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光学相干断层扫描的视网膜单层分析显示,亨廷顿舞蹈症患者的视网膜内层变薄,这可能是一种生物标志物。

Retinal single-layer analysis with optical coherence tomography shows inner retinal layer thinning in Huntington's disease as a potential biomarker.

作者信息

Gulmez Sevim Duygu, Unlu Metin, Gultekin Murat, Karaca Cagatay

机构信息

Department of Ophthalmology, Faculty of Medicine, Erciyes University, 38039, Kayseri, Turkey.

Department of Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.

出版信息

Int Ophthalmol. 2019 Mar;39(3):611-621. doi: 10.1007/s10792-018-0857-7. Epub 2018 Feb 12.

Abstract

PURPOSE

There have been ongoing clinical trials of therapeutic agents in Huntington's disease (HD) which requires development of reliable biomarkers of disease progression. There have been studies in the literature with conflicting results on the involvement of retina in HD, and up to date there is not a study evaluating the single retinal layers in HD. We aimed to evaluate the specific retinal changes in HD and their usability as potential disease progression markers.

METHODS

This cross-sectional study used spectral-domain optical coherence tomography with automatic segmentation to measure peripapillary retinal nerve fiber layer (pRNFL) thickness and the thickness and volume of retinal layers in foveal scans of 15 patients with HD and 15 age- and sex-matched controls. Genetic testing results, disease duration, HD disease burden scores and Unified HD Rating Scales motor scores were acquired for the patients.

RESULTS

Temporal pRNFL, macular RNFL (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer and outer plexiform layer thicknesses and IPL, retinal pigment epithelium and outer macular volume were found lower in HD compared to controls, while outer nuclear layer and outer retinal layer thickness were increased (p < 0.05). We found significant correlations between inner retinal layer thicknesses, most significantly with mRNFL and GCL and disease progression markers.

CONCLUSION

The outcomes of this study points out that retinal layers, most significantly mRNFL and GCL, are strongly correlated with the disease progression in HD and could serve as useful biomarkers for disease progression.

摘要

目的

亨廷顿舞蹈病(HD)的治疗药物临床试验一直在进行,这需要开发可靠的疾病进展生物标志物。文献中有一些关于视网膜在HD中作用的研究,结果相互矛盾,而且到目前为止,尚无研究评估HD患者单个视网膜层的情况。我们旨在评估HD患者视网膜的特定变化及其作为潜在疾病进展标志物的可用性。

方法

这项横断面研究使用具有自动分割功能的光谱域光学相干断层扫描技术,测量了15例HD患者和15例年龄及性别匹配的对照者的黄斑中心凹扫描图像中视乳头周围视网膜神经纤维层(pRNFL)厚度、视网膜各层的厚度和体积。获取了患者的基因检测结果、疾病持续时间、HD疾病负担评分和统一HD评定量表运动评分。

结果

与对照组相比,HD患者的颞侧pRNFL、黄斑区视网膜神经纤维层(mRNFL)、神经节细胞层(GCL)、内网状层(IPL)、内核层和外网状层厚度以及IPL、视网膜色素上皮和黄斑区外层体积均降低,而外核层和视网膜外层厚度增加(p<0.05)。我们发现视网膜内层厚度之间存在显著相关性,其中与mRNFL和GCL以及疾病进展标志物的相关性最为显著。

结论

本研究结果指出,视网膜各层,尤其是mRNFL和GCL,与HD疾病进展密切相关,可作为疾病进展的有用生物标志物。

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