iMIND Research Group, Duke University School of Medicine, Durham, North Carolina; Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Ophthalmol Retina. 2022 Jul;6(7):607-619. doi: 10.1016/j.oret.2022.03.001. Epub 2022 Mar 11.
To assess the baseline differences and longitudinal rate of change in retinal and choroidal imaging parameters between apolipoprotein ε4 (APOE ε4) carriers and noncarriers with normal cognition.
Prospective study.
Four hundred thirteen eyes of 218 individuals with normal cognition aged ≥ 55 years with known APOE status (98 APOE ε4 carriers and 120 noncarriers). The exclusion criteria included diabetes mellitus, uncontrolled hypertension, glaucoma, and vitreoretinal or neurodegenerative disease.
OCT and OCT angiography (OCTA) were performed at baseline and 2 years (Zeiss Cirrus HD-OCT 5000 with AngioPlex; Zeiss Meditec). The groups were compared using sex- and age-adjusted generalized estimating equations.
OCT parameters: retinal nerve fiber layer thickness, macular ganglion cell-inner plexiform layer thickness, central subfield thickness (CST), and choroidal vascularity index. OCT angiography parameters: foveal avascular zone area, perfusion density (PD), vessel density, peripapillary capillary PD (CPD), and capillary flux index (CFI). The rate of change per year was calculated.
At the baseline, the APOE ε4 carriers had lower CST (P = 0.018), PD in the 6-mm ETDRS circle (P = 0.049), and temporal CFI (P = 0.047). Seventy-one APOE ε4 carriers and 78 noncarriers returned at 2 years; at follow-up, the 6-mm ETDRS circle (P = 0.05) and outer ring (P = 0.049) showed lower PD in the APOE ε4 carriers, with no differences in the rates of change between the groups (all P > 0.05).
There was exploratory evidence of differences in the CST, PD, and peripapillary CFI between the APOE ε4 carriers and noncarriers with normal cognition. Larger and longer-term studies may help further elucidate the potential prognostic value of these findings.
评估认知正常的载脂蛋白 E4（APOE ε4）携带者与非携带者的视网膜和脉络膜影像学参数的基线差异和纵向变化率。
前瞻性研究。
218 名年龄≥55 岁认知正常的个体的 413 只眼，已知 APOE 状态（98 名 APOE ε4 携带者和 120 名非携带者）。排除标准包括糖尿病、未控制的高血压、青光眼以及玻璃体积血或神经退行性疾病。
在基线和 2 年时进行 OCT 和 OCT 血管造影（OCTA）检查（蔡司 Cirrus HD-OCT 5000 与 AngioPlex；蔡司 Meditec）。使用性别和年龄调整的广义估计方程比较两组。
OCT 参数：视网膜神经纤维层厚度、黄斑神经节细胞-内丛状层厚度、中央小凹区厚度（CST）和脉络膜血管指数。OCTA 参数：中心凹无血管区面积、灌注密度（PD）、血管密度、视盘周围毛细血管 PD（CPD）和毛细血管血流指数（CFI）。每年的变化率是计算得出的。
在基线时，APOE ε4 携带者的 CST 较低（P=0.018），6mm ETDRS 环的 PD 较低（P=0.049），颞侧 CFI 较低（P=0.047）。71 名 APOE ε4 携带者和 78 名非携带者在 2 年时返回；在随访时，APOE ε4 携带者的 6mm ETDRS 环（P=0.05）和外环（P=0.049）的 PD 较低，但两组之间的变化率无差异（均 P＞0.05）。
认知正常的载脂蛋白 E4 携带者与非携带者之间 CST、PD 和视盘周围 CFI 存在差异的初步证据。更大规模和长期的研究可能有助于进一步阐明这些发现的潜在预后价值。
