ARVO 2025: Ocular and systemic mitochondrial diseases may be key to dementia diagnosis

At the 2025 Association for Research in Vision and Ophthalmology meeting in Salt Lake City, Utah, Viha Vig presented a poster mitochondrial eye and systemic diseases. Vig is a MBChB graduate student at the University of Auckland, New Zealand. Her work examined the relationship between mitochondiral disease, Alzheimer disease, and other types of dementia, including vascular dementia. Here, she shares some of the key findings from her research. Watch the video to hear the full details from her poster presentation.

Editor's note: The below transcript has been lightly edited for clarity.

A first-in-human study

"We're investigating the relationship between mitochondrial eye and systemic diseases and Alzheimer disease, vascular dementia, and other types of dementia. So this is one of the first studies in humans to investigate the relationship between mitochondrial diseases and different types of dementias...This is a retrospective cohort based longitudinal study, and our results indicated that there was a higher prevalence of dementia, higher in the ocular mitochondrial disease, than the systemic mitochondrial disease. In people with both those ocular and systemic mitochondrial disease had a much higher prevalence as well. And all three groups, ocular, systemic, and the combined mitochondrial disease group also had a pretty high incidence of all different types of dementia as well."

Key message for clinicians

"The clinical takeaway is that mitochondrial dysfunction is a part of the shared neuropathic physiology of different types of dementia as well as mitochondrial diseases. And we know some of this already. We use PET scans in our clinical practice as standard of care to detect dementia. The clinical application is that mitochondrial dysfunction can be used as biomarker or a target for pharmacological therapies to reduce cognitive decline, because mitochondrial dysfunction does happen before the onset of symptoms in dementia, and there's enough studies in the literature supporting this...If we can quantify the mitochondrial dysfunction in the retina through direct methods FLIM imaging or indirect methods like electroretinograms, then we have an idea of dementia progression over time and the pathology going on in the brain...This would be a much less expensive and less invasive way to detect dementia."

Looking to the future

"At the moment, there's two thoughts amongst the scientists who are investigating eye disease and dementia. One school of thought is focused on retinal neurodegeneration and vascular changes in the retina, and that directly correlates with what's happening in the brain. And that's a direct correlation. Another school of thought is a little bit of an indirect correlation...Vision loss leads to social isolation, which is a huge risk factor for dementia. So both these theories, I believe, are quite valid...When talking about the mitochondrial disease study, specifically, I think that [mitochondrial disease] would be a really good target for pharmacological therapies, and because we already know that mitochondrial dysfunction, it has a huge role to play in dementia. That's a well established thing, and it's more well established in animal models. And mitochondrial dysfunction happens before the onset of symptoms of dementia. So it gives us a chance to reduce the rate of cognitive decline, and if I'm going to be ambitious, may also give us a chance to, you know, reverse dementia to an extent. I think it will mainly just reduce the rate of cognitive decline."