光学相干断层扫描（OCT）与OCT血管造影术相结合可提高帕金森病的诊断效能。
Combination of optical coherence tomography (OCT) and OCT angiography increases diagnostic efficacy of Parkinson's disease.
作者信息
Zou Jing, Liu Kangcheng, Li Fangling, Xu Yi, Shen Lu, Xu Huizhuo
机构信息
Eye Center of Xiangya Hospital, Central South University, Changsha, China.
Hunan Key Laboratory of Ophthalmology, Changsha, China.
出版信息
Quant Imaging Med Surg. 2020 Oct;10(10):1930-1939. doi: 10.21037/qims-20-460.
BACKGROUND
To assess the diagnostic efficacy of optical coherence tomography (OCT) and OCT angiography (OCTA) in Parkinson's disease (PD).
METHODS
OCT was used to obtain macular parameters and peripapillary retinal nerve fiber layer (RNFL) thickness. The macular superficial retinal vessel and foveal avascular zone (FAZ) were quantified with OCTA. The area under the receiver operating characteristic curve (AUC) indicated the diagnostic efficacy of the parameters.
RESULTS
Thirty-five eyes from 35 PD patients and 35 eyes from 35 age-matched healthy subjects who served as controls were evaluated. The mean RNFL thickness overall and the thicknesses of the other three quadrants were similar in PD patients compared with controls (P≥0.358). The RNFL thickness at the temporal quadrant, total macular volume (TMV), macular retinal thickness (MRT), and ganglion cell-inner plexiform layer complex (GCL-IPL) thickness were reduced in the eyes of PD patients (P≤0.046). There was no difference between the CMT of PD patients compared with control subjects (P=0.163). The vessel length density (VLD) in the central, inner and full regions; vessel perfusion density (VPD) in all regions; and the FAZ circularity index in PD patients were significantly lower than in controls (P≤0.049). The AUC of the VLD in PD in the central, inner and full regions were 0.712, 0.728, and 0.650, respectively; The VPD in the central, inner and full region were 0.711, 0.756, and 0.682, respectively. The mean RNFL thickness in the temporal quadrant, TMV and MRT revealed an AUC of 0.718, 0.693 and 0.699, respectively. The VPD in the outer region, FAZ circularity and GCL-IPL thickness did not have diagnostic ability in distinguishing PD from normal eyes (P≥0.05). The AUCs of a combination of the VLD in the inner region and TMV, the VLD in the inner region and MRT, the VPD in the inner region and TMV, and the VPD in the inner region and MRT, were 0.843, 0.849, 0.849, and 0.848, respectively (P≤0.001).
CONCLUSIONS
Decreased OCT and OCTA parameters were detected in the eyes of PD patients. Combined non-invasive measurements of OCT and OCTA had better diagnostic ability than either alone, and may provide an additional biomarker for PD progression.
背景
评估光学相干断层扫描（OCT）和OCT血管造影（OCTA）在帕金森病（PD）中的诊断效能。
方法
使用OCT获取黄斑参数和视乳头周围视网膜神经纤维层（RNFL）厚度。用OCTA对黄斑浅表视网膜血管和中心凹无血管区（FAZ）进行定量分析。受试者工作特征曲线（AUC）下的面积表明参数的诊断效能。
结果
对35例PD患者的35只眼和35例年龄匹配的健康受试者作为对照的35只眼进行了评估。与对照组相比，PD患者的平均RNFL总厚度以及其他三个象限的厚度相似（P≥0.358）。PD患者眼颞侧象限的RNFL厚度、黄斑总体积（TMV）、黄斑视网膜厚度（MRT）和神经节细胞-内丛状层复合体（GCL-IPL）厚度降低（P≤0.046）。PD患者与对照受试者的中央黄斑厚度（CMT）无差异（P = 0.163）。PD患者中央、内层和全层区域的血管长度密度（VLD）；所有区域的血管灌注密度（VPD）；以及FAZ圆度指数均显著低于对照组（P≤0.049）。PD患者中央、内层和全层区域VLD的AUC分别为0.712、0.728和0.650；中央、内层和全层区域VPD的AUC分别为0.711、0.756和0.682。颞侧象限的平均RNFL厚度、TMV和MRT的AUC分别为0.718、0.693和0.699。外层区域的VPD、FAZ圆度和GCL-IPL厚度在区分PD患者与正常眼方面没有诊断能力（P≥0.05）。内层区域VLD与TMV、内层区域VLD与MRT、内层区域VPD与TMV以及内层区域VPD与MRT组合的AUC分别为0.843、0.849、0.849和0.848（P≤0.001）。
结论
在PD患者眼中检测到OCT和OCTA参数降低。OCT和OCTA的联合非侵入性测量比单独测量具有更好的诊断能力，并且可能为PD进展提供额外的生物标志物。
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