Goerdt L, Holz F G, Finger R P
Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
Universitäts-Augenklinik Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Ophthalmologie. 2024 Feb;121(2):84-92. doi: 10.1007/s00347-023-01947-w. Epub 2023 Oct 17.
Due to the general aging of society, the prevalence and incidence of dementia are expected to increase considerably. In order to timely identify patients and assess their need for treatment and/or supportive measures, comprehensive and easy access screening methods are required, which, however, are yet to be developed. To date, several biomarkers for the presence of dementia on high-resolution spectral domain optical coherence tomography (OCT) and OCT angiography (OCT-A) images were identified.
To summarize previously identified OCT biomarkers in dementia and to assess their suitability for comprehensive screening examinations.
A literature search was conducted on PubMed until March 2023 for the keywords "dementia", "mild cognitive impairment", "OCT", "OCT angiography" and "retinal biomarkers". Relevant publications were identified and summarized.
Numerous unspecific alterations on OCT imaging and OCT‑A were identified in patients with (predementia) dementia according to many population and clinical studies. These include a reduced thickness of the peripapillary retinal nerve fiber layer, the ganglion cell complex and the central retinal region. Additionally, a reduced vascular density and an enlarged foveal avascular zone (FAZ) were identified on OCT‑A imaging.
The currently known OCT biomarkers are too unspecific, and there is to date no OCT or OCT-A-based signature distinguishing between different types of dementia. Further longitudinal studies with larger sample sizes are warranted to develop and evaluate such distinct OCT signatures for different types of dementia and their respective early disease stages and to assess their prognostic value. Only then is the inclusion in comprehensive screening investigations feasible.
由于社会的普遍老龄化，预计痴呆症的患病率和发病率将大幅上升。为了及时识别患者并评估他们对治疗和/或支持措施的需求，需要全面且易于使用的筛查方法，然而，此类方法尚未开发出来。迄今为止，已在高分辨率光谱域光学相干断层扫描（OCT）和OCT血管造影（OCT-A）图像上确定了几种痴呆症存在的生物标志物。
总结先前确定的痴呆症OCT生物标志物，并评估其用于全面筛查检查的适用性。
在PubMed上进行文献检索，直至2023年3月，搜索关键词为“痴呆症”、“轻度认知障碍”、“OCT”、“OCT血管造影”和“视网膜生物标志物”。识别并总结相关出版物。
根据许多人群和临床研究，在患有（痴呆前期）痴呆症的患者中，OCT成像和OCT-A上发现了许多非特异性改变。这些改变包括视乳头周围视网膜神经纤维层、神经节细胞复合体和视网膜中央区域的厚度减少。此外，在OCT-A成像上还发现血管密度降低和黄斑无血管区（FAZ）扩大。
目前已知的OCT生物标志物特异性不足，迄今为止，尚无基于OCT或OCT-A的特征能够区分不同类型的痴呆症。有必要进行更大样本量的进一步纵向研究，以开发和评估针对不同类型痴呆症及其各自早期疾病阶段的独特OCT特征，并评估其预后价值。只有这样，将其纳入全面筛查研究才可行。
