视网膜血管变化与基于pet的阿尔茨海默病生物标志物相关:一项初步研究

IF 2.8 Q2 NEUROSCIENCES
Journal of Alzheimer's disease reports Pub Date : 2024-12-08 eCollection Date: 2024-01-01 DOI:10.1177/25424823241300416
Kristie Hing Chi Leung, Victor T T Chan, Bonnie Yin Ka Lam, Vincent Ct Mok, Carol Y Cheung
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引用次数: 0

摘要

背景:视网膜是评估脑微血管变化的非侵入性通道,与阿尔茨海默病(AD)的病理生理有关。既往研究显示临床诊断的AD与视网膜血管系统有显著关系。然而,临床诊断的敏感性和特异性有限,而且这些调查是通过传统的视网膜眼底照片进行的,这些照片只捕获了眼底的一小部分。目的:确定正电子发射断层扫描(PET)生物标志物确诊AD的受试者与对照组相比视网膜血管的更大面积变化。方法:从社区和认知障碍诊所招募参与者。PET扫描显示明显的淀粉样蛋白β (Aβ)和tau蛋白摄取证实了AD的诊断。使用超宽视场(UWF)扫描激光检眼镜对视网膜血管进行成像,并使用半自动新加坡I血管评估(SIVA)软件对一系列血管参数进行量化。统计分析根据年龄、性别和收缩压进行调整。此外,根据小静脉的相同测量值调整小动脉参数,反之亦然。结果:39例患者中,18例经影像学证实为AD。这些AD患者在UWF图像中动脉分形维数明显小于对照组(p = 0.032),在标准眼底图像中静脉扭曲度明显大于对照组(p = 0.011)。存在显著的Aβ和tau负担与小动脉直径降低相关(OR 3.857;95% ci 1.014-14.67;p = 0.048)。结论:UWF成像观察到的视网膜小动脉分形维数降低与生物标志物确诊的AD患者的大脑Aβ和tau负荷有关。在这项试点研究中,宽视场视网膜成像为展示与AD相关的微血管改变提供了另一种视角。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retinal vascular changes are associated with PET-based biomarkers of Alzheimer's disease: A pilot study.

Background: Retina is a non-invasive channel for assessing changes in brain microvasculature, which has been implicated in the pathophysiology of Alzheimer's disease (AD). Previous studies revealed significant relationship between clinically diagnosed AD and retinal vasculature. However, clinical diagnosis has limited sensitivity and specificity, and those investigations were conducted from traditional retinal fundus photographs which only captured a narrow section of the fundus.

Objective: Determining changes in retinal vasculature from larger area of retina between subjects with positron emission tomography (PET) biomarker-confirmed AD compared to controls.

Methods: Participants were recruited from the community and cognitive disorder clinics. Diagnosis of AD was confirmed by significant amyloid-β (Aβ) and tau uptake on PET scan. Retinal vasculature was imaged with ultra-widefield (UWF) scanning laser ophthalmoscopy and a series of vessel parameters were quantified using the semi-automated Singapore I Vessel Assessment (SIVA) software. Statistical analyses were adjusted for age, gender and systolic blood pressure. In addition, arteriole parameters were adjusted against the same measurements in venules, and vice versa.

Results: Out of the 39 patients, 18 had radiologically confirmed AD. These individuals with AD showed significantly smaller arteriolar fractal dimension (p = 0.032) in UWF images and greater venular tortuosity (p = 0.011) in standard fundus images compared with controls. Presence of significant Aβ and tau burden was associated with lower arteriolar caliber (OR 3.857; 95% CI 1.014-14.67; p = 0.048).

Conclusions: Reduction of fractal dimension in retinal arterioles observed in UWF imaging is associated with cerebral Aβ and tau burden in people with biomarker-confirmed AD. Wide field retinal imaging provides an alternative perspective in demonstrating microvascular alterations related to AD in this pilot study.

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