实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (5): 461-465.doi: 10.3969/j.issn.1003-9198.2025.05.006

• 临床研究 • 上一篇    下一篇

视网膜结构和功能的改变对高原地区阿尔茨海默病病人诊断的意义

王赟, 付丽萍   

  1. 810000 青海省西宁市,西宁市第一人民医院眼科
  • 收稿日期:2024-08-15 出版日期:2025-05-20 发布日期:2025-05-20
  • 基金资助:
    西宁市科技计划项目(2021-M-33)

Significance of retinal structural and functional changes in the diagnosis of Alzheimer’s disease in high-altitude regions

WANG Yun, FU Liping   

  1. Department of Ophthalmology, Xining First People’s Hospital, Xining 810000, China
  • Received:2024-08-15 Online:2025-05-20 Published:2025-05-20

PDF (PC)

16

摘要： 目的 通过图形视觉诱发电位(pattern visual evoked potential,PVEP)和光学相干断层成像(optical coherence tomography,OCT)评估高原地区AD病人视网膜结构和功能的改变,分析其在高原地区AD诊断中的价值。 方法 选取2021年1月至2023年3月西宁市第一人民医院收治的60例AD病人(AD组)和30例认知功能正常的老年人(HC组)为研究对象,通过PVEP检测P100波的潜伏期和幅值,采用OCT检查视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度及黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT)。比较2组间各指标的差异,采用ROC曲线分析其在AD诊断中的价值。 结果 2组年龄、性别及眼压差异均无统计学意义(P＞0.05)。与HC组相比,AD组P100波潜伏期明显延迟(P<0.01),波幅明显下降(P<0.01),颞象限的RNFL更厚(P<0.05),上、下象限的RNFL更薄(P<0.01),SFCT也更薄(P<0.001)。上象限RNFL厚度及SFCT随着AD的进展存在明显的变薄趋势(P<0.05)。Logistic回归分析显示,P100波潜伏期、P100波幅值和SFCT是AD的影响因素。ROC曲线分析显示,P100波潜伏期、P100波幅值及SFCT联合诊断AD的价值(AUC=0.99)高于各指标单独诊断(AUC=0.81、0.94、0.76)。 结论 高原地区AD病人的视网膜结构和功能存在改变,采用PVEP和OCT评估的视网膜参数有望成为诊断AD的标志物。

关键词: 视网膜, 视觉诱发电位, 光学相干断层成像, 阿尔茨海默病, 高原地区

Abstract: Objective To evaluate the changes in retinal structure and function in the patients with Alzheimer’s disease (AD) in high-altitude regions using pattern visual evoked potential (PVEP) and optical coherence tomography (OCT), and to analyze their diagnostic value for AD. Methods Sixty AD patients (AD group) and 30 elderly individuals with normal cognition (HC group) admitted to Xining First People’s Hospital from January 2021 to March 2023 were enrolled. The latency and amplitude of the P100 wave were measured by PVEP. Retinal nerve fiber layer (RNFL) thickness and subfoveal choroidal thickness (SFCT) were tested by OCT. The differences in these indicators were compared between the two groups, and receiver operating characterisitc (ROC) curve analysis was performed to evaluate their diagnostic value for AD. Results There were no statistically significant differences in age, gender and intraocular pressure between the two groups (P>0.05). Compared to HC group, AD group showed significantly prolonged P100 wave latency (P<0.01), reduced P100 wave amplitude (P<0.01), thicker RNFL in the temporal quadrant (P<0.05), thinner PNFL in the superior and inferior quadrants (P<0.01), and thinner SFCT (P<0.001). The thickness of RNFL in superior quadrant and SFCT showed a significant thinning trends with AD progression (P<0.05). Logistic regression analysis showed that P100 latency, P100 amplitude and SFCT were independent factors for AD. ROC curve analysis revealed that the combined diagnostic value of P100 latency, P100 amplitude, and SFCT for AD (AUC=0.99) was superior to the parameters alone (AUC=0.81, 0.94 and 0.76, respectively). Conclusions AD patients in high-altitude regions present with distinct retinal structural and functional changes. Retinal parameters assessed by PVEP and OCT may serve as potential biomarkers for diagnosing AD in these populations.

Key words: retina, visual evoked potential, optical coherence tomography imaging, Alzheimer’s disease, high-altitude region

中图分类号: