Multimodal Characterization of APOE ε4-Associated Neurovascular Heterogeneity Using Retinal, Plasma, and Neuroimaging Biomarkers in Alzheimer's Disease

Background

Biological heterogeneity remains a major challenge in Alzheimer's disease (AD), even among individuals with biomarker-confirmed disease. The apolipoprotein E (APOE) ε4 allele is associated with greater amyloid burden, neurodegeneration, and vascular dysfunction. We investigated whether retinal microvascular imaging provides complementary information beyond plasma and neuroimaging biomarkers for characterizing APOE ε4-associated neurovascular heterogeneity in biologically defined AD.