阿尔茨海默病视网膜变化的临床研究进展
收稿日期: 2024-01-31
录用日期: 2024-08-05
网络出版日期: 2025-02-25
Clinical research progress on retinal changes in Alzheimer’s disease
Received date: 2024-01-31
Accepted date: 2024-08-05
Online published: 2025-02-25
阿尔兹海默病（Alzheimer disease, AD）早期症状隐匿，缺乏特异性生物学标志物，导致疾病晚期才得以确诊，错失最佳治疗时机。近年来，随着胚胎学和眼脑病理学的进展，视网膜作为中枢神经系统的一部分，其与脑部在生理学、解剖学结构上高度相似。研究表明，视网膜神经纤维层（retinal nerve fiber layer, RNFL）和神经节细胞-内丛状层（ganglion cell and inner plexiform layer, GCIPL）等结构的变化与中枢神经系统退行性疾病的进程密切相关，且这些变化往往早于脑部症状的出现。光学相干断层扫描（optical coherence tomography, OCT）及其血管造影术（optical coherence tomography angiography, OCTA），可通过无创、快速、可重复的视网膜影像学检查，观察视网膜上的微血管网络和微结构，来实现对神经退行性疾病的早期诊断。目前，针对AD患者再视网膜结构及功能上改变的研究成果表明，视网膜神经纤维层（retinal nerve fiber layer, RNFL）厚度、神经节细胞-内丛状层（ganglion cell and inner plexiform layer, GCIP）、视网膜血管密度以及视功能等视网膜功能性指标变化，可用于AD早期诊断。视网膜参数、视网膜血管和视功能检测指标可作为神经系统退行性疾病的一种潜在的生物学标志物。
关键词： 神经系统退行性疾病; 阿尔兹海默病; 视网膜参数; 光学相干断层扫描血管造影
彭涵蔚 , 沈玺 . 阿尔茨海默病视网膜变化的临床研究进展[J]. 诊断学理论与实践, 2025 , 24(01) : 89 -94 . DOI: 10.16150/j.1671-2870.2025.01.013
Neurodegenerative disorders, such as Alzheimer’s disease (AD), often have with subtle early symptoms and lack specific biological markers, leading to a diagnosis typically in the later stages of the disease and missing optimal treatment window. In recent years, advances in embryology and ocular-brain pathology have revealed that the retina, as part of the central nervous system, is found to have a Physiology and anatomical structure highly similar to that of the brain. Research shows that changes in retinal structures, such as the retinal nerve fiber layer (RNFL) and the ganglion cell and inner plexiform layer (GCIPL), are closely associated with the progression of degenerative diseases in central nervous system, and these changes often occur before brain symptoms appear. With the advent of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), non-invasive, rapid, and reproducible retinal imaging examinations can now be performed to observe the microvascular networks and microstructures of the retina, enabling the early diagnosis of neurodegenerative diseases. Currently, research on changes of retinal structure and function in AD patients demonstrates that retinal functional indicators, including RNFL thickness, GCIPL, retinal vascular density, and visual function, undergo significant changes in neurodegenerative diseases. These findings offer valuable insights into the retina as a window reflec-ting the progression of neurodegenerative diseases and demonstrate that retinal parameters can serve as a potential biological marker for neurodegenerative diseases.
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