Mahajan Deepti, Votruba Marcela
School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK.
University Hospital of Wales, Cardiff, UK.
Acta Ophthalmol. 2017 Dec;95(8):768-777. doi: 10.1111/aos.13472. Epub 2017 Jun 9.
Alzheimer's disease (AD) is a neurodegenerative disease and the most common cause of senile dementia. It impairs the quality of life of a person and their family, posing a serious economic and social threat in developed countries. The fact that the diagnosis can only be definitively made post-mortem, or when the disease is fairly advanced, presents a serious problem if novel therapeutic interventions are to be devised and used early in the course of the disease. There is therefore a pressing need for more sensitive and specific diagnostic tests with which we can detect AD in the preclinical stage. The tau proteins and beta-amyloid proteins start to accumulate 20 years before the symptoms begin to manifest. Detecting them in the preclinical stage would be a potential breakthrough in the management of AD. A high degree of clinical suspicion is needed to correlate problems in cognition with the changes in the eye, particularly the retina, pupil and ocular movements, so that the disease can be detected early and managed in the prodromal phase. In this systematic review, we ask the question whether the retina can be used to make a specific and early diagnosis of AD.
阿尔茨海默病（AD）是一种神经退行性疾病，也是导致老年痴呆最常见的病因。它会损害患者及其家人的生活质量，在发达国家构成严重的经济和社会威胁。如果要在疾病早期设计并采用新的治疗干预措施，那么仅能在尸检时或疾病相当严重时才能做出明确诊断这一事实就会带来严重问题。因此，迫切需要更灵敏、特异的诊断测试，以便我们能够在临床前期检测出AD。在症状开始出现的20年前，tau蛋白和β-淀粉样蛋白就开始积累。在临床前期检测到它们将是AD治疗方面的一个潜在突破。需要高度的临床怀疑来将认知问题与眼部变化（尤其是视网膜、瞳孔和眼球运动的变化）联系起来，以便在疾病前驱期早期检测并治疗该疾病。在本系统评价中，我们提出视网膜是否可用于AD的特异性早期诊断这一问题。
