Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain.
Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
Sci Rep. 2022 Oct 8;12(1):16938. doi: 10.1038/s41598-022-21558-w.
Optical coherence tomography angiography (OCT-A) allows the detection of retinal vessel density (VD) loss, which is a reflection of brain vascular pathology. We aimed to investigate differences in macular VD in the superficial plexus in a large cohort of individuals cognitively unimpaired (CU), with mild cognitive impairment due to Alzheimer´s disease (MCI-AD), MCI due to cerebrovascular pathology (MCI-Va), probable Alzheimer´s disease dementia (ADD) and Vascular Dementia (VaD). Clinical, demographical, ophthalmological and OCT-A data from the Neuro-ophthalmology Research at Fundació ACE (NORFACE) project were analyzed. Differences of macular VD in four quadrants (superior, nasal, inferior and temporal) among the five diagnostic groups were assessed in a multivariate regression model, adjusted by age, sex, education, hypertension, diabetes mellitus, heart disease and stroke. The study cohort comprised 672 participants: 128 CU, 120 MCI-AD, 111 MCI-Va, 257 ADD and 56 VaD. Regression analysis showed a significantly higher VD in the temporal quadrant in MCI-AD compared to CU participants (49.05 ± 4.91 vs 47.27 ± 4.17, p = 0.02, d = 0.40), and a significantly lower VD in the inferior quadrant in MCI-Va compared to CU participants (48.70 ± 6.57 vs 51.27 ± 6.39, p = 0.02, d = 0.40). Individuals with heart disease presented significantly lower VD in the inferior quadrant than those without (p = 0.01). The interaction of sex and diagnosis had no effect in differentiating VD. Mini-Mental State Examination (MMSE) scores were not correlated to VD (all r < 0.16; p > 0.07). In conclusion, our study showed that the MCI-AD and MCI-Va groups had significant differences in macular VD in opposite directions in the temporal and inferior quadrants, respectively, compared to CU participants, suggesting that macular VD might be able to differentiate two pathogenic pathways (AD- and cerebrovascular-related) in early stages of cognitive decline.
光学相干断层扫描血管造影术（OCT-A）可检测视网膜血管密度（VD）损失，这反映了脑部血管病理学变化。我们旨在研究在一大群认知正常（CU）、阿尔茨海默病导致的轻度认知障碍（MCI-AD）、血管性认知障碍导致的轻度认知障碍（MCI-Va）、可能的阿尔茨海默病痴呆（ADD）和血管性痴呆（VaD）患者中，黄斑浅层丛的黄斑 VD 差异。对神经眼科研究基金会 ACE（NORFACE）项目的临床、人口统计学、眼科和 OCT-A 数据进行了分析。在调整年龄、性别、教育程度、高血压、糖尿病、心脏病和中风等因素的多变量回归模型中，评估了五个诊断组中四个象限（上方、鼻侧、下方和颞侧）的黄斑 VD 差异。回归分析显示，与 CU 参与者相比，MCI-AD 患者的颞侧 VD 明显较高（49.05±4.91 与 47.27±4.17，p=0.02，d=0.40），而 MCI-Va 患者的下方 VD 明显较低（48.70±6.57 与 51.27±6.39，p=0.02，d=0.40）。与无心脏病的参与者相比，患有心脏病的参与者的下方 VD 明显较低（p=0.01）。性别和诊断的相互作用对区分 VD 没有影响。简易精神状态检查（MMSE）评分与 VD 不相关（所有 r<0.16；p>0.07）。总之，我们的研究表明，与 CU 参与者相比，MCI-AD 和 MCI-Va 组的颞侧和下方象限的黄斑 VD 分别出现了显著差异，这表明黄斑 VD 可能能够区分认知能力下降的两种致病途径（AD 相关和血管性相关）。
