Wu Shirley Z, Masurkar Arjun V, Balcer Laura J
Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States.
Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, United States.
Front Aging Neurosci. 2020 Sep 11;12:572337. doi: 10.3389/fnagi.2020.572337. eCollection 2020.
Vision, which requires extensive neural involvement, is often impaired in Alzheimer's disease (AD). Over the last few decades, accumulating evidence has shown that various visual functions and structures are compromised in Alzheimer's dementia and when measured can detect those with dementia from those with normal aging. These visual changes involve both the afferent and efferent parts of the visual system, which correspond to the sensory and eye movement aspects of vision, respectively. There are fewer, but a growing number of studies, that focus on the detection of predementia stages. Visual biomarkers that detect these stages are paramount in the development of successful disease-modifying therapies by identifying appropriate research participants and in identifying those who would receive future therapies. This review provides a summary and update on common afferent and efferent visual markers of AD with a focus on mild cognitive impairment (MCI) and preclinical disease detection. We further propose future directions in this area. Given the ease of performing visual tests, the accessibility of the eye, and advances in ocular technology, visual measures have the potential to be effective, practical, and non-invasive biomarkers of AD.
视觉需要广泛的神经参与，在阿尔茨海默病（AD）中常常受损。在过去几十年里，越来越多的证据表明，阿尔茨海默病性痴呆患者的各种视觉功能和结构都受到了损害，通过测量这些指标可以区分痴呆患者和正常衰老者。这些视觉变化涉及视觉系统的传入和传出部分，分别对应视觉的感觉和眼动方面。虽然关注痴呆前期阶段检测的研究较少，但数量在不断增加。通过识别合适的研究参与者以及确定未来接受治疗的人群，能够检测这些阶段的视觉生物标志物对于成功开发疾病修饰疗法至关重要。本综述总结并更新了AD常见的传入和传出视觉标志物，重点关注轻度认知障碍（MCI）和临床前疾病检测。我们还提出了该领域未来的发展方向。鉴于视觉测试操作简便、眼部易于检查以及眼科技术的进步，视觉测量有可能成为有效的、实用的和非侵入性的AD生物标志物。
