OCT观察帕金森病患者视网膜形态变化的Meta分析

Meta-analysis of Retinal Morphological Changes in Patients with Parkinson's Disease Using OCT Observation

目的采用Meta分析探究光学相干断层扫描(OCT)观察帕金森病(PD)患者视网膜形态变化的价值。方法检索2017年1月—2022年1月PubMed、Embase、The Cochrane Library、万方、中国知网数据库关于OCT观察PD患者视网膜形态变化的临床研究,视网膜神经纤维层(RNFL)厚度、神经节细胞层(GCL)厚度、视盘面积、视杯面积、黄斑厚度为主要结局指标,使用RevMan 5.3软件进行Meta分析。结果共纳入26篇文献,共计1,795例患者(2,790只眼),其中PD组873例(1,343只眼),对照组922例(1,447只眼)。与对照组比较,PD组患者RNFL厚度降低[SMD=-0.550,95%CI(-0.730,-0.360),Z=5.840,P=0.000],GCL厚度降低[SMD=-0.430,95%CI(-0.680,-0.180),Z=3.370,P=0.001],黄斑厚度降低[SMD=0.220,95%CI(-0.330,-0.100),Z=3.780,P=0.000],差异均有统计学意义;但PD组患者视盘面积、视杯面积较对照组差异无统计学意义(均P>0.05)。结论PD患者RNFL、GCL、黄斑区厚度均低于正常人群,OCT可以辅助早期诊断PD。

OBJECTIVE To investigate the value of optical coherence tomography(OCT)in observing retinal morphological changes in patients with Parkinson's disease(PD)using Metaanalysis.METHODS Clinical studies on OCT observation of retinal morphological changes in PD patients were retrieved from PubMed,Embase,The Cochrane Library,Wanfang and China National Knowledge Infrastructure(CNKI)databases from January 2017 to January 2022.The main outcome measures included retinal nerve fiber layer(RNFL)thickness,ganglion cell layer(GCL)thickness,optic disc area,cup area,and macular thickness.Meta-analysis was performed using RevMan 5.3 software.RESULTS A total of 26 studies were included,comprising 1,795 patients(2,790 eyes),with 873 cases(1,343 eyes)in the PD group and 922 cases(1,447 eyes)in the control group.Compared to the control group,the PD group exhibited a decrease in RNFL thickness[SMD=-0.550,95%CI(-0.730,-0.360),Z=5.840,P=0.000],GCL thickness[SMD=-0.430,95%CI(-0.680,-0.180),Z=3.370,P=0.001],and macular thickness[SMD=0.220,95%CI(-0.330,-0.100),Z=3.780,P=0.000],all with statistically significant differences.However,there were no statistically significant differences in optic disc area and cup area between the PD group and the control group(both P>0.05).CONCLUSIONS Patients with PD have lower RNFL,GCL,and macular thickness compared to the normal population.OCT can assist in the early diagnosis of PD.