Optical Coherence Tomography in Alzheimer's Disease: A Meta-Analysis.
Optical Coherence Tomography in Alzheimer's Disease: A Meta-Analysis.
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DOI：
10.1371/journal.pone.0134750
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Parisi V
中科院分区：
文献类型：
--
作者：
Coppola G;Di Renzo A;Ziccardi L;Martelli F;Fadda A;Manni G;Barboni P;Pierelli F;Sadun AA;Parisi V
阿尔茨海默病（Alzheimer's disease，AD）是一种神经退行性疾病，在其临床表现成熟前数年，可能会以轻度认知功能障碍（mild cognitive impairment，MCI）开始。光学相干断层扫描（OCT）已用于检测受MCI或AD影响的人的视乳头周围视网膜神经纤维层（RNFL）的损失以及黄斑厚度和体积的减少。在这里，我们进行了汇总荟萃分析，结合不同研究的结果。数据来源是2001年1月至2014年8月期间发表的病例对照研究（通过PubMed和Google Scholar数据库识别），这些研究通过OCT检查了AD和MCI患者的RNFL厚度，并与认知健康对照进行了比较。11项研究，包括380例AD患者，68例MCI患者和293例健康对照（HC）。研究表明，与HC相比，MCI患者的平均RNFL厚度降低（加权平均差异μm，WMD =-13.39，95% CI：-17.34至-9.45，p = 0.031），AD患者更是如此（WMD =-15.95，95% CI：-21.65至-10.21，p<0.0001）。AD上级组4个象限RNFL均明显变薄（上级WMD =-24.0，95% CI：-34.9至-13.1，p<0.0001;低级WMD =-20.8，95% CI：-32.0至-9.7，p<0.0001;鼻WMD =-14.7，95% CI：-23.9至-5.5，p<0.0001;颞侧WMD =-10.7，95%CI：-19.9 to-1.4，p <0.0001）; MCI患者与HC患者相比，象限RNFL同样显著降低（下方WMD =-20.22，95% CI：-30.41至-10.03，p = 0.0001;鼻侧WMD =-7.4，95% CI：-10.08至-4.7，p = 0.0000;颞侧WMD =-6.88，95% CI：-12.62至-1.13，p = 0.01），上级象限除外（WMD =-19.45，95% CI：-40.23至1.32，p = 0.06）。荟萃分析的结果支持OCT用于RNFL分析在监测AD进展和评估声称的AD治疗有效性方面的重要作用。
Alzheimer’s disease (AD) is a neurodegenerative disorder, which is likely to start as mild cognitive impairment (MCI) several years before the its full-blown clinical manifestation. Optical coherence tomography (OCT) has been used to detect a loss in peripapillary retina nerve fiber layer (RNFL) and a reduction in macular thickness and volume of people affected by MCI or AD. Here, we performed an aggregate meta-analysis combining results from different studies. Data sources were case-control studies published between January 2001 and August 2014 (identified through PubMed and Google Scholar databases) that examined the RNFL thickness by means of OCT in AD and MCI patients compared with cognitively healthy controls. 11 studies were identified, including 380 patients with AD, 68 with MCI and 293 healthy controls (HC). The studies suggest that the mean RNFL thickness is reduced in MCI (weighted mean differences in μm, WMD = -13.39, 95% CI: -17.34 to -9.45, p = 0.031) and, even more so, in AD (WMD = -15.95, 95% CI: -21.65 to -10.21, p<0.0001) patients compared to HC. RNFL in the 4 quadrants were all significantly thinner in AD superior (superior WMD = -24.0, 95% CI: -34.9 to -13.1, p<0.0001; inferior WMD = -20.8, 95% CI: -32.0 to -9.7, p<0.0001; nasal WMD = -14.7, 95% CI: -23.9 to -5.5, p<0.0001; and temporal WMD = -10.7, 95% CI: -19.9 to -1.4, p<0.0001); the same significant reduction in quadrant RNFL was observed in MCI patients compared with HC (Inferior WMD = -20.22, 95% CI: -30.41 to -10.03, p = 0.0001; nasal WMD = -7.4, 95% CI: -10.08 to -4.7, p = 0.0000; and temporal WMD = -6.88, 95% CI: -12.62 to -1.13, p = 0.01), with the exception of superior quadrant (WMD = -19.45, 95% CI: -40.23 to 1.32, p = 0.06). Results from the meta-analysis support the important role of OCT for RNFL analysis in monitoring the progression of AD and in assessing the effectiveness of purported AD treatments.