Abstract: Objective To evaluate the changes in retinal structure and function in the patients with Alzheimer’s disease (AD) in high-altitude regions using pattern visual evoked potential (PVEP) and optical coherence tomography (OCT), and to analyze their diagnostic value for AD. Methods Sixty AD patients (AD group) and 30 elderly individuals with normal cognition (HC group) admitted to Xining First People’s Hospital from January 2021 to March 2023 were enrolled. The latency and amplitude of the P100 wave were measured by PVEP. Retinal nerve fiber layer (RNFL) thickness and subfoveal choroidal thickness (SFCT) were tested by OCT. The differences in these indicators were compared between the two groups, and receiver operating characterisitc (ROC) curve analysis was performed to evaluate their diagnostic value for AD. Results There were no statistically significant differences in age, gender and intraocular pressure between the two groups (P>0.05). Compared to HC group, AD group showed significantly prolonged P100 wave latency (P<0.01), reduced P100 wave amplitude (P<0.01), thicker RNFL in the temporal quadrant (P<0.05), thinner PNFL in the superior and inferior quadrants (P<0.01), and thinner SFCT (P<0.001). The thickness of RNFL in superior quadrant and SFCT showed a significant thinning trends with AD progression (P<0.05). Logistic regression analysis showed that P100 latency, P100 amplitude and SFCT were independent factors for AD. ROC curve analysis revealed that the combined diagnostic value of P100 latency, P100 amplitude, and SFCT for AD (AUC=0.99) was superior to the parameters alone (AUC=0.81, 0.94 and 0.76, respectively). Conclusions AD patients in high-altitude regions present with distinct retinal structural and functional changes. Retinal parameters assessed by PVEP and OCT may serve as potential biomarkers for diagnosing AD in these populations.

Key words: retina, visual evoked potential, optical coherence tomography imaging, Alzheimer’s disease, high-altitude region