Amyloid Plaques in Retina for Diagnosis in Alzheimer's Patients: a Meta-Analysis.
Amyloid Plaques in Retina for Diagnosis in Alzheimer's Patients: a Meta-Analysis.
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用于诊断阿尔茨海默病患者视网膜中的淀粉样蛋白斑：荟萃分析
DOI：
10.3389/fnagi.2016.00267
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发表时间：
2016
影响因子：
4.8
通讯作者：
Li C
中科院分区：
文献类型：
--
作者：
Jiang J;Wang H;Li W;Cao X;Li C
背景资料：检测视网膜β淀粉样蛋白（Aβ）的积聚是一种新的诊断阿尔茨海默病（AD）的方法，但其准确性尚无确切证据。目的：通过荟萃分析方法确定病理性视网膜Aβ检测对AD诊断的准确性。研究方法：进行了电子和参考文献检索，以确定与视网膜Aβ检测在AD中的诊断作用相关的研究，这些研究符合预定义的纳入标准。使用QUADAS-2工具评估偏倚风险，使用Review Manager和Open Meta-Analyst进行数据分析。结果：从493份未重复的报告中，5项小样本研究纳入本综述。采用六种染色方法。合格的研究显示出极宽的灵敏度（0-1.00）和特异性（0.50-1.00）范围，具有显著的异质性。阳性似然比（PLR）、阴性似然比（NLR）和诊断优势比（DOR）的估计值也极不相同（PLR为0.71 ~ 11.57，NLR为0.04 ~ 1.11，DOR为0.69 ~ 297.00）。结论：合格研究的数量有限及其方法学的异质性使得无法得出结论，病理性视网膜Aβ检测是否是AD的有效诊断工具。需要更多的研究，特别是在连续或随机样本中采用定量方法对视网膜Aβ负荷进行大规模调查，以确定Aβ检测诊断AD的准确性。
Background: Detection of retinal β-amyloid (Aβ) peptide accumulation is a novel diagnostic method for Alzheimer’s disease (AD), but there is, as yet, no conclusive evidence of its accuracy. Aim: To identify the diagnostic accuracy of pathological retinal Aβ detection for AD by a meta-analytic approach. Methods: Electronic and reference searches were conducted to identify studies related to the diagnostic effects of retinal Aβ detection in AD that met pre-defined inclusion criteria. The QUADAS-2 tool was employed to assess the risk of bias, and Review Manager plus the Open Meta-Analyst were used to perform the data analysis. Results: From 493 unduplicated reports, five studies with small sample sizes were included in this review. Six staining methods were employed. The eligible studies showed extremely broad ranges of sensitivity (0–1.00) and specificity (0.50–1.00) with substantial heterogeneity. The estimates of positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) were also extremely varied (from 0.71 to 11.57 for PLR, from 0.04 to 1.11 for NLR, and from 0.69 to 297.00 for DOR). Conclusions: The limited number of eligible studies and their methodological heterogeneity make it impossible to come to a conclusion whether pathological retinal Aβ detection is an effective diagnostic tool for AD. More studies, especially large surveys investigating retina Aβ load with quantitative methods among consecutive or random samples, are needed to determine the accuracy of Aβ detection for diagnosing AD.