Ding J, Patton N, Deary I J, Strachan M W J, Fowkes F G R, Mitchell R J, Price J F
Department of Public Health Sciences, Medical School, University of Edinburgh, Edinburgh, UK.
Br J Ophthalmol. 2008 Aug;92(8):1017-25. doi: 10.1136/bjo.2008.141994. Epub 2008 Jul 9.
To examine the evidence for an association between cognitive impairment or dementia and the presence of retinal microvascular abnormalities.
A systematic review of observational studies identified through searching five electronic databases and reference lists. Studies were required to have both a recognised cognitive function assessment (either a structured neuropsychological test or a clinical evaluation of dementia), and assessment of the retinal microvasculature (either characteristics associated with generalised retinopathy or changes specific to arterioles or venules).
6 studies were included. Studies were clinically and methodologically heterogeneous and of variable quality. Some degree of cognitive impairment was found to be associated with the presence of retinal microvascular abnormalities in all studies, although the extent of the association varied. The presence of retinal vascular signs was mostly associated with poorer verbal memory, mental speed and executive function in the general population, but not consistently associated with other cognitive modalities.
There is some evidence suggesting a positive association between retinal microvascular abnormalities and cognitive impairment or dementia in elderly people and in patients with diabetes. Findings are inconclusive, and further better designed studies are required, with standardised and objective retinal vascular assessment and a range of sensitive cognitive tests.
探讨认知障碍或痴呆与视网膜微血管异常之间关联的证据。
通过检索五个电子数据库及参考文献列表对观察性研究进行系统综述。研究需具备公认的认知功能评估（结构化神经心理学测试或痴呆的临床评估）以及视网膜微血管系统评估（与全身性视网膜病变相关的特征或小动脉或小静脉的特定变化）。
纳入6项研究。这些研究在临床和方法上存在异质性，质量参差不齐。在所有研究中均发现一定程度的认知障碍与视网膜微血管异常的存在有关，尽管关联程度有所不同。视网膜血管体征的存在在普通人群中大多与较差的言语记忆、思维速度和执行功能相关，但与其他认知方式的关联并不一致。
有证据表明老年人及糖尿病患者中视网膜微血管异常与认知障碍或痴呆之间存在正相关。研究结果尚无定论，需要进一步开展设计更优的研究，采用标准化且客观的视网膜血管评估以及一系列敏感的认知测试。
