Elvira-Hurtado Lorena, López-Cuenca Inés, de Hoz Rosa, Salas Mario, Sánchez-Puebla Lidia, Ramírez-Toraño Federico, Matamoros José A, Fernández-Albarral José A, Rojas Pilar, Alfonsín Soraya, Delgado-Losada María Luisa, Ramírez Ana I, Salazar Juan J, Maestu Fernando, Gil Pedro, Ramírez José M, Salobrar-García Elena
Ramon Castroviejo Institute for Ophthalmic Research, Complutense University of Madrid, Madrid, Spain.
Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Front Psychol. 2023 Jul 6;14:1124830. doi: 10.3389/fpsyg.2023.1124830. eCollection 2023.
Alzheimer's disease (AD) is the most common form of dementia affecting the central nervous system, and alteration of several visual structures has been reported. Structural retinal changes are usually accompanied by changes in visual function in this disease. The aim of this study was to analyse the differences in visual function at different stages of the pathology (family history group (FH+), mild cognitive impairment (MCI), mild AD and moderate AD) in comparison with a control group of subjects with no cognitive decline and no family history of AD.
We included 53 controls, 13 subjects with FH+, 23 patients with MCI, 25 patients with mild AD and, 21 patients with moderate AD. All were ophthalmologically healthy. Visual acuity (VA), contrast sensitivity (CS), colour perception, visual integration, and fundus examination were performed.
The analysis showed a statistically significant decrease in VA, CS and visual integration score between the MCI, mild AD and moderate AD groups compared to the control group. In the CS higher frequencies and in the colour perception test (total errors number), statistically significant differences were also observed in the MCI, mild AD and moderate AD groups with respect to the FH+ group and also between the control and AD groups. The FH+ group showed no statistically significant difference in visual functions compared to the control group. All the test correlated with the Mini Mental State Examination score and showed good predictive value when memory decline was present, with better values when AD was at a more advanced stage.
Alterations in visual function appear in subjects with MCI and evolve when AD is established, being stable in the initial stages of the disease (mild AD and moderate AD). Therefore, visual psychophysical tests are a useful, simple and complementary tool to neuropsychological tests to facilitate diagnosis in the preclinical and early stages of AD.
阿尔茨海默病（AD）是影响中枢神经系统的最常见痴呆形式，已有报道称多种视觉结构发生改变。在这种疾病中，视网膜结构变化通常伴随着视觉功能的改变。本研究的目的是分析与无认知功能下降且无AD家族史的对照组相比，该疾病不同病理阶段（家族史组（FH +）、轻度认知障碍（MCI）、轻度AD和中度AD）的视觉功能差异。
我们纳入了53名对照组、13名FH +受试者、23名MCI患者、25名轻度AD患者和21名中度AD患者。所有患者眼部均健康。进行了视力（VA）、对比敏感度（CS）、颜色感知、视觉整合和眼底检查。
分析显示，与对照组相比，MCI、轻度AD和中度AD组的VA、CS和视觉整合得分在统计学上有显著下降。在CS较高频率和颜色感知测试（总错误数）中，MCI、轻度AD和中度AD组与FH +组相比以及对照组与AD组之间也观察到统计学上的显著差异。与对照组相比，FH +组的视觉功能无统计学显著差异。所有测试均与简易精神状态检查表得分相关，并且在存在记忆衰退时显示出良好的预测价值，在AD处于更晚期时价值更高。
MCI患者出现视觉功能改变，在AD确诊后会进一步发展，在疾病初期（轻度AD和中度AD）保持稳定。因此，视觉心理物理学测试是一种有用、简单且可补充神经心理学测试的工具，有助于在AD的临床前和早期阶段进行诊断。
