Retinal nerve fiber layer thickness in patients with Alzheimer's disease_Chinese Journal of Ocular Fundus Diseases

Authors：

Xu Tingting , Zhang Qiang ,  Zhou Qiong

Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China;

Corresponding author：

Zhou Qiong, Email: qiongz-ms@126.com

Keywords：

Alzheimer's disease; Tomography, optical coherence; Retinal nerve fiber layer

DOI：

10.3760/cma.j.issn.1005-1015.2018.01.007

Video：

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Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness in patients with Alzheimer's disease (AD). Methods Twenty eyes of 40 patients with mild and (or) moderate AD confirmed by clinical examination (AD group) were included in the study. There were 11 males and 9 females with an average age of (72.75±8.25) years. Age and gender-matched normal 20 objectives were in the normal control group. Among them, there were 11 males and 9 females with a mean age of (71.05±7.08) years. There was no significant difference in gender composition, age and intraocular pressure between the two groups (P＞0.05). There were significant differences in visual acuity, cup disc ratio and mini-mental state examination score (P＜0.05). All eyes underwent high-resolution optical coherence tomography (OCT) examination. With a diameter of 3.4 mm and a center on the center of the optic disc, circular fast scans on optic disc were performed to obtain an average disc RNFL thickness, signal threshold ＞6. Computer image analysis system was used to measure the RNFL thickness from superior, inferior, temporal and nasal quadrants, and the average RNFL thickness. The changes of RNFL thickness between the two groups and between different eyes of the same group were compared. Results Compared with the normal control group, the average (t=5.591), superior (t=8.169, 8.053) and inferior (t=12.596, 11.377) thickness of RNFL in both eyes in AD group were thinner, the differences were significant (P＜0.05); the temporal (t=1.966, 0.838）and nasal (t=2.071, 0.916) thickness of RNFL in both eyes of AD group were thinner, but the difference was not statistically significant (P＞0.05). There was no significant difference of the mean and different quadrant RNFL thickness between different eyes in AD group and normal control group (AD group: t=0.097, 0.821, 0.059, 0.020, 0.116; normal control group: t=0.791, 1.938, 1.806, 2.058, 1.005; P＞0.05). Conclusion The RNFL thickness around the optic disc in AD patients is thinner; This occurs first in superior and inferior quadrants of the optic disc.

Citation： Xu Tingting, Zhang Qiang, Zhou Qiong. Retinal nerve fiber layer thickness in patients with Alzheimer's disease. Chinese Journal of Ocular Fundus Diseases, 2018, 34(1): 25-28. doi: 10.3760/cma.j.issn.1005-1015.2018.01.007 Copy

1.	Hinton DR, Sadun AA, Blanks JC, et al. Optic-nerve degeneration in Alzheimer's disease[J]. N Engl J Med, 1986, 315(8): 485-487. DOI: 10.1056/NEJM198608213150804.
2.	Berisha F, Feke GT, Trempe CL, et al. Retinal abnormalities in early Alzheimer's disease[J]. Invest Ophthalmol Vis Sci, 2007, 48(5): 2285-2289. DOI: 10.1167/iovs.06-1029.
3.	Iseri PK, Altinaş O, Tokay T, et al. Relationship between cognitive impairment and retinal morphological and visual functional abnormalities in Alzheimer disease[J]. J Neuroophthalmol, 2006, 26(1): 18-24. DOI: 10.1097/01.wno.0000204645.56873.26.
4.	Parisi V, Restuccia R, Fattapposta F, et al. Morphological and functional retinal impairment in Alzheimer's disease patients[J]. Clin Neurophysiol, 2001, 112(10): 1860-1867.
5.	Mckhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer's disease: report of the NINCDS--ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease[J]. Neurology, 1984, 34: 939-944.
6.	Frances A. Diagnostic and statistical manual of mental disorders(DSM-Ⅳ)[M]. American Psychiatric Association, 1994, 51(272): 828-829.
7.	Wang B, Niu Y, Miao L, et al. Decreased complexity in alzheimer's disease: resting-state fmri evidence of brain entropy mapping[J]. Front Aging Neurosci, 2017, 9: 378. DOI: 10.3389/fnagi.2017.00378.
8.	Danesh-Meyer HV, Birch H, Ku JY, et al. Reduction of optic nerve fibers in patients with Alzheimer disease identified by laser imaging[J]. Neurology, 2006, 67(10): 1852-1854. DOI: 10.1212/01.wnl.0000244490.07925.8b.
9.	Sadun AA, Bassi CJ. Optic nerve damage in Alzheimer's disease[J]. Ophthalmology, 1990, 97(1): 9-17. DOI: http://dx.doi.org/10.1016/S0161-6420(90)32621-0.
10.	Trick GL, Barris MC, Michelle Bickler-Bluth M. Abnormal pattern electroretinograms in patients with senile dementia of the alzheimer type[J]. Ann Neurol, 1989, 26(2): 226-231. DOI: 10.1002/ana.410260208.
11.	Armstrong RA. Visual field defects in Alzheimer's disease patients may reflect differential pathology in the primary visual cortex[J]. Optom Vis Sci, 1996, 73(11): 677-682.
12.	Hedges TR 3rd, Perez Galves R, Speigelman D, et al. Retinal nerve fiber layer ab12normalities in Alzheimer's disease[J]. Acta Ophthalmol Scand, 1996, 74(3): 271-275.
13.	Trick GL, Trick LR, Morris P, et al. Visual field loss in senile dementia of the Alzheimer's type[J]. Neurology, 1995, 45(1): 68-74.
14.	Regeur L, Jensen GB, Pakkenberg H, et al. No global neocortical nerve cell loss in brains from patients with senile dementia of Alzheimer's type[J]. Neurobiol Aging, 1994, 15(3): 347-352.
15.	Pearson R C, Esiri M M, Hiorns R W, et al. Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer disease[J]. Proc Natl Acad Sci USA, 1985, 82(13): 4531-4534.
16.	Parisi V, Restuccia R, Fattapposta F, et al. Morphological and functional retinal impairment in Alzheimer's disease patients[J]. Clin Neurophysiol, 2001, 112(10): 1860-1867.
17.	Iseri PK, Altinaş O, Tokay T, et al. Relationship between cognitive impairment and retinal morphological and visual functional abnormalities in Alzheimer disease[J]. J Neuroophthalmol, 2006, 26(1): 18-24. DOI: 10.1097/01.wno.0000204645.56873.26.
18.	Lu Y, Li Z, Zhang X, et al. Retinal nerve fiber layer structure abnormalities in early Alzheimer's disease: evidence in optical coherence tomography[J]. Neurosci Lett, 2010, 480(1): 69-72. DOI: 10.1016/j.neulet.2010.06.006.
19.	Nissen MJ, Corkin S, Buonanno FS, et al. Spatial vision in Alzheimer's disease. General findings and a case report[J]. Arch Neurol, 1985, 42(7): 667-671. DOI: 10.1001/archneur.1985.04060070057015.
20.	Tamura H, Kawakami H, Kanamoto T, et al. High frequency of open-angle glaucoma in Japanese patients with Alzheimer's disease[J]. J Neurol Sci, 2006, 246(1-2): 79-83. DOI: 10.1016/j.jns.2006.02.009.
21.	Ziangirova GG, Antonova OV. Local senile ocular amyloidosis in the pathogenesis of open-angle glaucoma and pseudo-exfoliative syndrome[J]. Vestn Ross Akad Med Nauk, 2003, (2): 40-43.
22.	Janciauskiene S, Krakau T. Alzheimer's peptide and serine proteinase inhibitors in glaucoma and exfoliation syndrome[J]. Doc Ophthalmol, 2003, 106(3): 215-223.

1. Hinton DR, Sadun AA, Blanks JC, et al. Optic-nerve degeneration in Alzheimer's disease[J]. N Engl J Med, 1986, 315(8): 485-487. DOI: 10.1056/NEJM198608213150804.
2. Berisha F, Feke GT, Trempe CL, et al. Retinal abnormalities in early Alzheimer's disease[J]. Invest Ophthalmol Vis Sci, 2007, 48(5): 2285-2289. DOI: 10.1167/iovs.06-1029.
3. Iseri PK, Altinaş O, Tokay T, et al. Relationship between cognitive impairment and retinal morphological and visual functional abnormalities in Alzheimer disease[J]. J Neuroophthalmol, 2006, 26(1): 18-24. DOI: 10.1097/01.wno.0000204645.56873.26.
4. Parisi V, Restuccia R, Fattapposta F, et al. Morphological and functional retinal impairment in Alzheimer's disease patients[J]. Clin Neurophysiol, 2001, 112(10): 1860-1867.
5. Mckhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer's disease: report of the NINCDS--ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease[J]. Neurology, 1984, 34: 939-944.
6. Frances A. Diagnostic and statistical manual of mental disorders(DSM-Ⅳ)[M]. American Psychiatric Association, 1994, 51(272): 828-829.
7. Wang B, Niu Y, Miao L, et al. Decreased complexity in alzheimer's disease: resting-state fmri evidence of brain entropy mapping[J]. Front Aging Neurosci, 2017, 9: 378. DOI: 10.3389/fnagi.2017.00378.
8. Danesh-Meyer HV, Birch H, Ku JY, et al. Reduction of optic nerve fibers in patients with Alzheimer disease identified by laser imaging[J]. Neurology, 2006, 67(10): 1852-1854. DOI: 10.1212/01.wnl.0000244490.07925.8b.
9. Sadun AA, Bassi CJ. Optic nerve damage in Alzheimer's disease[J]. Ophthalmology, 1990, 97(1): 9-17. DOI: http://dx.doi.org/10.1016/S0161-6420(90)32621-0.
10. Trick GL, Barris MC, Michelle Bickler-Bluth M. Abnormal pattern electroretinograms in patients with senile dementia of the alzheimer type[J]. Ann Neurol, 1989, 26(2): 226-231. DOI: 10.1002/ana.410260208.
11. Armstrong RA. Visual field defects in Alzheimer's disease patients may reflect differential pathology in the primary visual cortex[J]. Optom Vis Sci, 1996, 73(11): 677-682.
12. Hedges TR 3rd, Perez Galves R, Speigelman D, et al. Retinal nerve fiber layer ab12normalities in Alzheimer's disease[J]. Acta Ophthalmol Scand, 1996, 74(3): 271-275.
13. Trick GL, Trick LR, Morris P, et al. Visual field loss in senile dementia of the Alzheimer's type[J]. Neurology, 1995, 45(1): 68-74.
14. Regeur L, Jensen GB, Pakkenberg H, et al. No global neocortical nerve cell loss in brains from patients with senile dementia of Alzheimer's type[J]. Neurobiol Aging, 1994, 15(3): 347-352.
15. Pearson R C, Esiri M M, Hiorns R W, et al. Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer disease[J]. Proc Natl Acad Sci USA, 1985, 82(13): 4531-4534.
16. Parisi V, Restuccia R, Fattapposta F, et al. Morphological and functional retinal impairment in Alzheimer's disease patients[J]. Clin Neurophysiol, 2001, 112(10): 1860-1867.
17. Iseri PK, Altinaş O, Tokay T, et al. Relationship between cognitive impairment and retinal morphological and visual functional abnormalities in Alzheimer disease[J]. J Neuroophthalmol, 2006, 26(1): 18-24. DOI: 10.1097/01.wno.0000204645.56873.26.
18. Lu Y, Li Z, Zhang X, et al. Retinal nerve fiber layer structure abnormalities in early Alzheimer's disease: evidence in optical coherence tomography[J]. Neurosci Lett, 2010, 480(1): 69-72. DOI: 10.1016/j.neulet.2010.06.006.
19. Nissen MJ, Corkin S, Buonanno FS, et al. Spatial vision in Alzheimer's disease. General findings and a case report[J]. Arch Neurol, 1985, 42(7): 667-671. DOI: 10.1001/archneur.1985.04060070057015.
20. Tamura H, Kawakami H, Kanamoto T, et al. High frequency of open-angle glaucoma in Japanese patients with Alzheimer's disease[J]. J Neurol Sci, 2006, 246(1-2): 79-83. DOI: 10.1016/j.jns.2006.02.009.
21. Ziangirova GG, Antonova OV. Local senile ocular amyloidosis in the pathogenesis of open-angle glaucoma and pseudo-exfoliative syndrome[J]. Vestn Ross Akad Med Nauk, 2003, (2): 40-43.
22. Janciauskiene S, Krakau T. Alzheimer's peptide and serine proteinase inhibitors in glaucoma and exfoliation syndrome[J]. Doc Ophthalmol, 2003, 106(3): 215-223.

Chinese Journal of Ocular Fundus Diseases

Retinal nerve fiber layer thickness in patients with Alzheimer's disease

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