Meta-analysis of the relationship of peripheral retinal nerve fiber layer thickness to Alzheimer's disease and mild cognitive impairment.
Meta-analysis of the relationship of peripheral retinal nerve fiber layer thickness to Alzheimer's disease and mild cognitive impairment.
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DOI：
10.11919/j.issn.1002-0829.215100
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Shen Y
中科院分区：
文献类型：
--
作者：
Wang M;Zhu Y;Shi Z;Li C;Shen Y
以往的研究报道，阿尔茨海默病（AD）和轻度认知障碍（MCI）患者的外周视网膜神经纤维层（RNFL）的厚度比正常对照组（NC）明显变薄，但视神经不同象限的RNFL厚度仍不清楚。对评估AD和MCI患者外周RNFL厚度的研究进行系统回顾。根据预定义的标准，从PubMed、Embase、ISI知识网、奥维德/Medline、Science Direct、科克伦图书馆、中国知网（CNKI）、重庆维普数据库、万方数据和中国生物医学文献服务系统（SinoMed）中识别英文或中文研究。使用Review Manager 5.3进行分析。确定的19项横断面研究有1455名个体的合并样本。AD或MCI患者与正常对照组RNFL的比较研究存在显著异质性，但这种异质性主要限于低质量研究。结合6项高质量研究（n=578），AD患者RNFL总厚度、上级和下层RNFL厚度均明显薄于正常对照组。同样，结合5个高质量的研究（n=541）表明，MCI组的总RNFL厚度显著低于对照组。6项研究（n=589）发现MCI组上级和下象限的RNFL比对照组薄; 6项研究（n=487）发现MCI组颞象限的RNFL比对照组薄。最后，7项研究（n=432）表明，总的RNFL在AD比MCI薄，6项研究（n=364）表明，更薄的RNFL在AD的上级和下象限比MCI。以前研究结果的异质性可能是由于方法学不佳。外周RNFL厚度，特别是在上级和下级象限，随着认知功能下降而逐渐变薄，因此这可能是早期识别AD的候选生物标志物。需要在大规模人群队列研究中进行严格的方法学研究，这些研究随着时间的推移跟踪老年人，同时收集潜在介导因素（如血压，血糖和血脂水平）的信息，以证实或反驳RNFL的潜在预测价值。
Previous studies report that the thickness of the peripheral retinal nerve fiber layer (RNFL) in individuals with Alzheimer's disease (AD) and mild cognitive impairment (MCI) is significantly thinner than in normal controls (NC), but RNFL thickness in different quadrants of the optic nerve remains unclear. Conduct a systematic review of studies that assess peripheral RNFL thickness in AD and MCI. Based on pre-defined criteria, studies in English or Chinese were identified from PubMed, Embase, ISI web of knowledge, Ovid/Medline, Science Direct, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chongqing VIP database, WANFANG DATA, and the China BioMedical Literature Service System (SinoMed). Review Manager 5.3 was used for analysis. The 19 cross-sectional studies identified had a pooled sample of 1455 individuals. There was substantial heterogeneity between studies that compared RNFL in AD or MCI to normal controls, but this heterogeneity was primarily restricted to low-quality studies. Combining 6 high-quality studies (n=578) indicated that total RNFL thickness and the thickness of superior and inferior RNFL quadrants in AD were significantly thinner than in normal controls. Similarly, combining 5 high-quality studies (n=541) indicated significantly thinner total RNFL thickness in MCI than in controls. Six studies (n=589) found thinner RNFL in the superior and inferior quadrants in MCI than in controls;and 6 studies (n=487) found thinner RNFL in the temporal quadrant in MCI than in controls. Finally, 7 studies (n=432) indicated that total RNFL was thinner in AD than in MCI, and 6 studies (n=364) indicated thinner RNFL in the superior and inferior quadrants in AD than in MCI. Much of the heterogeneity in results from previous studies may be due to poor methodology. Peripheral RNFL thicknesses, particularly in the superior and inferior quadrants, becomes progressively thinner as cognitive function declines, so this could be a candidate biomarker for early identification of AD. Methodologically rigorous studies in large population-based cohort studies that follow elderly individuals over time and that simultaneously collect information on potential mediating factors (such as blood pressure, blood glucose, and lipid levels) are needed to confirm or disprove the potential predictive value of RNFL.