Gharbiya Magda, Trebbastoni Alessandro, Parisi Francesco, Manganiello Silvia, Cruciani Filippo, D'Antonio Fabrizia, De Vico Umberto, Imbriano Letizia, Campanelli Alessandra, De Lena Carlo
Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.
Department of Neurology and Psychiatry, Sapienza University, Umberto I Hospital, Rome, Italy.
J Alzheimers Dis. 2014;40(4):907-17. doi: 10.3233/JAD-132039.
The involvement of retina and its vasculature has been recently described in Alzheimer's disease (AD). However, none of the previous works have yet investigated the choroid in vivo.
Spectral domain optical coherence tomography (SD-OCT) and enhanced depth imaging (EDI) technique is non-invasively used to assess choroidal thickness in patients with AD and to determine whether the peripapillary retinal nerve fiber layer (RNFL) and central retinal thickness are reduced compared to normal subjects.
Forty-two eyes of 21 patients (mean age, 73.1 ± 6.9 years) with a diagnosis of mild to moderate AD and 42 eyes of 21 age-matched control subjects (mean age, 70.3 ± 7.3 years) were included in this prospective, cross-sectional study. All the subjects underwent neuropsychological (MMSE, ADAS-Cog, and CDR) and ophthalmological evaluation. The SD-OCT images of the choroid were obtained by EDI modality. Choroidal thickness was assessed by manual measurement. The following parameters, measured automatically by the OCT software, were also analyzed for each eye: 1-mm central subfield (CSF) retinal thickness, peripapillary RNFL thickness.
Choroidal thickness was significantly thinner in AD than in control eyes (p < 0.05). No difference in CSF retinal thickness was found between groups (p > 0.05). Mean peripapillary RNFL thickness in all four quadrants was similar between groups (p > 0.05). OCT measurements were not correlated with any of the tested psychometric parameters (p > 0.05).
Compared with healthy subjects, patients with AD showed a significant reduction in choroidal thickness. Choroidal thinning may represent an adjunctive biomarker for the diagnosis and follow-up of this disease.
近期研究表明视网膜及其血管系统与阿尔茨海默病（AD）有关。然而，此前尚无研究在活体中对脉络膜进行过研究。
采用光谱域光学相干断层扫描（SD-OCT）和增强深度成像（EDI）技术，对AD患者的脉络膜厚度进行无创评估，并确定与正常受试者相比，AD患者的视乳头周围视网膜神经纤维层（RNFL）和视网膜中央厚度是否减小。
本前瞻性横断面研究纳入了21例诊断为轻度至中度AD患者的42只眼（平均年龄73.1±6.9岁）和21例年龄匹配的对照受试者的42只眼（平均年龄70.3±7.3岁）。所有受试者均接受了神经心理学（MMSE、ADAS-Cog和CDR）和眼科评估。通过EDI模式获取脉络膜的SD-OCT图像。通过手动测量评估脉络膜厚度。还对每只眼睛自动由OCT软件测量的以下参数进行了分析：1毫米中央子区域（CSF）视网膜厚度、视乳头周围RNFL厚度。
AD患者的脉络膜厚度显著低于对照眼（p<0.05）。两组间CSF视网膜厚度无差异（p>0.05）。两组间所有四个象限的平均视乳头周围RNFL厚度相似（p>0.05）。OCT测量值与任何测试的心理测量参数均无相关性（p>0.05）。
与健康受试者相比，AD患者的脉络膜厚度显著降低。脉络膜变薄可能是该疾病诊断和随访的辅助生物标志物。
