Impact of Alzheimer’s Disease in Ocular Motility and Visual Perception: A Narrative Review

Purpose: Alzheimer’s disease (AD) is a neurodegenerative disease generating a progressive neuronal loss as well as cognitive deficiencies. This disease can be accompanied by ocular manifestations, including alterations in ocular motility and visual perception. The aim of the current review article was to collect all the information about these alterations and to analyze if there is scientific evidence supporting the potential use of these changes as biomarkers of the disease. Methods: A bibliographic search was performed using two different databases, Pubmed and Google Scholar, as well as a search of material in non-peer reviewed journals about Alzheimer’s and Neurology. A total of 227 articles were found in the initial search, but only 76 were included considering their relevance according to the purpose of the review. Results: This narrative review describes the findings obtained in this area to this date, confirming that deficiencies in saccades is the most common condition among AD patients. Furthermore, other visual alterations have also been reported in these patients, including a compromise of visual acuity and contrast sensitivity, fluctuations of colour vision, stereopsis impairment and visual field losses. Likewise, other complex visuo-spatial and visuo-perceptual impairments can be present. More studies are still needed to understand better what type of changes occurs in ocular alignment, binocularity, and fixation pattern in AD patients. Conclusions: AD is associated to visual perception and ocular motility alterations. All the scientific information found in this review should be considered as a guide for designing future studies and to define adequate clinical protocols for the visual evaluation of patients with AD, considering the cognitive limitations that are normally present in this type of patients.This work was supported by the Ministry of Economy and Competitiveness [RYC-2016-20471]