Bulut Mehmet, Kurtuluş Fatma, Gözkaya Onursal, Erol Muhammet Kazım, Cengiz Ayşe, Akıdan Melih, Yaman Aylin
Department of Ophthalmology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Neurology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
Br J Ophthalmol. 2018 Feb;102(2):233-237. doi: 10.1136/bjophthalmol-2017-310476. Epub 2017 Jun 9.
BACKGROUND/AIMS: To identify the retinal vascular pathologies in patients with Alzheimer's type dementia (ATD) through optical coherence tomography angiography (OCTA) imaging.
Our study included 26 patients in the patient group, and age-matched and sex-matched 26 subjects in the control group. A detailed ophthalmological and neurological examination was performed for all subjects included in the study. The retinal, choroidal vascular structures and choroidal thickness (CT) of all subjects were analysed in a detailed way with a commercial spectral domain OCTA. Moreover, all participants underwent detailed neurological examination including Mini Mental State Examination (MMSE) test to evaluate cognitive function.
In the group of patients with ATD, the MMSE score was significantly lower than that of the control group (p<0.001). The retinal vascular density was significantly lower than that of the control group in all zones (p<0.05). Foveal avascular zone (FAZ) was significantly enlarged compared with the control group (p=0.001). CT was significantly lower in the group of patients with ATD (p<0.001). Outer retinal and choroidal flow rates were lower in the group of patients with ATD, while the difference was not significant (p>0.05). Furthermore, significant correlation was found between the MMSE and all vascular density parameters, CT parameter and FAZ tested with OCTA imaging (p<0.05).
In patients with ATD, retinal and choroidal vascular pathologies detected through OCTA imaging can be used as a new biomarker in the early diagnosis of the disease, follow-up of its progression and in investigating the efficacy of the drugs.
背景/目的：通过光学相干断层扫描血管造影（OCTA）成像来识别阿尔茨海默型痴呆（ATD）患者的视网膜血管病变。
我们的研究包括患者组中的26例患者，以及年龄和性别匹配的对照组中的26名受试者。对研究中纳入的所有受试者进行了详细的眼科和神经学检查。使用商用光谱域OCTA对所有受试者的视网膜、脉络膜血管结构和脉络膜厚度（CT）进行了详细分析。此外，所有参与者都接受了包括简易精神状态检查（MMSE）测试在内的详细神经学检查，以评估认知功能。
在ATD患者组中，MMSE评分显著低于对照组（p<0.001）。所有区域的视网膜血管密度均显著低于对照组（p<0.05）。与对照组相比，中心凹无血管区（FAZ）明显扩大（p=0.001）。ATD患者组的CT显著更低（p<0.001）。ATD患者组的视网膜外层和脉络膜血流速度较低，不过差异不显著（p>0.05）。此外，通过OCTA成像测试发现MMSE与所有血管密度参数、CT参数和FAZ之间存在显著相关性（p<0.05）。
在ATD患者中，通过OCTA成像检测到的视网膜和脉络膜血管病变可作为该疾病早期诊断、病情进展随访以及研究药物疗效的一种新的生物标志物。
