摘要
目的结合图形视觉诱发电位(pattern visual evoked potential,PVEP)和光学相干断层扫描(optical coherence tomography,OCT)来评估阿尔茨海默病(Alzheimer’s disease,AD)患者的视网膜变化及其在AD诊断中的意义。方法收集2018年8月到2019年11月在重庆医科大学附属第一医院老年科诊断明确的AD患者31例,以及年龄匹配的健康老年人37例,分别对其进行PVEP和OCT检查,记录PVEP中P100波的潜伏期和幅值、OCT中的各象限的视乳头周围视网膜神经纤维层(peripapillary retinal nerve fiber layer,pRNFL)厚度,分析AD组和HC组之间的差异,研究其在AD诊断中的价值。结果与HC组相比,AD患者P100波的幅值显著降低(P<0.05),潜伏期没有显著差异(P>0.05)。AD患者的鼻侧、鼻上方、颞上方、颞下方pRNFL厚度显著变薄(P<0.05),颞侧和鼻下方pRNFL则没有显著性差异(P>0.05);并且通过受试者工作特征(ROC)曲线分析发现视网膜功能或结构单个参数的曲线下面积(area under curve,AUC)低于多个参数组合的AUC。结论 P100波幅值和颞上方、鼻上方pRNFL厚度相结合,对于鉴别患者有无AD具有较高的诊断效能。提示PVEP和OCT联合应用有望成为AD诊断的临床生物标记。
Objective To assess the value of detecting retinal changes with pattern visual evoked potential(PVEP) combined with optical coherence tomography(OCT) in the diagnosis of Alzheimer’s disease(AD). Methods This study was conducted among 31 patients with established diagnosis of AD in the First Affiliated Hospital of Chongqing Medical University between August, 2018 and November, 2019, with 37 age-matched healthy elderly individuals from local community as the control group. All the subjects underwent examinations with both PVEP and OCT. The latency and amplitude of P100 wave in PVEP and peripapillary retinal nerve fiber layer(pRNFL) thickness in each quadrant in OCT were recorded and compared between the two groups to assess the diagnostic value of these parameters for AD. Results Compared with the healthy control group, the patients with AD had significantly lowered amplitude of P100 wave(P<0.05) without obvious changes in the latency of P100 wave(P>0.05);they also exhibited significantly thinner pRNFL in the nasal, superonasal, superotemporal and inferotemporal quadrants(P<0.05), but not in the temporal or inferonasal quadrant(P>0.05). ROC curve analysis showed that the area under curve(AUC) of a single functional or structural parameter of the retina was smaller than that of multiple retinal parameters combined. Conclusion The amplitude of P100 wave combined with superonasal and superotemporal pRNFL thickness has a high diagnostic value for AD, which supports the combination of PVEP and OCT for clinical diagnosis of AD.
作者
邬涵韵
李欣
秦张瑾
杨文凯
吕洋
张黎
WU Hanyun;LI Xin;QIN Zhangjin;YANG Wenkai;LYU Yang;ZHANG Li(Department of Ophthalmology,Chongqing Key Laboratory of Ophthalmology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China;Department of Geriatrics,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2020年第8期848-854,共7页
Journal of Third Military Medical University
基金
重庆市教委研究生教改课题一般项目(yjg153108)。
关键词
光学相干断层扫描
视觉诱发电位
阿尔茨海默病
联合诊断
optical coherence tomography
pattern visual evoked potential
Alzheimer’s disease
combined diagnosis
