Microvascular network alterations in the retina of patients with Alzheimer's disease

被引:232
作者
Cheung, Carol Yim-lui [1 ,2 ,3 ]
Ong, Yi Ting [1 ,2 ,4 ]
Ikram, M. Kamran [1 ,2 ,3 ,5 ,6 ]
Ong, Shin Yeu [1 ,3 ]
Li, Xiang [1 ,2 ]
Hilal, Saima [5 ]
Catindig, Joseree-Ann S. [5 ]
Venketasubramanian, Narayanaswamy [5 ]
Yap, Philip [7 ]
Seow, Dennis [8 ]
Chen, Christopher P. [5 ,9 ]
Wong, Tien Yin [1 ,2 ]
机构
[1] Singapore Natl Eye Ctr, Singapore Eye Res Inst, Singapore, Singapore
[2] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Ophthalmol, Singapore 117595, Singapore
[3] Duke NUS Grad Med Sch, Off Clin Sci, Ctr Quantitat Med, Singapore, Singapore
[4] Natl Univ Singapore, NUS Grad Sch Integrat Sci & Engn, Singapore 117548, Singapore
[5] Natl Univ Hlth Syst, Memory Aging & Cognit Ctr, Singapore, Singapore
[6] Erasmus MC, Dept Ophthalmol, Rotterdam, Netherlands
[7] Khoo Teck Puat Hosp, Dept Geriatr Med, Singapore, Singapore
[8] Singapore Gen Hosp, Dept Geriatr Med, Singapore, Singapore
[9] Natl Univ Singapore, Dept Pharmacol, Singapore 117548, Singapore
基金
英国医学研究理事会;
关键词
Retina; Retinal vasculature; Alzheimer's disease; Microcirculation; Small-vessel disease; ATHEROSCLEROSIS RISK; CEREBROVASCULAR-DISEASE; ARTERIOLAR TORTUOSITY; COGNITIVE IMPAIRMENT; VASCULAR CALIBER; OLDER PERSONS; EYE DISEASES; ABNORMALITIES; METHODOLOGY; RETINOPATHY;
D O I
10.1016/j.jalz.2013.06.009
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Although cerebral small-vessel disease has been implicated in the development of Alzheimer's disease (AD), the cerebral microcirculation is difficult to visualize directly in vivo. Because the retina provides a noninvasive window to assess the microcirculation, we determined whether quantitatively measured retinal microvascular parameters are associated with AD. Methods: We conducted a case-control study (case:control matching approximate to 1:2). Retinal photographs were analyzed using a computer program, and a spectrum of quantitative retinal microvascular parameters (caliber, fractal dimension, tortuosity, and bifurcation) were measured. Logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval for AD adjusting for age, gender, ethnicity, smoking, hypertension, diabetes, hypercholesterolemia, and history of myocardial infarction. Results: We included 136 demented patients with AD and 290 age-gender-race-matched controls. Persons with narrower venular caliber (OR per standard deviation [SD] decrease, 2.01 [1.27-3.19]), decreased arteriolar and venular fractal dimension (OR per SD decrease 1.35 [1.08-1.68], 1.47 [1.17-1.84], respectively) and increased arteriolar and venular tortuosity (OR per SD increase, 1.84 [1.40-2.31], 1.94 [1.48-2.53], respectively) were more likely to have AD. These associations still persisted when only AD cases without a history of cerebrovascular disease were included. Conclusions: Patients with AD have altered microvascular network in the retina (narrower retinal venules and a sparser and more tortuous retinal vessels) compared with matched nondemented controls. These changes in retinal microvasculature may reflect similar pathophysiological processes in cerebral microvasculature in the brains of patients with AD. (C) 2014 The Alzheimer's Association. All rights reserved.
引用
收藏
页码:135 / 142
页数:8
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