song MY, Jang H, Kim HJ, Seo SW, Na DL, Chung MJ, Ham DI, Kim K. Enhancing foveal avascular zone analysis for Alzheimer's diagnosis with AI segmentation and machine learning using multiple radiomic features. Sci Rep. 2024;14(1):1841. https://doi.org/10.1038/s41598-024-51612-8
16. Salobrar-Garcia E, Méndez-Hernández C, Hoz R, Ramírez AI, López-Cuenca I, Fernández-Albarral JA, Rojas P, Wang S, García-Feijoo J, Gil P, Salazar JJ, Ramírez JM. Ocular Vascular Changes in Mild Alzheimer's Disease Patients: Foveal Avascular Zone, Choroidal Thickness, and ONH Hemoglobin Analysis. J Pers Med. 2020;10(4):231. https://doi.org/10.3390/jpm10040231
17. Liu WW, Margeta MA. Imaging Retinal Ganglion Cell Death and Dysfunction in Glaucoma. Int Ophthalmol Clin. 2019;59(4):41-54. https://doi.org/10.1097/IIO.0000000000000285
18. Mutlu U, Ikram MK, Roshchupkin GV, Bonnemaijer PWM, Colijn JM, Vingerling JR, Niessen WJ, Ikram MA, Klaver CCW, Vernooij MW. Thinner retinal layers are associated with changes in the visual pathway: A population-based study. Hum Brain Mapp. 2018;39(11):4290-4301. https://doi.org/10.1002/hbm.24246
19. Dhirachaikulpanich D, Chanthongdee K, Zheng Y, Beare NAV. A systematic review of OCT and OCT angiography in retinal vasculitis. J Ophthalmic Inflamm Infect. 2023;13(1):1. https://doi.org/10.1186/s12348-023-00327-4
20. Meng Z, He Y, Guo K, Li L. Imaging biomarkers in optic neuritis: current tools and future directions. Front Neurol. 2025;16:1666835. https://doi.org/10.3389/fneur.2025.1666835
21. Abd Hamid MR, Wan Hitam WH, Abd Halim S. Retinal Nerve Fiber Layer and Macular Thickness in Parkinson's Disease Patients. Cureus. 2021;13(7):e16224. https://doi.org/10.7759/cureus.16224
22. Svetel M, Marić G, Božić M, Pekmezović T, Petrović I, Jakšić J, Dimitrijević A, Lazić U, Kostić S, Knežević M, Petrović T, Pajić SP, Šobot V, Vasilijević J, Svetel M. Retinal Thickness Profiles in Parkinsonian Syndromes: Discerning Parkinson's Disease, Multiple System Atrophy, and Progressive Supranuclear Palsy via Optical Coherence Tomography. Biomedicines. 2026;14(1):249. doi: https://doi.org/10.3390/biomedicines14010249
23. Jessney B, Chen X, Gu S, Huang Y, Goddard M, Brown A, Obaid D, Mahmoudi M, Garcia Garcia HM, Hoole SP, Räber L, Prati F, Schönlieb CB, Roberts M, Bennett M. Artificial Intelligence-Led Whole Coronary Artery OCT Analysis; Validation and Identification of Drug Efficacy and Higher-Risk Plaques. Circ Cardiovasc Imaging. 2025;18(11):e018133. https://doi.org/10.1161/CIRCIMAGING.125.018133.
24. Reeß LG, Salih H, Delikaya M, Paul F, Oertel FC. Barriers in Healthcare to the Use of Optical Coherence Tomography Angiography in Multiple Sclerosis. Neurol Ther. 2025;14(1):45-56. https://doi.org/10.1007/s40120-024-00670-1
25. Ueda E, Watanabe M, Nakamura D, Matsuse D, Tanaka E, Fujiwara K, Hashimoto S, Nakamura S, Isobe N, Sonoda KH. Distinct retinal reflectance spectra from retinal hyperspectral imaging in Parkinson's disease. J Neurol Sci. 2024;461:123061. https://doi.org/10.1016/j.jns.2024.123061
26. Ortuño-Lizarán I, Sánchez-Sáez X, Lax P, Serrano GE, Beach TG, Adler CH, Cuenca N. Dopaminergic Retinal Cell Loss and Visual Dysfunction in Parkinson Disease. Ann Neurol. 2020;88(5):893-906. https://doi.org/10.1002/ana.25897
27. 2025 Alzheimer's disease facts and figures. Alzheimers Dement. 2025;21(4):e70235. https://doi.org/10.1002/alz.70235
28. Giachos I, Doumazos S, Tsiogka A, Manoli K, Tagaris G, Rotsos T, Kozobolis V, Iliopoulos I, Moschos M. Retinal capillary plexus in Parkinson's disease using optical coherence tomography angiography. Int J Ophthalmol. 2024;17(1):131-136. https://doi.org/10.18240/ijo.2024.01.18
29. Pang C, Li Y, Jiang W, Xie H, Cao W, Yu H, Lin Z, Cheng Y, Fan D, Deng B. Analysis of retinal markers and incident amyotrophic lateral sclerosis: An optical coherence tomography-based cohort study. PLoS Med. 2025;22(6):e1004545. https://doi.org/10.1371/journal.pmed.1004545
30. Zhao Y, Xiao Q, Fan B, Tang L, Chen X, Dai Y. Multimodal optical coherence tomography and angiography and serologic markers for accurate early diagnosis of dysthyroid optic neuropathy. Am J Transl Res. 2026;18(1):676-690. https://doi.org/10.62347/SDKT8956
31. Vujosevic S, Parra MM, Hartnett ME, O'Toole L, Nuzzi A, Limoli C, Villani E, Nucci P. Optical coherence tomography as retinal imaging biomarker of neuroinflammation/neurodegeneration in systemic disorders in adults and children. Eye (Lond). 2023;37(2):203-219. https://doi.org/10.1038/s41433-022-02056-9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Agata Król, Emilia Muraszewska , Łukasz Muraszewski , Patrycja Kwitowska, Eryk Ubysz, Edyta Lewandowska, Cezary Łuczyński, Maciej Paczkowski , Mariusz Wręczycki , Małgorzata Pyjecka

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 80
Number of citations: 0