This comparative descriptive study was approved by the Faculty of Medicine, Chulalongkorn University’s institutional review board, and the study was conducted and performed in accordance with the ethical standards set out in the Declaration of Helsinki. Informed consent was obtained from all patients. We recruited the participants with ATD who visited the Cognitive Fitness Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand into the ATD group and age- and sex-matched healthy participants who had normal cognitive status into the control group.
The diagnosis of ATD was made using the 2011 Alzheimer’s disease diagnostic guideline of the National Institutes of Health and the Alzheimer’s Association. All participants in both the ATD and the control group underwent comprehensive examinations including a complete neurological examination, the Thai Mental State Examination (TMSE), which is a Thai version of the Mini-Mental State Examination (MMSE) developed in 1993 (Supplementary File 1
Participants in both groups received a complete ophthalmic examination including best-corrected visual acuity (BCVA), intraocular pressure (IOP), blink rate (times per minute), anterior and posterior segment examination using slit lamp biomicroscopy, tear breakup time (TBUT), ocular surface evaluation using the Ocular Surface Disease Index (OSDI), and axial length measurement using optical biometry (IOLMaster 500, Carl Zeiss AG, Oberkochen, Germany). We used the criteria of the Asia Dry Eye Society (ADES) to diagnose dry eye.9 (link)
Demographic and clinical data, including medical conditions, were recorded. The exclusion criteria for both groups were: BCVA < 20/200; refractive error > ±4.00 D spherical equivalent; axial length < 22 mm and > 26 mm; IOP >22 mmHg; pre-existing macular pathologies such as age-related macular degeneration, epiretinal membrane or macular hole; other retinopathies such as retinal vascular occlusion or retinal dystrophy; pre-existing ocular diseases such as glaucoma, optic neuropathy or uveitis; previous intraocular surgery within 12 months before enrollment except for uncomplicated cataract surgery; history of ocular trauma; current smoker; and presence of other neurological or psychiatric disorders, including other types of dementia.
The diagnosis of ATD was made using the 2011 Alzheimer’s disease diagnostic guideline of the National Institutes of Health and the Alzheimer’s Association. All participants in both the ATD and the control group underwent comprehensive examinations including a complete neurological examination, the Thai Mental State Examination (TMSE), which is a Thai version of the Mini-Mental State Examination (MMSE) developed in 1993 (
Participants in both groups received a complete ophthalmic examination including best-corrected visual acuity (BCVA), intraocular pressure (IOP), blink rate (times per minute), anterior and posterior segment examination using slit lamp biomicroscopy, tear breakup time (TBUT), ocular surface evaluation using the Ocular Surface Disease Index (OSDI), and axial length measurement using optical biometry (IOLMaster 500, Carl Zeiss AG, Oberkochen, Germany). We used the criteria of the Asia Dry Eye Society (ADES) to diagnose dry eye.9 (link)
Demographic and clinical data, including medical conditions, were recorded. The exclusion criteria for both groups were: BCVA < 20/200; refractive error > ±4.00 D spherical equivalent; axial length < 22 mm and > 26 mm; IOP >22 mmHg; pre-existing macular pathologies such as age-related macular degeneration, epiretinal membrane or macular hole; other retinopathies such as retinal vascular occlusion or retinal dystrophy; pre-existing ocular diseases such as glaucoma, optic neuropathy or uveitis; previous intraocular surgery within 12 months before enrollment except for uncomplicated cataract surgery; history of ocular trauma; current smoker; and presence of other neurological or psychiatric disorders, including other types of dementia.
