Shi Zhongyong, Wu Yujie, Wang Meijuan, Cao Jing, Feng Wei, Cheng Yan, Li Chunbo, Shen Yuan
Department of Psychiatry, Tenth People's Hospital of Tongji University, Shanghai, P. R. China School of Medicine, Tongji University, Shanghai, P. R. China.
Department of Psychiatry, Tenth People's Hospital of Tongji University, Shanghai, P. R. China.
J Alzheimers Dis. 2014;40(2):277-83. doi: 10.3233/JAD-131898.
Thinning of retinal nerve fiber layer (RNFL) may reflect neurodegeneration of the central nervous system, which has been reported as part of the neuropathogenesis of Alzheimer's disease (AD). Specifically, AD patients have thinner RNFL as compared to age-matched normal controls. However, whether reduction of RNFL over time can predict those at higher risk to develop cognitive deterioration remains unknown. We therefore set out a prospective clinical investigation to determine both the reduction of RNFL thickness and the deterioration of cognitive function over a period of 25 months in 78 participants (mean age 72.31 ± 3.98 years, 52% men). The participants were categorized as stable participants whose cognitive status remained unchanged (n = 60) and converted participants whose cognitive status deteriorated, which was diagnosed by DSM-VI (for AD) and Petersen's definition (for mild cognitive impairment) (n = 18). Here we show for the first time that the converted participants had greater reduction of RNFL thickness than the stable participants. Specifically, the reduction in the thickness of the inferior quadrant RNFL in the converted participants was greater than that in stable participants [-11.0 ± 12.8 (mean ± standard deviation) μm versus 0.4 ± 15.7 μm, p = 0.009]. These data showed that greater reduction in the inferior quadrant of RNFL thickness might indicate a higher risk for the old adults to develop cognitive deterioration. These findings have established a system to embark on a larger scale study to further test whether changes in RNFL thickness can serve as a biomarker of AD.
视网膜神经纤维层（RNFL）变薄可能反映中枢神经系统的神经退行性变，这已被报道为阿尔茨海默病（AD）神经发病机制的一部分。具体而言，与年龄匹配的正常对照相比，AD患者的RNFL更薄。然而，RNFL随时间的减少是否能预测认知功能恶化风险较高的人群仍不清楚。因此，我们开展了一项前瞻性临床研究，以确定78名参与者（平均年龄72.31±3.98岁，52%为男性）在25个月内RNFL厚度的减少情况以及认知功能的恶化情况。参与者被分为认知状态保持不变的稳定参与者（n = 60）和认知状态恶化的转化参与者，后者由DSM-VI（用于AD）和彼得森定义（用于轻度认知障碍）诊断（n = 18）。在此我们首次表明，转化参与者的RNFL厚度减少幅度大于稳定参与者。具体而言，转化参与者下象限RNFL厚度的减少幅度大于稳定参与者[-11.0±12.8（平均值±标准差）μm对0.4±15.7μm，p = 0.009]。这些数据表明，RNFL厚度下象限更大幅度的减少可能表明老年人发生认知功能恶化的风险更高。这些发现建立了一个系统，可用于开展更大规模的研究，以进一步测试RNFL厚度的变化是否可作为AD的生物标志物。
