视乳头周围视网膜神经纤维层检测对轻度阿尔茨海默病诊断的辅助作用

Accessory effect of retinal nerve fiber layer detection on the diagnosis of light Alzheimer's disease

目的阿尔茨海默病(AD)患者常伴有视觉功能障碍,这可能与视神经的变性改变相关。本次研究旨在通过视网膜光学相干断层扫描(OCT)检测早期AD患者视乳头周围视网膜神经纤维层(RNFL)厚度值,探讨患者的RNFL厚度变化与AD的相关性。方法检查AD患者最佳矫正视力、眼内压、扩瞳孔眼底检查,排除内眼疾病后,对89名AD患者以及66名健康老年人进行眼底视乳头周围OCT检查,获得其RNFL厚度值。结果 AD患者组的RNFL厚度(96.68±27.45)较对照组(105.86±26.57)差异有统计学意义(P<0.05);AD患者组乳头上方的RNFL厚度(116.97±12.36)较对照组(130.26±9.25)差异有统计学意义(P<0.05);但视乳头下方、鼻侧与颞侧与对照组相比,差异无统计学意义(P>0.05)。结论早期AD患者的RNFL厚度出现变薄,提示早期AD患者可能存在视网膜神经纤维及视神经的退行性改变。其中,视乳头上方RNFL厚度出现的变薄,可能是AD患者在视神经方面的病变中较早期的变化。

Objective To investigate changes in the thickness of retinal nerve fiber layer （RNFL） of Alzheimer′s disease （AD） patients and the association with AD .Methods Optical coherence tomography （OCT） was performed to measure optimal cor-rected visual acuity , intraocular pressure and dilated fundus thickness of retinal nerve fiber layer in 89 AD patients （ the AD group ） and 66 healthy old controls （the control group）.Results As compared with that of the control group （105.86 ±26.57）, statistical signifi-cance could be noted in the RNFL thickness of the AD group （96.68 ±27.45） （P〈0.05）.RNFL thickness above papilla in the AD group（116.97 ±12.36） was thinner, as compared with that of the control group （130.26 ±9.25）, and statistical significance could be found when comparisons were made between them （P〈0.05）.However, in the area below papilla, no significant difference could be seen in the values of nasal side and temporal side , when compared with those of the control group （P〈0.05）.Conclusion RNFL thickness became thinner in early AD patients , indicating that there was retinal nerve degeneration in the neural fibers of the retina and optic nerves in early AD patients .And RNFL thickness in the area above the optic papilla also became thinner , which might be early pathological changes in the optic nerve fibers of the AD patients .