Parafoveal vessel loss and correlation between peripapillary vessel density and cognitive performance in amnestic mild cognitive impairment and early Alzheimer's Disease on optical coherence tomography angiography
Parafoveal vessel loss and correlation between peripapillary vessel density and cognitive performance in amnestic mild cognitive impairment and early Alzheimer's Disease on optical coherence tomography angiography
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DOI：
10.1371/journal.pone.0214685
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发表时间：
2019-04-02
期刊：
影响因子：
3.7
通讯作者：
Fawzi, Amani A.
中科院分区：
文献类型：
--
作者：
Zhang, Yi Stephanie;Zhou, Nina;Fawzi, Amani A.
目的阿尔茨海默病（AD）患者表现为视网膜血流量和血管密度（VD）减少。然而，尚不清楚这些变化是否也存在于早期AD （eAD）或遗忘型轻度认知障碍（aMCI）患者中，这是一个丰富的AD前期人群，发展为痴呆的风险更高。我们进行了一项前瞻性病例对照临床研究，以调查aMCI和eAD患者黄斑和椎间盘的光学相干断层扫描血管造影（OCTA）参数是否发生改变。方法本研究为单中心研究，共有32名参与者。aMCl/eAD患者（n = 16）与认知正常对照（n = 16） 1:1匹配。我们评估了OCTA图像的中央凹旁浅毛细血管丛（SCP）和两个血管层在乳头周围区域，径向乳头周围毛细血管（RPC）和浅血管复群（SVC）。结果血管和结构参数包括VD、血管长度密度（VLD）、调节血流指数（AFI）和视网膜结构神经纤维层（RNFL）厚度。我们比较了两组的这些参数，并检查了OCTA参数与蒙特利尔认知评估（MoCA）认知表现之间的相关性。结果与对照组相比，认知受损的参与者在中央凹旁SCP VD和AFI方面有统计学意义的降低，但在乳头周围参数方面无统计学意义的差异。此外，我们发现整个研究队列的MoCA评分与中央凹旁SCP VD和乳头周围RPC VLD之间存在显著的正相关。结论octa显示AD相关早期认知障碍患者的中央凹旁血流和VD显著下降，提示这些参数可能作为早期疾病的生物标志物具有潜在的效用。相反，在乳头周围区域存在较大的血管通道可能掩盖了该区域细微的毛细血管变化。总的来说，血管OCTA参数与认知能力之间的相关性支持在该人群中进行进一步的OCTA研究。
PurposePatients with Alzheimer's Disease (AD) exhibit decreased retinal blood flow and vessel density (VD). However, it is not known whether these changes are also present in individuals with early AD (eAD) or amnestic type mild cognitive impairment (aMCI), an enriched pre-AD population with a higher risk for progressing to dementia. We performed a prospective case control clinical study to investigate whether optical coherence tomography angiography (OCTA) parameters in the macula and disc are altered in those with aMCI and eAD.MethodsThis is a single center study of 32 participants. Individuals with aMCl/eAD (n = 16) were 1:1 matched to cognitively normal controls (n = 16). We evaluated OCTA images of the parafoveal superficial capillary plexus (SCP) and two vascular layers in the peripapillary region, the radial peripapillary capillary (RPC) and superficial vascular complex (SVC). Outcome vascular and structural parameters included VD, vessel length density (VLD), adjusted flow index (AFI) and structural retinal nerve fiber layer (RNFL) thickness. We compared these parameters between the two groups and examined the correlation between OCTA parameters and cognitive performance on the Montreal Cognitive Assessment (MoCA).ResultsCognitively impaired participants demonstrated statistically significant decrease in parafoveal SCP VD and AFI as compared to controls, but no statistically significant difference in peripapillary parameters. Furthermore, we found a significant positive correlation between MoCA scores for the entire study cohort and both the parafoveal SCP VD and peripapillary RPC VLD.ConclusionOCTA shows significant decline in parafoveal flow and VD in individuals with early cognitive impairment related to AD, suggesting that these parameters could have potential utility as early disease biomarkers. In contrast, the presence of larger vascular channels in the peripapillary region may have obscured subtle capillary changes in that region. Overall, the correlation between vascular OCTA parameters and cognitive performance supports further OCTA studies in this population.