Sheriff Samran, Shen Ting, Abdal Sandra, Saks Danit, Mirzaei Mehdi, Gupta Veer, Chitranshi Nitin, You Yuyi, Schultz Angela, Graham Stuart L, Gupta Vivek
Macquarie Medical School, Macquarie University, Sydney, NSW, Australia.
Macquarie Medical School, Macquarie University; Save Sight Institute, The University of Sydney, Sydney, NSW, Australia.
Neural Regen Res. 2023 Nov;18(11):2504-2513. doi: 10.4103/1673-5374.371380.
Examining the retinal tissue has the potential to provide a unique method and technique to quantify Alzheimer's disease-related changes in participants at various stages of the disease. In this meta-analysis, we aimed to investigate the association of various optical coherence tomography parameters with Alzheimer's disease and whether retinal measurements can be used to differentiate between Alzheimer's disease and control subjects. Scientific databases including Google Scholar, Web of Science, and PubMed were systematically searched for published articles that evaluated retinal nerve fiber layer thickness and retinal microvascular network in Alzheimer's disease and control subjects. Seventy-three studies (5850 participants, including 2249 Alzheimer's disease patients and 3601 controls) were included in this meta-analysis. Relative to controls, Alzheimer's disease patients had a significantly lower global retinal nerve fiber layer thickness (standardized mean difference [SMD] = -0.79, 95% confidence intervals [CI]: -1.03 to -0.54, P < 0.00001) as well as each quadrant being thinner in Alzheimer's disease versus controls. Regarding macular parameters, values measured by optical coherence tomography were significantly lower in Alzheimer's disease than controls for macular thickness (pooled SMD: -0.44, 95% CI: -0.67 to -0.20, P = 0.0003), foveal thickness (pooled SMD = -0.39, 95% CI: -0.58 to -0.19, P < 0.0001), ganglion cell inner plexiform layer (SMD = -1.26, 95% CI: -2.24 to -0.27, P = 0.01) and macular volume (pooled SMD = -0.41, 95% CI -0.76 to -0.07, P = 0.02). Analysis using optical coherence tomography angiography parameters revealed mixed results between Alzheimer's disease and controls. Superficial vessel density (pooled SMD = -0.42, 95% CI: -0.68 to -0.17, P = 0.0001) and deep vessel density (pooled SMD = -0.46, 95% CI: -0.75 to -0.18, P = 0.001) were found to be thinner in Alzheimer's disease patients whereas the foveal avascular zone (SMD = 0.84, 95% CI: 0.17-1.51, P = 0.01) was larger in controls. Vascular density and thickness of various retinal layers were decreased in Alzheimer's disease patients compared to controls. Our results provide evidence for optical coherence tomography technology having the potential to detect retinal and microvascular changes in patients diagnosed with Alzheimer's disease and aid in monitoring and early diagnosis methods.
检查视网膜组织有可能提供一种独特的方法和技术，用于量化处于疾病不同阶段的参与者与阿尔茨海默病相关的变化。在这项荟萃分析中，我们旨在研究各种光学相干断层扫描参数与阿尔茨海默病的关联，以及视网膜测量是否可用于区分阿尔茨海默病患者和对照者。我们系统地检索了包括谷歌学术、科学网和PubMed在内的科学数据库，以查找评估阿尔茨海默病患者和对照者视网膜神经纤维层厚度和视网膜微血管网络的已发表文章。这项荟萃分析纳入了73项研究（5850名参与者，包括2249名阿尔茨海默病患者和3601名对照者）。与对照者相比，阿尔茨海默病患者的整体视网膜神经纤维层厚度显著更低（标准化均数差[SMD]=-0.79，95%置信区间[CI]：-1.03至-0.54，P<0.00001），并且阿尔茨海默病患者各象限的视网膜神经纤维层厚度均比对照者更薄。关于黄斑参数，通过光学相干断层扫描测量的值在阿尔茨海默病患者中显著低于对照者，包括黄斑厚度（合并SMD：-0.44,95%CI：-0.67至-0.20，P=0.0003）、中央凹厚度（合并SMD=-0.39，95%CI：-0.58至-0.19，P<0.0001）、神经节细胞内丛状层（SMD=-1.26，95%CI：-2.24至-0.27，P=0.01）和黄斑体积（合并SMD=-0.41，95%CI -0.76至-0.07,P=0.02）。使用光学相干断层扫描血管造影参数进行的分析显示，阿尔茨海默病患者和对照者之间的结果不一。发现阿尔茨海默病患者的浅表血管密度（合并SMD=-0.42，95%CI：-0.68至-0.17，P=0.0001）和深部血管密度（合并SMD=-0.46，95%CI：-0.75至-0.18，P=0.001）更低，而对照者的中央凹无血管区更大（SMD=0.84，95%CI：0.17 - 1.51，P=0.01）。与对照者相比，阿尔茨海默病患者各种视网膜层的血管密度和厚度均降低。我们的结果为光学相干断层扫描技术有可能检测出被诊断为阿尔茨海默病的患者的视网膜和微血管变化，并有助于监测和早期诊断方法提供了证据。
