Choroidal Thinning as a New Finding in Alzheimer's Disease: Evidence from Enhanced Depth Imaging Spectral Domain Optical Coherence Tomography
Choroidal Thinning as a New Finding in Alzheimer's Disease: Evidence from Enhanced Depth Imaging Spectral Domain Optical Coherence Tomography
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DOI：
10.3233/jad-132039
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发表时间：
2014-01-01
影响因子：
4
通讯作者：
De Lena, Carlo
中科院分区：
文献类型：
--
作者：
Gharbiya, Magda;Trebbastoni, Alessandro;De Lena, Carlo
背景：近年来，阿尔茨海默病（AD）累及视网膜及其血管系统的报道越来越多。目的：应用光谱域光学相干断层扫描（SD-OCT）和增强深度成像（EDI）技术无创性地评估AD患者脉络膜厚度，并确定其视乳头周围视网膜神经纤维层（RNFL）和中央视网膜厚度是否较正常人减少。本前瞻性横断面研究纳入了21例诊断为轻度至中度AD的患者（平均年龄73.1 ± 6.9岁）的42只眼和21例年龄匹配的对照受试者（平均年龄70.3 ± 7.3岁）的42只眼。所有受试者均接受神经心理学（MMSE、ADAS-Cog和CDR）和眼科评估。通过EDI模式获得脉络膜的SD-OCT图像。通过手动测量评估脉络膜厚度。还分析了每只眼睛通过OCT软件自动测量的以下参数：1 mm中央子场（CSF）视网膜厚度、视乳头周围RNFL厚度。结果：AD患者脉络膜厚度较对照眼明显变薄（p < 0.05）。脑脊液视网膜厚度组间无差异（p > 0.05）。在所有四个象限中，两组间的平均视乳头周围RNFL厚度相似（p > 0.05）。OCT测量结果与任何心理测量参数均无相关性（p > 0.05）。结论：与健康受试者相比，AD患者的脉络膜厚度明显减少。脉络膜变薄可能是该病诊断和随访的一个重要生物标志物。
Background: The involvement of retina and its vasculature has been recently described in Alzheimer's disease (AD). However, none of the previous works have yet investigated the choroid in vivo.Objective: Spectral domain optical coherence tomography (SD-OCT) and enhanced depth imaging (EDI) technique is non-invasively used to assess choroidal thickness in patients with AD and to determine whether the peripapillary retinal nerve fiber layer (RNFL) and central retinal thickness are reduced compared to normal subjects.Methods: Forty-two eyes of 21 patients (mean age, 73.1 +/- 6.9 years) with a diagnosis of mild to moderate AD and 42 eyes of 21 age-matched control subjects (mean age, 70.3 +/- 7.3 years) were included in this prospective, cross-sectional study. All the subjects underwent neuropsychological (MMSE, ADAS-Cog, and CDR) and ophthalmological evaluation. The SD-OCT images of the choroid were obtained by EDI modality. Choroidal thickness was assessed by manual measurement. The following parameters, measured automatically by the OCT software, were also analyzed for each eye: 1-mm central subfield (CSF) retinal thickness, peripapillary RNFL thickness. Results: Choroidal thickness was significantly thinner in AD than in control eyes (p < 0.05). No difference in CSF retinal thickness was found between groups (p > 0.05). Mean peripapillary RNFL thickness in all four quadrants was similar between groups (p > 0.05). OCT measurements were not correlated with any of the tested psychometric parameters (p > 0.05).Conclusion: Compared with healthy subjects, patients with AD showed a significant reduction in choroidal thickness. Choroidal thinning may represent an adjunctive biomarker for the diagnosis and follow-up of this disease.