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帕金森病患者的视网膜神经纤维层厚度变化:一项荟萃分析。

Retinal nerve fiber layer thickness changes in Parkinson disease: a meta-analysis.

机构信息

Department of Ophthalmology, The Central Hospital of Wuhan, Hubei, China.

Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

PLoS One. 2014 Jan 21;9(1):e85718. doi: 10.1371/journal.pone.0085718. eCollection 2014.

Abstract

BACKGROUND

Parkinson disease (PD) is a neurodegenerative process that leads to a selective loss of dopaminergic neurons, mainly in the basal ganglia of the brain. Numerous studies have analyzed the ability of optical coherence tomography (OCT) to detect retinal nerve fiber layer (RNFL) thickness abnormalities and changes in PD, but the results have not always been consistent. Therefore, we carried out a meta-analysis to evaluate the RNFL thickness measured with OCT in PD.

METHODS AND FINDINGS

Case-control studies were selected through an electronic search of the Cochrane Controlled Trials Register, PUBMED and EMBASE. For the continuous outcomes, we calculated the weighted mean difference (WMD) and 95% confidence interval (CI). The statistical analysis was performed by RevMan 5.0 software. Thirteen case-control studies were included in the present meta-analysis, containing a total of 644 eyes in PD patients and 604 eyes in healthy controls. The results of our study showed that there was a significant reduction in average RNFL thickness in patients with PD compared to healthy controls (WMD = -5.76, 95% CI: -8.99 to -2.53, P = 0.0005). Additionally, differences of RNFL thickness in superior quadrant (WMD = -4.44, 95% CI: -6.93 to -1.94, P = 0.0005), inferior quadrant (WMD = -7.56, 95% CI: -11.33 to -3.78, P<0.0001), nasal quadrant (WMD = -3.12, 95% CI: -5.63 to -0.61, P = 0.01) and temporal quadrant (WMD = -4.63, 95% CI: -7.20 to -2.06, P = 0.0004) were all significant between the two groups.

CONCLUSION

In view of these results and the noninvasive nature of OCT technology, we surmise that OCT could be a useful tool for evaluating the progression of the Parkinson disease.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01928212.

摘要

背景

帕金森病(PD)是一种神经退行性疾病,导致多巴胺能神经元选择性丧失,主要发生在大脑的基底神经节。许多研究分析了光学相干断层扫描(OCT)检测 PD 患者视网膜神经纤维层(RNFL)厚度异常和变化的能力,但结果并不总是一致。因此,我们进行了一项荟萃分析,以评估 OCT 测量的 PD 患者的 RNFL 厚度。

方法和发现

通过电子搜索 Cochrane 对照试验注册中心、PUBMED 和 EMBASE 选择病例对照研究。对于连续结果,我们计算了加权均数差(WMD)和 95%置信区间(CI)。统计分析使用 RevMan 5.0 软件进行。本荟萃分析共纳入 13 项病例对照研究,包含 PD 患者 644 只眼和健康对照者 604 只眼。研究结果表明,PD 患者的平均 RNFL 厚度与健康对照者相比显著降低(WMD=-5.76,95%CI:-8.99 至-2.53,P=0.0005)。此外,上象限(WMD=-4.44,95%CI:-6.93 至-1.94,P=0.0005)、下象限(WMD=-7.56,95%CI:-11.33 至-3.78,P<0.0001)、鼻侧象限(WMD=-3.12,95%CI:-5.63 至-0.61,P=0.01)和颞侧象限(WMD=-4.63,95%CI:-7.20 至-2.06,P=0.0004)的 RNFL 厚度差异均有统计学意义。

结论

鉴于这些结果和 OCT 技术的非侵入性,我们推测 OCT 可能是评估帕金森病进展的有用工具。

试验注册

ClinicalTrials.gov NCT01928212。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaf6/3897496/6e1610837818/pone.0085718.g001.jpg

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