Salobrar-Garcia Elena, Méndez-Hernández Carmen, Hoz Rosa de, Ramírez Ana I, López-Cuenca Inés, Fernández-Albarral José A, Rojas Pilar, Wang Surina, García-Feijoo Julián, Gil Pedro, Salazar Juan J, Ramírez José M
Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain.
Facultad de Óptica y Optometría, Departamento de Inmunología, Oftalmología y ORL, UCM, 28037 Madrid, Spain.
J Pers Med. 2020 Nov 15;10(4):231. doi: 10.3390/jpm10040231.
In Alzheimer's disease (AD), vascular changes could be caused by amyloid beta (Aβ) aggregates replacing the contractile smooth musculature of the arteriole walls. These changes happen in the brain vascular network, but also in the eye, and are related to decreased vascular density and low blood flow. In patients with Alzheimer's disease, thinning of the choroid and the retina has been shown. The aim of this prospective study was to assess the retinal and choroidal vascular systems, analyzing the choroidal thickness with optical coherence tomography (OCT), the foveal avascular zone (FAZ) with OCT-angiography (OCTA), and the optic nerve head (ONH) hemoglobin with the Laguna ONhE program, to evaluate which of the two ocular vascular systems shows earlier changes in mild AD patients. These patients, compared to controls, showed a significantly thinner choroid at all the analyzed points, with the exception of the temporal macula (at 1000 and 1500 µm from the fovea). On the other hand, the FAZ and ONH hemoglobin did not show significant differences. In conclusion, a thinner choroid was the main ocular vascular change observed in mild AD patients, while the retinal vessels were not yet affected. Therefore, choroidal thickness could be used an early biomarker in AD.
在阿尔茨海默病（AD）中，血管变化可能是由淀粉样β蛋白（Aβ）聚集体取代小动脉壁的收缩性平滑肌组织引起的。这些变化不仅发生在脑血管网络中，也发生在眼睛中，并且与血管密度降低和血流减少有关。在阿尔茨海默病患者中，已显示脉络膜和视网膜变薄。这项前瞻性研究的目的是评估视网膜和脉络膜血管系统，通过光学相干断层扫描（OCT）分析脉络膜厚度，通过OCT血管造影（OCTA）分析黄斑无血管区（FAZ），并使用Laguna ONhE程序分析视神经乳头（ONH）血红蛋白，以评估在轻度AD患者中两个眼血管系统中哪个显示出更早的变化。与对照组相比，这些患者在所有分析点的脉络膜均明显变薄，但颞侧黄斑（距黄斑中心凹1000和1500 µm处）除外。另一方面，FAZ和ONH血红蛋白没有显示出显著差异。总之，脉络膜变薄是在轻度AD患者中观察到的主要眼血管变化，而视网膜血管尚未受到影响。因此，脉络膜厚度可作为AD的早期生物标志物。
