Department of Ophthalmology (HJ, YW, YS, GG, FZ, EAV, BLL, JW), Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida; Department of Neurology (HJ, CBW, XS, TR), Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida; State Key Laboratory of Ophthalmology (YW), Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, Guangdong, China; and BioStatistics Center (EAV), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
J Neuroophthalmol. 2018 Sep;38(3):292-298. doi: 10.1097/WNO.0000000000000580.
The goal of the present study was to analyze the macular microvacular network in mild cognitive impirment (MCI) and Alzheimer disease (AD).
Twelve patients with AD and 19 patients with MCI were recruited together with 21 cognitively normal controls with a similar range of ages. Optical coherence tomography angiography was used to image the retinal microvascular network at the macular region, including retinal vascular network (RVN), superficial vascular plexus (SVP), and deep vascular plexus (DVP). Fractal analysis (box counting, Dbox) representing the microvascular density was performed in different annular zones and quadrantal sectors. The macular ganglion cell-inner plexiform layer (GC-IPL) thickness was measured using Zeiss OCT. The relationship between the retinal microvasculature and clinical manifestations was analyzed.
Patients with AD had lower densities of RVN, SVP, and DVP in the annulus, from 0.6 to 2.5 mm in diameter (P < 0.05) in comparison with controls. Patients with MCI had lower density of DVP in the superior nasal quadrant (P < 0.05) than that of the controls. There were no significant differences of GC-IPL thickness among groups (P > 0.05). There was a trend of vascular density loss from control to MCI then AD (P < 0.05). Retinal microvascular density of DVP was correlated with GC-IPL thickness (P < 0.05) in patients with AD, but not in patients with MCI and controls.
Patients with AD had less density of retinal microvascular networks than controls. Our findings suggest the presence of retinal microvascular dysfunction in AD.
本研究旨在分析轻度认知障碍（MCI）和阿尔茨海默病（AD）患者的黄斑微血管网络。
共招募了 12 例 AD 患者、19 例 MCI 患者和 21 例年龄相匹配的认知正常对照者。应用光学相干断层扫描血管造影术（OCTA）对黄斑区视网膜微血管网络（RVN、SVP 和 DVP）进行成像。在不同环形区和象限区进行分形分析（盒计数，Dbox）以表示微血管密度。使用 Zeiss OCT 测量黄斑神经节细胞-内丛状层（GC-IPL）厚度。分析视网膜微血管与临床表现之间的关系。
AD 患者的 RVN、SVP 和 DVP 密度在 0.6 至 2.5mm 直径的环区均低于对照组（P<0.05）。MCI 患者的上鼻象限 DVP 密度低于对照组（P<0.05）。三组间 GC-IPL 厚度无显著差异（P>0.05）。血管密度从对照组到 MCI 再到 AD 呈下降趋势（P<0.05）。AD 患者的 DVP 视网膜微血管密度与 GC-IPL 厚度呈正相关（P<0.05），而 MCI 患者和对照组无相关性。
AD 患者的视网膜微血管网络密度低于对照组。我们的研究结果表明 AD 存在视网膜微血管功能障碍。
