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Medicine

眼底イメージングを使用して認知症を研究するには

Published: November 06, 2017
doi:
10.3791/56137
, , , , , , ,
1Department of Ophthalmology and Visual Sciences,The Chinese University of Hong Kong, 2Department of Medicine & Therapeutics,The Chinese University of Hong Kong, 3Therese Pei Fong Chow Research Centre for Prevention of Dementia,The Chinese University of Hong Kong, 4Gerald Choa Neuroscience Centre,The Chinese University of Hong Kong, 5Memory Aging and Cognition Centre,National University Health System, 6Department of Pharmacology,National University of Singapore, 7Singapore Eye Research Institute,Singapore National Eye Centre, 8Duke-NUS Medical School,National University of Singapore

Summary

網膜は脳と顕著な類似性を共有し、従って非侵襲的血管と脳の神経構造を研究するためのユニークなウィンドウを表します。このプロトコルでは、網膜のイメージング技術を用いた痴呆を調査する手法について説明します。このメソッドは、潜在的認知症の診断とリスク アセスメントを援助できます。

Abstract

網膜と中枢神経系 (CNS) の延長である発生学的起源は、解剖学的特徴の面で脳と顕著な類似性を共有して、脳で認知症の病態生理を研究するユニークな「窓」を提供しています、生理学的プロパティ。 網膜の血管や神経の構造は簡単に可視化し非侵襲的網膜イメージング技術、眼底写真と光干渉断層計 (OCT) などを含む、半自動的を用いて定量化できるようになりました計算機援用解析プログラム。網膜の血管や神経の変化と認知症の関係を勉強して改善できる認知症への理解と、潜在的に、診断とリスク評価に役立ちます。 このプロトコルは、定量化し、潜在的認知と関連付けられる網膜血管と神経構造分析の手法を目指しています。このプロトコルはまた認知症被験者の網膜の変化の例を提供し、技術的な問題および眼底イメージングの現在の制限事項について説明します。

Introduction

平均寿命に伴い重要な社会に貢献すること、主要な医療問題となっている認知症と経済の健康負担グローバル1,2,3,4,5。今日では、アメリカ合衆国の人は、アルツハイマー病 (AD)、66 秒6、認知症の最も一般的なフォームを開発しています。それは 2050 年までには、1 億 1500 万人が広告7影響を受けるが推定されています。

網膜は脳とそのような解剖学的および生理学的な特性のための認知症を勉強するユニークな「窓」を提供していますいます。血管、網膜細動脈、細静脈、直径 100 ~ 300 μ m の測定点で終わり細動脈吻合、バリア機能と自動規制8,なしなどの脳小血管と似たような機能を共有します。9. 神経構造の観点から網膜神経節細胞 (Rgc) は中枢神経系 (CNS) 10 のニューロンの典型的なプロパティを共有します。Rgc は、外側膝状核、上丘は網膜から視神経とプロジェクト視覚信号のフォームとして目立つように脳と接続されます。視神経、中枢神経系、神経繊維の多くと同様、オリゴデンドロ サイトによって有髄髄膜層で鞘です。特に、視神経への侮辱が結果することができますその他の中枢神経系の軸索にみられるような応答のように逆行と軸索、瘢痕形成、髄鞘破壊、二次変性、神経栄養因子の異常なレベルの前向性変性因子と神経伝達物質11,12,13,14。いくつかの AD 患者における視覚的症状の出現は、網膜と脳15,16の堅牢な関係によって説明されるかもしれない。その結果、網膜は脳で認知症の病態を反映可能性があり、認知症を勉強する眼底イメージングを使用ことができます示唆されています。

網膜血管と神経の構造は、非侵襲的網膜イメージング技術を使用して今視覚化できます。例えば、眼底カメラで眼底写真を取り込めるし、網膜血管 (例えば容器の口径、蛇行とフラクタル次元) の特徴は、コンピューターによる解析を用いて定量化します。プログラム。さらに、網膜の神経構造 (神経節細胞内網状層 [GC IPL] と [視神経] 網膜神経線維層の厚み) などのパラメーターの光コヒーレンストモグラフィ (OCT) を使用して測定することができます、組み込みを用いて定量化解析アルゴリズム。

認知症を勉強する眼底イメージングの重要性の観点からこのプロトコルはイメージングと網膜血管と神経構造体内の網膜イメージング技術を使用して分析する方法を説明を目指しています。このプロトコルはまた認知症被験者の網膜の変化の例を提供し、技術的な問題および眼底イメージングの現在の制限事項について説明します。

Protocol

ここで説明したすべてのメソッドは、香港で地元の臨床研究倫理委員会によって承認されている。 注: 眼底イメージングとその後の分析の手順を説明するために簡単にするため、材料の表 に記載されている装置を使用します。網膜血管パラメーターの測定は、シンガポール I 容器評価プログラム (シヴァ) 17 (バージョン 4.0、位シンガポー…

Representative Results

図 10:正常者と広告対象の網膜血管系の違いを示した例です。正常者と比較して、広告対象の眼底写真を示した狭い容器口径 (CRAE のゾーン B、μ m 116.4対156.4 μ m;ゾーン B、μ m 186.9対207.5 μ m; CRVECRAE ゾーン C μ m 138.5対165.8 μ m;ゾーン C, 232.2 μ m対</em…

Discussion

このプロトコルでは、生体内で網膜の神経細胞および血管の変化の定量の手順について説明します。網膜は脳と同じような発生学的起源、解剖学的特徴と生理学的性質を共有しているこれらの眼底所見は血管および脳の神経の構造と同様の変更を反映可能性があります。

図 10 表 1に示すように、健常人と比較して減少した容器口…

Disclosures

The authors have nothing to disclose.

Acknowledgements

潜在的な金融関係に関する著者の Y. ウォンはこの記事で使用されるシンガポール I 容器評価 (シヴァ) プログラムの共同発明者です。

Materials

Non-mydriatic Retinal Camera  Topcon, Inc, Tokyo, Japan TRC 50DX  N/A
Singapore I Vessel Assessment Program National University of Singapore Version 4.0 N/A
CIRRUS HD-OCT  Carl Zeiss Meditec, Inc, Dublin, CA Model 4000 N/A
Mydriatic Agents  N/A N/A Prepared from 1% tropicamide and 2.5% phenylephrine hydrochloride
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Retinal ImagingDementiaAlzheimer’s DiseaseBiomarkersVascular ChangesNeuronal ChangesFundus CameraPupil DilationImage CaptureOptic DiscRetinaComputer-assisted Analysis
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Chan, V. T., Tso, T. H., Tang, F., Tham, C., Mok, V., Chen, C., Wong, T. Y., Cheung, C. Y. Using Retinal Imaging to Study Dementia. J. Vis. Exp. (129), e56137, doi:10.3791/56137 (2017).
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