Alber Jessica, Arthur Edmund, Goldfarb Danielle, Drake Jonathan, Boxerman Jerrold L, Silver Brian, Ott Brian R, Johnson Lenworth N, Snyder Peter J
Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, USA; George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, USA; Memory & Aging Program, Butler Hospital, Providence, RI, USA.
Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, USA; George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, USA; Memory & Aging Program, Butler Hospital, Providence, RI, USA.
J Neurol Sci. 2021 Apr 15;423:117383. doi: 10.1016/j.jns.2021.117383. Epub 2021 Mar 1.
The standard in vivo diagnostic imaging technique for cerebral amyloid angiopathy (CAA) is costly and thereby of limited utility for point-of-care diagnosis and monitoring of treatment efficacy. Recent recognition that retinal changes may reflect cerebral changes in neurodegenerative disease provides an ideal opportunity for development of accessible and cost-effective biomarkers for point-of-care use in the detection and monitoring of CAA. In this pilot study, we examined structural and angiographic retinal changes in CAA patients relative to a control group, and compared retinal and cerebral pathology in a group of CAA patients.
We used spectral domain optical coherence tomography (SD-OCT) to image the retina and compared retinal microbleeds to both cerebral microbleeds and white matter hyperintensities (WMH) in CAA patients, as seen on MRI. We compared retinal angiographic changes, along with structural retinal neuronal layer changes in CAA patients and cognitively normal older adults, and examined the relationship between retinal and cerebral microbleeds and cognition in CAA patients.
We found a trend level correlation between retinal and cerebral microbleeds in CAA patients. Moreover, we found a significant correlation between retinal microbleeds and episodic memory performance in CAA patients. There were no significant group differences between CAA patients and cognitively normal older adults on retinal angiographic or structural measurements.
Retinal microbleeds may reflect degree of cerebral microbleed burden in CAA. This picture was complicated by systolic hypertension in the CAA group, which is a confounding factor for the interpretation of these data. Our results stimulate motivation for pursuit of a more comprehensive prospective study to determine the feasibility of retinal biomarkers in CAA.
脑淀粉样血管病（CAA）的标准体内诊断成像技术成本高昂，因此在即时诊断和治疗效果监测方面的应用有限。最近认识到视网膜变化可能反映神经退行性疾病中的脑部变化，这为开发用于CAA检测和监测的即时可用且具有成本效益的生物标志物提供了理想机会。在这项初步研究中，我们检查了CAA患者相对于对照组的视网膜结构和血管造影变化，并比较了一组CAA患者的视网膜和脑部病理情况。
我们使用光谱域光学相干断层扫描（SD - OCT）对视网膜进行成像，并将CAA患者视网膜微出血与MRI上显示的脑部微出血和白质高信号（WMH）进行比较。我们比较了CAA患者与认知正常的老年人的视网膜血管造影变化以及视网膜神经元层结构变化，并研究了CAA患者视网膜和脑部微出血与认知之间的关系。
我们发现CAA患者视网膜和脑部微出血之间存在趋势水平的相关性。此外，我们发现CAA患者视网膜微出血与情景记忆表现之间存在显著相关性。在视网膜血管造影或结构测量方面，CAA患者与认知正常的老年人之间没有显著的组间差异。
视网膜微出血可能反映CAA中脑微出血负担的程度。CAA组的收缩期高血压使情况变得复杂，这是解释这些数据的一个混杂因素。我们的结果激发了开展更全面前瞻性研究的动力，以确定视网膜生物标志物在CAA中的可行性。
