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Using optical coherence tomography angiography (OCTA), we present a choriocapillaris model sensitive to EOAD, correlating with serum biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Eighty\u2010four EOAD patients and 73 controls were assigned to swept\u2010source OCTA (SS\u2010OCTA) or the spectral domain OCTA (SD\u2010OCTA) cohorts. Our hypothesis on choriocapillaris predictive potential in EOAD was tested and validated in these two cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Both cohorts revealed diminished choriocapillaris signals, demonstrating the highest discriminatory capability (area under the receiver operating characteristic curve: SS\u2010OCTA 0.913, SD\u2010OCTA 0.991; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). A sparser SS\u2010OCTA choriocapillaris correlated with increased serum amyloid beta (A\u03b2)42, A\u03b242\/40, and phosphorylated tau (p\u2010tau)181 levels (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). Apolipoprotein E status did not affect choriocapillaris measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>The choriocapillaris, observed in both cohorts, proves sensitive to EOAD diagnosis, and correlates with serum A\u03b2 and p\u2010tau181 levels, suggesting its potential as a diagnostic tool for identifying and tracking microvascular changes in EOAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Optical coherence tomography angiography may be applied for non\u2010invasive screening of Alzheimer's disease (AD).<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Choriocapillaris demonstrates high sensitivity and specificity for early\u2010onset AD diagnosis.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Microvascular dynamics abnormalities are associated with AD.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.13871","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T08:19:35Z","timestamp":1715761175000},"page":"4185-4198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Choriocapillaris reduction accurately discriminates against early\u2010onset Alzheimer's disease"],"prefix":"10.1002","volume":"20","author":[{"given":"William Robert","family":"Kwapong","sequence":"first","affiliation":[{"name":"Department of Neurology West China Hospital Sichuan University  Chengdu P.R. 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