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Ophthalmology. 2019 Apr;126(4):497-510. doi: 10.1016/j.ophtha.2018.08.009. Epub 2018 Aug 13.

Spectral-Domain OCT Measurements in Alzheimer's Disease: A Systematic Review and Meta-analysis.

Author information

1
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
2
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
3
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
4
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Duke-NUS Medical School, National University of Singapore, Singapore, Republic of Singapore.
5
Memory Aging and Cognition Centre, National University Health System, Singapore, Republic of Singapore; Department of Pharmacology, National University of Singapore, Singapore, Republic of Singapore.
6
Departments of Neurology and Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
7
Duke University Medical Center, Durham, North Carolina; Geriatrics Research Education and Clinical Center (GRECC), Durham VA Medical Center, Durham, North Carolina.
8
Duke University Medical Center, Durham, North Carolina.
9
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong, China.
10
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: carolcheung@cuhk.edu.hk.

Abstract

TOPIC:

OCT is a noninvasive tool to measure specific retinal layers in the eye. The relationship of retinal spectral-domain (SD) OCT measurements with Alzheimer's disease (AD) and mild cognitive impairment (MCI) remains unclear. Hence, we conducted a systematic review and meta-analysis to examine the SD OCT measurements in AD and MCI.

CLINICAL RELEVANCE:

Current methods of diagnosing early AD are expensive and invasive. Retinal measurements of SD OCT, which are noninvasive, technically simple, and inexpensive, are potential biomarkers of AD.

METHODS:

We conducted a literature search in PubMed and Excerpta Medica Database to identify studies published before December 31, 2017, that assessed the associations between AD, MCI, and measurements of SD OCT: ganglion cell-inner plexiform layer (GC-IPL), ganglion cell complex (GCC), macular volume, and choroidal thickness, in addition to retinal nerve fiber layer (RNFL) and macular thickness. We used a random-effects model to examine these relationships. We also conducted meta-regression and assessed heterogeneity, publication bias, and study quality.

RESULTS:

We identified 30 eligible studies, involving 1257 AD patients, 305 MCI patients, and 1460 controls, all of which were cross-sectional studies. In terms of the macular structure, AD patients showed significant differences in GC-IPL thickness (standardized mean difference [SMD], -0.46; 95% confidence interval [CI], -0.80 to -0.11; I2 = 71%), GCC thickness (SMD, -0.84; 95% CI, -1.10 to -0.57; I2 = 0%), macular volume (SMD, -0.58; 95% CI, -1.03 to -0.14; I2 = 80%), and macular thickness of all inner and outer sectors (SMD range, -0.52 to -0.74; all P < 0.001) when compared with controls. Peripapillary RNFL thickness (SMD, -0.67; 95% CI, -0.95 to -0.38; I2 = 89%) and choroidal thickness (SMD range, -0.88 to -1.03; all P < 0.001) also were thinner in AD patients.

CONCLUSIONS:

Our results confirmed the associations between retinal measurements of SD OCT and AD, highlighting the potential usefulness of SD OCT measurements as biomarkers of AD.

PMID:
30114417
PMCID:
PMC6424641
[Available on 2020-04-01]
DOI:
10.1016/j.ophtha.2018.08.009

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