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Journal of Ophthalmology
Volume 2017 (2017), Article ID 7935406, 8 pages
Research Article

Evaluation of Cholinergic Deficiency in Preclinical Alzheimer’s Disease Using Pupillometry

1Commonwealth Scientific and Industrial Research Organisation (CSIRO), Perth, WA, Australia
2Australian e-Health Research Centre, Perth, WA, Australia
3Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, VIC, Australia
4Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
5The Mental Health Research Institute (MHRI), University of Melbourne, Melbourne, VIC, Australia
6National Ageing Research Institute, Melbourne, VIC, Australia
7School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
8Sir James McCusker Alzheimer’s Disease Research Unit, Hollywood Private Hospital, Perth, WA, Australia
9School of Biomedical Sciences, Macquarie University, North Ryde, NSW, Australia
10School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia

Correspondence should be addressed to Shaun Frost

Received 28 April 2017; Accepted 4 June 2017; Published 15 August 2017

Academic Editor: Alejandro Cerviño

Copyright © 2017 Shaun Frost et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cortical cholinergic deficiency is prominent in Alzheimer’s disease (AD), and published findings of diminished pupil flash response in AD suggest that this deficiency may extend to the visual cortical areas and anterior eye. Pupillometry is a low-cost, noninvasive technique that may be useful for monitoring cholinergic deficits which generally lead to memory and cognitive disorders. The aim of the study was to evaluate pupillometry for early detection of AD by comparing the pupil flash response (PFR) in AD () and cognitively normal healthy control (HC, ) participants, with the HC group stratified according to high () and low () neocortical amyloid burden (NAB). Constriction phase PFR parameters were significantly reduced in AD compared to HC (maximum acceleration , maximum velocity , average velocity , and constriction amplitude ). The high-NAB HC subgroup had reduced PFR response cross-sectionally, and also a greater decline longitudinally, compared to the low-NAB subgroup, suggesting changes to pupil response in preclinical AD. The results suggest that PFR changes may occur in the preclinical phase of AD. Hence, pupillometry has a potential as an adjunct for noninvasive, cost-effective screening for preclinical AD.