帕金森病中视网膜神经纤维层变薄的具体模式：系统评价和荟萃分析。
The specific pattern of retinal nerve fiber layer thinning in Parkinson's disease: a systematic review and meta-analysis.
机构信息
Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjingbei Street, Heping District, Shenyang, 110001, People's Republic of China.
Department of Neurology, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China.
出版信息
J Neurol. 2021 Nov;268(11):4023-4032. doi: 10.1007/s00415-020-10094-0. Epub 2020 Jul 20.
BACKGROUND AND PURPOSE
The peripapillar nerve fiber layer (pRNFL) thinning in different retinal quadrants or sectors remains controversy. We conducted a systematic review and meta-analysis on the pattern of pRNFL thinning in Parkinson's disease (PD) patients to provide a biomarker for PD differential diagnosis.
METHODS
We systematically searched PubMed and EMBASE to identify studies comparing pRNFL thickness in PD patients and health controls using spectral domain-optical coherence tomography from inception to April 25, 2020. Random effects mode was used to pool mean difference (μm) of the average thickness of pRNFL and the thickness of pRNFL in four quadrants (superior, inferior, nasal and temporal) and in the subdivisions of superior (superonasal and superotemporal sectors) and inferior quadrants (inferonasal and inferotemporal sectors) between PD patients and health controls.
RESULTS
We included 32 studies (33 sets of data) enrolling 2126 PD eyes and 2318 health control eyes. Between the eyes of PD patients and that of health controls, the pooled mean difference (μm) of average pRNFL was - 4.85 (95% CI [- 6.12, - 3.58]); the pooled mean difference (μm) of four quadrants were - 2.30 (95% CI [- 3.32, - 1.28], nasal), - 2.74 (95% CI [- 4.34, - 1.14], temporal), - 5.24 (95% CI [- 7.04, - 3.43], superior) and - 7.29 (95% CI [- 9.23, - 5.34], inferior); those of four sectors were - 5.16 (95% CI [- 7.70, - 2.62], superotemporal), - 3.55 (95% CI [- 5.87, - 1.23], superonasal), - 9.19 (95% [- 13.27, - 5.12], inferotemporal) and - 7.62 (95% CI [- 11.84, - 3.40], inferonasal).
CONCLUSION
In PD patients, pRNFL thinning followed a specific pattern with inferotemporal thinning most and nasal quadrant thinning least.
背景与目的
不同视网膜象限或区域的神经纤维层（pRNFL）变薄在帕金森病（PD）患者中仍然存在争议。我们进行了一项系统综述和荟萃分析，以探讨 PD 患者 pRNFL 变薄的模式，为 PD 的鉴别诊断提供生物标志物。
方法
我们系统地检索了 PubMed 和 EMBASE，以确定从成立到 2020 年 4 月 25 日比较 PD 患者和健康对照者使用谱域光学相干断层扫描的 pRNFL 厚度的研究。使用随机效应模型来汇总 pRNFL 平均厚度（μm）的均值差和 pRNFL 厚度在四个象限（上方、下方、鼻侧和颞侧）和 pRNFL 在上方象限（上方鼻侧和上方颞侧扇区）和下方象限（下方鼻侧和下方颞侧扇区）的厚度的均值差（μm）在 PD 患者和健康对照者之间。
结果
我们纳入了 32 项研究（33 组数据），共纳入 2126 只 PD 眼和 2318 只健康对照眼。与健康对照组相比，PD 患者的平均 pRNFL 平均差值（μm）为-4.85（95%可信区间[-6.12，-3.58]）；四个象限的平均差值（μm）分别为-2.30（95%可信区间[-3.32，-1.28]，鼻侧）、-2.74（95%可信区间[-4.34，-1.14]，颞侧）、-5.24（95%可信区间[-7.04，-3.43]，上方）和-7.29（95%可信区间[-9.23，-5.34]，下方）；四个扇区的平均差值（μm）分别为-5.16（95%可信区间[-7.70，-2.62]，上方颞侧）、-3.55（95%可信区间[-5.87，-1.23]，上方鼻侧）、-9.19（95%可信区间[-13.27，-5.12]，下方颞侧）和-7.62（95%可信区间[-11.84，-3.40]，下方鼻侧）。
结论
在 PD 患者中，pRNFL 变薄呈现出特定的模式，即颞下侧最薄，鼻侧最薄。
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