Edmund Arthur, OD, PhD, FAAO, has been awarded a National Institutes of Health (NIH) R56 grant to advance the development of widely available and cost-effective methods for the early detection of Alzheimer’s disease (AD) using the retina. The study will be conducted in partnership with the University of Alabama at Birmingham’s Alzheimer’s Disease Research Center and supports the potential for AD to one day be detected during a routine comprehensive eye examination.
Titled Novel Retinal Biomarker Development in Early Alzheimer’s Disease, the one-year grant totals $405,955. Its primary objective is to quantify and validate two novel retinal biomarkers for early AD detection: retinal mid-peripheral capillary-free zones and putative retinal gliosis.
Arthur, a UAB School of Optometry assistant professor, notes that AD remains one of the most significant global health challenges, affecting approximately 416 million individuals worldwide, an estimated 315 million of whom are asymptomatic. This preclinical phase represents a critical window for intervention, as it is when the disease is most responsive to treatment—before substantial neurodegeneration occurs.
“The disease process begins decades before clinical symptoms of cognitive decline manifest, and by the time symptoms appear, considerable and often irreversible damage has already occurred,” Arthur said. “Early detection is therefore essential for enabling timely disease-modifying interventions, particularly as therapies targeting the preclinical stage continue to advance.”
By utilizing ophthalmic technology already widely available in clinical eye care, this work has strong potential to expand access to early AD detection in a cost-effective manner.
“The retina provides a uniquely accessible and noninvasive window into the brain for early detection and longitudinal monitoring of AD,” Arthur said. “Importantly, many older adults already undergo regular eye examinations that include retinal imaging techniques such as spectral-domain optical coherence tomography, which enhances the feasibility of integrating this approach into routine clinical care.”
Routine comprehensive eye examinations among aging adults, particularly those requiring vision correction, may offer a scalable and efficient pathway for broader population-level screening for Alzheimer’s disease.
This research aligns closely with high-priority areas identified by the National Institute on Aging (NIA). First, it supports the NIA’s emphasis on expanding beyond amyloid-focused models to include vascular and inflammatory mechanisms in AD pathogenesis. The biomarkers under investigation may serve as clinically relevant endpoints for evaluating therapies that target these pathways.
Second, the study contributes to the NIA’s priority to diversify the biomarker toolkit by enabling the collection and integration of baseline and longitudinal plasma and ocular biomarkers across representative cohorts. This approach is intended to support validation of retinal biomarkers that reflect disease processes beyond amyloid and tau.