Blanks J C, Torigoe Y, Hinton D R, Blanks R H
Department of Ophthalmology, University of Southern California, Los Angeles.
Ann N Y Acad Sci. 1991;640:44-6. doi: 10.1111/j.1749-6632.1991.tb00188.x.
Recent reports (Hinton et al. 1986; Blanks et al. 1989) document the involvement of the retina in the constellation of neurodegenerative changes present in Alzheimer's disease (AD). These studies demonstrate the degeneration of large numbers of optic nerve axons and loss of retinal ganglion cells (RGCs) in patients with AD, but the quantitative changes in the retina of patients with AD compared with age-matched controls have not been examined. An important question is whether the lesion affects the macula, the area of highest visual acuity and the region of the greatest density of cone photoreceptor cells and RGCs. Additionally, it is unknown if patients with AD have a uniform thinning of cells in the ganglion cell layer (GCL) or if there is a differential loss of the medium- to large-sized cells, as suggested earlier (Bassi et al. 1987) and documented histopathologically in some areas of the central nervous system of patients with AD (Kemper 1984). If patients with AD were to show a differential loss of large versus small RGCs with characteristic differences in density, distribution, central projections, and physiologic properties (see review by Rowe and Stone 1977), then a loss of the visual functions normally ascribed to these classes of mammalian RGCs might be expected. This quantitative study of the retinal lesions in the macula of patients with AD provides important data on the progression of the disease and may eventually be the basis for diagnostic procedures for assessing the severity of AD.
近期报告（辛顿等人，1986年；布兰克斯等人，1989年）记录了视网膜参与阿尔茨海默病（AD）所呈现的神经退行性变化。这些研究表明，AD患者存在大量视神经轴突退化和视网膜神经节细胞（RGCs）丢失的情况，但与年龄匹配的对照组相比，AD患者视网膜的定量变化尚未得到研究。一个重要问题是，该病变是否会影响黄斑，即视力最高且视锥光感受器细胞和RGCs密度最大的区域。此外，AD患者神经节细胞层（GCL）中的细胞是否均匀变薄，或者是否如先前所示（巴西等人，1987年）以及在AD患者中枢神经系统的某些区域经组织病理学证实（肯珀，1984年）那样，中型至大型细胞存在差异性丢失，目前尚不清楚。如果AD患者表现出大、小RGCs的差异性丢失，且在密度、分布、中枢投射和生理特性方面存在特征差异（见罗和斯通，1977年的综述），那么可能会预期与这些类别的哺乳动物RGCs相关的视觉功能丧失。这项对AD患者黄斑区视网膜病变的定量研究为疾病进展提供了重要数据，并最终可能成为评估AD严重程度的诊断程序的基础。
