Peripheral Retinal Imaging Biomarkers for Alzheimer's Disease: A Pilot Study

Peripheral Retinal Imaging Biomarkers for Alzheimer's Disease: A Pilot Study
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DOI:
10.1159/000487053
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发表时间:
2018-01-01
影响因子:
2.1
通讯作者:
Lengyel, Imre
Lengyel, Imre
中科院分区:
医学3区
文献类型:
--
作者:
Csincsik, Lajos;MacGillivray, Thomas J.;Lengyel, Imre

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目的:研究超宽视野(UWF)视网膜成像能否识别阿尔茨海默病(AD)及其进展的生物标志物。方法:采用UWF扫描激光检眼镜(Optos P200C AF)对59例AD患者和48例健康对照进行基线(BL)表型分析。所有活着的参与者在2年后被邀请进行随访(FU),并再次成像(如果仍能参与)。所有参与者都在BL抽取血液进行基因分型。根据与年龄相关的黄斑变性样病变和视网膜血管参数的患病率对图像进行分级。AD患者与对照组的比较采用t检验和x(2)检验。结果:BL分析显示AD患者外周硬性玻璃体表型的发生率(14/55;25.4%)显著高于对照组(2/48;4.2%)[chi(2)=9.9,df=4,p=0.04]。与对照组相比,AD患者在2年的FU中观察到明显的葡萄膜数量增加。B区(C区:8.425×10~(-3)+/-2.865×10~(-3)vs 6.375×10~(-3)+/-1.532×10~(-3))静脉宽度梯度显著增加,p=0.008;全图:8.235×10(-3)+/-2.839×10(-3)vs 6.050×10(-3)+/-1.414×10~(-3),P=0.004)。在BL期AD患者动脉分维值显著降低(全图:1.250+/-0.086 vs 1.304+/-0.089,p=0.049)。结论:UWF视网膜成像显示AD与外周硬性玻璃体形成及后极部血管的改变密切相关,提示监测外周视网膜的病理变化可能成为监测AD的有价值的工具。(C)2018年S.Karger AG,巴塞尔
Purpose: To examine whether ultra-widefield (UWF) retinal imaging can identify biomarkers for Alzheimer's disease (AD) and its progression. Methods: Images were taken using a UWF scanning laser ophthalmoscope (Optos P200C AF) to determine phenotypic variations in 59 patients with AD and 48 healthy controls at baseline (BL). All living participants were invited for a follow-up (FU) after 2 years and imaged again (if still able to participate). All participants had blood taken for genotyping at BL. Images were graded for the prevalence of age-related macular degeneration-like pathologies and retinal vascular parameters. Comparison between AD patients and controls was made using the Student t test and the chi(2) test. Results: Analysis at BL revealed a significantly higher prevalence of a hard drusen phenotype in the periphery of AD patients (14/55; 25.4%) compared to controls (2/48; 4.2%) [chi(2) = 9.9, df = 4, p = 0.04]. A markedly increased drusen number was observed at the 2-year FU in patients with AD compared to controls. There was a significant increase in venular width gradient at BL (zone C: 8.425 x 10(-3) +/- 2.865 x 10(-3) vs. 6.375 x 10(-3) +/- 1.532 x 10(-3), p = 0.008; entire image: 8.235 x 10(-3) +/- 2.839 x 10(-3) vs. 6.050 x 10(-3) +/- 1.414 x 10-(3), p = 0.004) and a significant decrease in arterial fractal dimension in AD at BL (entire image: 1.250 +/- 0.086 vs. 1.304 +/- 0.089, p = 0.049) with a trend for both at FU. Conclusions: UWF retinal imaging revealed a significant association between AD and peripheral hard drusen formation and changes to the vasculature beyond the posterior pole, at BL and after clinical progression over 2 years, suggesting that monitoring pathological changes in the peripheral retina might become a valuable tool in AD monitoring. (C) 2018 S. Karger AG, Basel