摘要
目的通过Cirrus高分辨率光学相干断层扫描(Cirrus HD-OCT)分析帕金森病(PD)患者的黄斑视网膜厚度及视盘周围视网膜神经纤维层厚度(RNFL)变化特点,以及帕金森病黄斑区各象限视网膜厚度与简易精神状况量表(MMSE)、蒙特利尔认知评估量表(MoCA)总分、日常生活能力评定(ADL)及视空间与执行发生的相关性,并进一步探讨帕金森病痴呆组和非痴呆组的黄斑视网膜及视盘周围RNFL变化。方法选择2018年11月至2019年10月在山西医科大学第一医院神经内科确诊的帕金森病患者25例(50只眼)作为PD组,以及与之年龄、性别相匹配的健康者15例(30只眼)作为对照组,行HD-OCT检查,分析PD组和对照组间及PD非痴呆和痴呆组黄斑视网膜及视盘周围RNFL厚度变化,分析PD患者黄斑区各象限视网膜厚度与认知障碍之间的相关性。采用SPSS20.0统计学软件对两组受检者数据进行分析,以P<0.05为差异有统计学意义。结果PD组与对照组相比,黄斑区外环上方(t=-2.105,P=0.035)、鼻侧(t=-2.140,P=0.036)、颞侧(t=-2.339,P=0.019)、内环鼻侧(t=-2.072,P=0.042)视网膜厚度差异均具有统计学意义。视盘周围各象限及平均视网膜厚度间差异无统计学意义(P>0.05)。PDD组与n-PDD组相比较,黄斑区外环颞侧与内环各象限(上、下、鼻、颞)视网膜差异有统计学意义(P<0.05),且PDD组黄斑区视网膜厚度较n-PDD组及对照组普遍变薄。PDD组与对照组相比,PDD组外环上方、颞侧及内环各象限(上、下、鼻、颞)视网膜厚度均较对照组差异有统计学意义(P<0.05)。其中内环上方、内环颞侧厚度对于帕金森病痴呆有较好的诊断价值,其受试者工作特征曲线下面积分别为71.4%(95%CI 0.547~0.881)、74.7%(95%CI 0.582~0.911)。PDD组与n-PDD组比较,视盘颞侧神经纤维层厚度变薄,差异有统计学意义。结论帕金森病患者黄斑区视网膜厚度较对照组明显变薄,帕金森病痴呆组黄斑区视网膜厚度较非痴呆组及对照组明显变薄,其中内环上方、内环颞侧厚度对于帕金森病痴呆有较好的诊断价值。帕金森病痴呆组患者视盘颞侧神经纤维层厚度较非痴呆组及对照组明显变薄。
Objective To analyze the characteristic changes of macular retinal thickness and circumpapillary retinal nerve fiber layer thickness in patients with Parkinson’s disease(PD)by cirrus High resolution optical coherence tomography(cirrus-HD OCT),and find out the association between macular thickness with simple mental status scale(MMSE),Montreal Cognitive Assessment(MOCA)total scores,ability of daily living assessment(ADL),visual space and execution occurrence.To further discuss the changes of macular retinal and circumpapillary nerve fiber layer thickness in Parkinson’s disease dementia group and non-dementia group.Methods 25 patients(50 eyes)with PD from the neurology department of the first hospital in Shanxi Medical University from November 2018 to October 2019 were selected as the group of Parkinson’s disease,and 15 healthy persons(30 eyes)matched with the age and sex were selected as the control group and the HD-OCT examination was performed.To analyze the changes of the macular retinal and circumpapillary retinal nerve fiber layer thickness in the Parkinson’s disease group and the control group and the non-dementia and dementia group in the Parkinson’s disease,and the retinal thickness of each quadrant in the macular region of the patients with Parkinson’s disease and cognitive disorder.The data of two groups of subjects were analyzed by using the spss 20.0 statistical software,and the difference of P<0.05 was of statistical significance.Results Compared with the control group,the difference of the macular retinal thickness on the superior(t=-2.105,P=0.035),nasal(t=-2.140l,P=0.036),temporal quadrants(t=-2.339,P=0.019)of outer ring and the nasal(t=-2.072,P=0.042)quadrant of inner ring was of statistical significance.There was no significant difference between all quadrants and the average retinal thickness around the optic disc(P>0.05).In the PDD group and the n-PDD group,there was a significant difference in temporal thickness of the outer ring and all quardrants of the inner ring(superior,inferior,nasal and temporal)of the macular region(P<0.05),and In the PDD group,all quadrants of the macular thickness was generally thinner than that of the n-PDD and the control group.the macular retinal thickness of the superior,temporal quarants of outer ring and all quarants of inner ring(superior,inferior,nasal,temporal)in the PDD group was significantly different from that in the control group(P<0.05).The superior and the temporal quarants of the inner ring have good diagnostic value for Parkinson’s disease dementia,the area under the working characteristic curve of the subjects is 71.4%(95%CI 0.547~0.881)and 74.7%(95%CI 0.582~0.911),respectively.Compared with n-PDD group,the thickness of temporal nerve fiber layer in PDD group was thinner than that in n-PDD group,and the difference was statistically significant.Conclusions The macular retinal thickness in patients with Parkinson’s disease is significantly thinner than that in the control group,and the retinal thickness in the macular area in the Parkinson’s disease dementia group is significantly thinner than that in the non-dementia group and the control group.The macular thickness on the inner superior and the temporal quadrants is of good diagnostic value for Parkinson’s disease dementia.The thickness of optic disc temporal nerve fiber layer in Parkinson’s disease dementia group was significantly thinner than that in non-dementia group and control group.
作者
王芳
田玉玲
王秀秀
WANG Fang;TIAN Yuling;WAGN Xiuxiu(Shanxi Medical University,Taiyuan 030001,China)
出处
《中风与神经疾病杂志》
CAS
2020年第7期611-617,共7页
Journal of Apoplexy and Nervous Diseases
关键词
帕金森病
光学相干断层扫描
视网膜
厚度
痴呆
Parkinson’s disease
Optical coherence tomography
Retina layers
Thickness
Dementia
