Turski G N, Schmitz-Valckenberg S, Holz F G, Finger R P
Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
Ophthalmologe. 2017 Feb;114(2):114-119. doi: 10.1007/s00347-016-0412-8.
Due to current demographic trends, the prevalence of mild cognitive impairment and dementia is expected to increase considerably. For potential new therapies it is important to identify patients at risk as early as possible. Currently, there is no population-based screening. Therefore, identification of biomarkers that will help screen the population at risk is urgently needed. Thus, a literature review on retinal pathology in neurodegenerative diseases was performed.
PubMed was searched for studies published up to August 2016 using the following keywords: "mild cognitive impairment", "dementia", "eye", "ocular biomarkers", "OCT" and "OCT angiography". Relevant publications were selected and summarized qualitatively.
Multiple studies using noninvasive in vivo optical coherence tomography (OCT) imaging showed nonspecific retinal pathological changes in patients with neurodegenerative diseases such as mild cognitive impairment, Alzheimer's and Parkinson's disease. Pathological changes in macular volume, optic nerve fiber layer thickness and the ganglion cell complex were observed. However, based on available evidence, no ocular biomarkers for neurodegeneration which could be integrated in routine clinical diagnostics have been identified.
The potential use of OCT in the early diagnostic workup and monitoring of progression of neurodegenerative diseases needs to be further explored in longitudinal studies with large cohorts.
由于当前的人口趋势,轻度认知障碍和痴呆症的患病率预计将大幅上升。对于潜在的新疗法而言,尽早识别有风险的患者非常重要。目前,尚无基于人群的筛查方法。因此,迫切需要识别有助于筛查高危人群的生物标志物。因此,开展了一项关于神经退行性疾病视网膜病理学的文献综述。
在PubMed上检索截至2016年8月发表的研究,使用以下关键词:“轻度认知障碍”、“痴呆症”、“眼睛”、“眼部生物标志物”、“光学相干断层扫描(OCT)”和“OCT血管造影”。选择相关出版物并进行定性总结。
多项使用无创体内光学相干断层扫描(OCT)成像的研究显示,神经退行性疾病患者,如轻度认知障碍、阿尔茨海默病和帕金森病患者,存在非特异性视网膜病理变化。观察到黄斑体积、视神经纤维层厚度和神经节细胞复合体的病理变化。然而,根据现有证据,尚未发现可用于常规临床诊断的神经退行性变眼部生物标志物。
在大规模队列的纵向研究中,需要进一步探索OCT在神经退行性疾病早期诊断检查和病情进展监测中的潜在应用。