Oktem Ece Ozdemir, Derle Eda, Kibaroglu Seda, Oktem Caglar, Akkoyun Imren, Can Ufuk
Department of Neurology, Ahi Evran University Education and Research Hospital, Kervansaray Mah. 2019. sk, No:1 Merkez, Kırsehir, Turkey,
Neurol Sci. 2015 Jul;36(7):1141-6. doi: 10.1007/s10072-014-2055-3. Epub 2015 Jan 10.
The goal of the present study is to investigate the relationship between the degree of cognitive impairment and retinal nerve fiber layer (RNFL) thickness which is measured by the optical coherence tomography (OCT). Thirty-five patients with Alzheimer's disease (AD), 35 patients with mild cognitive impairment (MCI), and 35 healthy volunteers, between the ages of 60-87, who were examined in the neurology outpatient clinic among 2012-2013 were prospectively involved in our study. Mini mental state examination (MMSE) test, montreal cognitive assessment (MOCA), and also neuropsychological test batteries were used for the neurocognitive evaluation. RNFL thickness was measured by the OCT technique and the differences among groups were studied. The relationship between RNFL thickness and MMSE scores with demographic characteristics was investigated. RNFL thickness was significantly lower in AD and MCI groups compared with the control group (p < 0.01). No significant differences of RNFL were found between the MCI and the AD groups (p > 0.05). Significant correlation was found between MMSE scores and the RNFL values (p < 0.05). Significant thinning in RNFL along with age was detected (p < 0.05). In our study, it is thought that retinal nerve fiber degeneration and central nervous system degeneration may be concurrent according to the thinning of RNFL measured by OCT in AD and MCI groups. RNFL measurement may also be useful for early diagnosis and evaluation of the disease progression. Further studies are needed to optimize the utility of this method as an ocular biomarker in AD.
本研究的目的是探讨通过光学相干断层扫描（OCT）测量的认知障碍程度与视网膜神经纤维层（RNFL）厚度之间的关系。2012年至2013年期间在神经科门诊接受检查的35例阿尔茨海默病（AD）患者、35例轻度认知障碍（MCI）患者和35例年龄在60至87岁之间的健康志愿者被前瞻性纳入我们的研究。使用简易精神状态检查表（MMSE）测试、蒙特利尔认知评估（MOCA）以及神经心理测试组合进行神经认知评估。通过OCT技术测量RNFL厚度，并研究组间差异。研究了RNFL厚度与MMSE评分以及人口统计学特征之间的关系。与对照组相比，AD组和MCI组的RNFL厚度显著降低（p<0.01）。MCI组和AD组之间未发现RNFL有显著差异（p>0.05）。发现MMSE评分与RNFL值之间存在显著相关性（p<0.05）。检测到RNFL随年龄显著变薄（p<0.05）。在我们的研究中，根据AD组和MCI组中通过OCT测量的RNFL变薄情况，认为视网膜神经纤维变性和中枢神经系统变性可能同时发生。RNFL测量也可能有助于疾病的早期诊断和病情进展评估。需要进一步研究以优化这种方法作为AD眼部生物标志物的效用。
