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Introduction
Protocol
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Medicine

利用视网膜成像研究痴呆

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

视网膜与大脑有着显著的相似性, 因此它是研究脑性中血管和神经元结构的独特窗口。本协议描述了一种利用视网膜成像技术研究痴呆症的方法。这种方法对痴呆的诊断和风险评估有潜在的帮助。

Abstract

视网膜提供了一个独特的 “窗口” 来研究大脑中的老年痴呆的病理生理过程, 因为它是中枢神经系统 (CNS) 的延伸, 与大脑在胚胎起源、解剖特征和生理特性。 视网膜的血管和神经元结构现在可以很容易地被形象化和性使用视网膜成像技术, 包括眼底摄影和光学相干断层扫描 (OCT), 和量化半自动使用计算机辅助分析程序。研究视网膜和痴呆的血管和神经元变化之间的联系可以提高我们对痴呆症的认识, 并可能有助于诊断和风险评估。 本议定书的目的是描述一种量化和分析视网膜血管和神经元结构的方法, 这可能与痴呆有关。该协议还提供了一些例子, 视网膜变化的主题与痴呆, 并讨论技术问题和目前的局限性, 视网膜成像。

Introduction

由于预期寿命的增加, 痴呆已成为一个重大的医疗问题, 导致重大的社会和经济健康负担全球1,2,3,4,5。今天, 一个人在美国发展老年痴呆症 (AD), 最常见的形式的痴呆, 每六十六年代6。据估计, 到公元 2050, 1亿1500万人将受到 AD7的影响。

视网膜提供了一个独特的 “窗口”, 以研究痴呆, 由于其类似的解剖和生理特性与大脑。在血管方面, 视网膜动脉和静脉, 测量直径100至300µm, 与脑小血管有相似的特征, 如无吻合的端动脉, 屏障功能, 和调节8,9. 在神经元结构方面, 视网膜节细胞 (视网膜) 与中枢神经系统 (CNS) 10 的神经元有着典型的特性。视网膜是突出的连接与大脑, 因为他们形成的视神经和项目的视觉信号从视网膜到外侧膝状核和优越的丘。视神经, 类似于中枢神经系统中的许多神经纤维, 由突髓, ensheathed 于脑膜层。值得注意的是, 对视神经的污辱会导致其他中枢神经系统轴突的类似反应, 如轴突逆行和顺变性、瘢痕形成、髓鞘破坏、继发变性和神经营养异常水平因素和神经递质11,12,13,14。一些 AD 患者的视觉症状的出现也可以通过视网膜和大脑之间的强关联来解释15,16。因此, 有人建议, 视网膜可能反映痴呆的病理过程中的大脑和视网膜成像可以用来研究痴呆症。

视网膜血管和神经元结构现在可以可视化性利用视网膜成像技术。例如, 视网膜眼底照片可以使用眼底照相机捕捉, 而视网膜血管的特征 (例如,血管口径、曲折和分形维数) 可以通过计算机辅助分析进行量化程序.此外, 还可以使用光学相干断层扫描 (OCT) 测量视网膜神经元结构 (如神经节细胞-内状层的厚度 [GC-光子) 和视网膜神经纤维层 [纤维]) 的参数, 并使用内置分析算法。

鉴于视网膜成像对研究痴呆的重要性, 本议定书的目的是描述一种成像和分析视网膜血管和神经元结构在体内使用视网膜成像技术的方法。该协议还提供了一些例子, 视网膜变化的主题与痴呆, 并讨论技术问题和目前的局限性, 视网膜成像。

Protocol

此处描述的所有方法均已得到香港当地临床研究伦理委员会的批准. 注意: 为了简单起见, 在 材料表中列出的设备 用于说明视网膜成像的过程和随后的分析。利用新加坡 I 船评估计划 (湿婆) 17 (新加坡国立大学, 新加坡), 对视网膜血管参数的测量进行了说明。然而, 应该指出的是, 可以采用一套不同的设备, 因为基本原则仍然是相似的. <p cl…

Representative Results

图 10:一个例子, 以显示在正常的主题和一个广告主题之间的视网膜血管的差异.与正常人相比, AD 的眼底照片显示狭窄的血管口径 (CRAE 区 B、116.4 µm vs. 156.4 µm;CRVE 区 B, 186.9 µm vs. 207.5 µm;CRAE 区 C, 138.5 µm vs. 165.8 µm;CRVE 区 C, 206.6 µm vs. 232.2 µm), 更小…

Discussion

本协议描述了在视网膜体内量化神经元和血管变化的过程。由于视网膜与大脑有着相似的胚胎来源、解剖特征和生理特性, 这些视网膜的变化可能反映了大脑中血管和神经元结构的类似变化。

如图 10和表 1所示, 与健康主题相比, AD 主题显示的容器口径减少。据报道, 减少 CRVE 和 CRAE 是与阿尔茨海默氏病相关的46,</s…

Disclosures

The authors have nothing to disclose.

Acknowledgements

关于潜在的金融关系, 作者发明是新加坡 I 船评估 (湿婆) 项目中使用的一份文件。

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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