Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
School of Medicine, Tongji University, Shanghai, China.
Acta Ophthalmol. 2020 Sep;98(6):e781-e787. doi: 10.1111/aos.14381. Epub 2020 Mar 9.
To explore regional variation of the macular microvasculature in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), also to detect the association between retinal macular microvascular parameters and the progress of preclinical AD.
Prospective study of healthy controls, patients with MCI and patients with AD by using Optical coherence tomography angiography (OCT-A). We quantified foveal avascular zone (FAZ) areas, densities of the superficial retinal capillary plexuses (SRCP) and deep retinal capillary plexuses (DRCP). The SRCP and DRCP were divided into inner (3 mm) and external (6 mm) annular rings, each containing four quadrants (SI, II, TI, NI, SE, IE, TE and NE). The data were analysed statistically by using SPSS 22 software.
Totally, 60 subjects including 21 HC (33 eyes), 21 patients with MCI (32 eyes) and 18 AD patients (28 eyes) were recruited. The microvascular densities of DRCP at all quadrants of the parafovea and perifovea were significantly lower in AD patients compared to HC group (p < 0.05). Compared to the HCs, MCI patients showed significant microvascular loss in most sectors of the parafovea and the SE sector of the DRCP (p < 0.05), but not in the parafovea (p = 0.829) or perifovea (p = 0.824) of the SRCP. No significant difference was found in microvascular density of SRCP among the groups, except at SI between the AD and HC groups (p = 0.048).
Our findings demonstrated the macular microvascular attenuation in MCI and AD patients. Both AD and MCI patients showed retinal microvascular density loss, which is more significant in the deep retinal capillary plexuses. Optical coherence tomography angiography (OCT-A) can be used to identify early microvascular abnormalities in AD and MCI. Quantified microvascular density in the DRCP might serve as potential biomarkers of early sign of AD then contribute to forestall the progression of preclinical AD.
探讨轻度认知障碍（MCI）和阿尔茨海默病（AD）患者黄斑区微血管的区域性变化，并检测视网膜黄斑区微血管参数与 AD 临床前进展的相关性。
采用光学相干断层扫描血管造影（OCT-A）对健康对照组、MCI 患者和 AD 患者进行前瞻性研究。我们量化了黄斑无血管区（FAZ）面积、浅层视网膜毛细血管丛（SRCP）和深层视网膜毛细血管丛（DRCP）密度。SRCP 和 DRCP 分为内（3mm）和外（6mm）环形环，每个环包含四个象限（SI、II、TI、NI、SE、IE、TE 和 NE）。数据使用 SPSS 22 软件进行统计分析。
共纳入 60 名受试者，包括 21 名健康对照者（33 只眼）、21 名 MCI 患者（32 只眼）和 18 名 AD 患者（28 只眼）。与 HC 组相比，AD 患者的旁中心凹和中心凹周围的 DRCP 各象限的微血管密度均显著降低（p<0.05）。与 HCs 相比，MCI 患者在旁中心凹和 DRCP 的 SE 象限的大多数区域表现出明显的微血管丢失（p<0.05），但旁中心凹（p=0.829）或 SRCP 的中心凹周围（p=0.824）无明显差异。除 AD 组与 HC 组的 SI 象限外（p=0.048），各组 SRCP 的微血管密度无显著差异。
本研究发现 MCI 和 AD 患者存在黄斑区微血管萎缩。AD 和 MCI 患者均出现视网膜微血管密度下降，在深层视网膜毛细血管丛更为明显。光学相干断层扫描血管造影（OCT-A）可用于识别 AD 和 MCI 的早期微血管异常。定量分析 DRCP 的微血管密度可能成为 AD 早期征象的潜在生物标志物，有助于阻止 AD 临床前进展。
