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Summary
Abstract
Introduction
Protocol
Results
Discussion
Disclosures
Acknowledgements
Materials
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Medicine

Met behulp van retinale Imaging te bestuderen van dementie

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

Het netvlies deelt opvallende gelijkenissen met de hersenen en vormt aldus een uniek venster te bestuderen van therapieën en neuronale structuur in de hersenen niet-gebeurt. Dit protocol beschrijft een methode om te studeren met behulp van retinale beeldvormingstechnieken dementie. Deze methode kan kunnen helpen bij de diagnose en risicobeoordeling van dementie.

Abstract

Het netvlies biedt een unieke “venster” om te studeren pathofysiologische processen van dementie in de hersenen, zoals het is een uitbreiding van het centrale zenuwstelsel (CNS) en opvallende gelijkenissen met de hersenen in termen van de embryologische oorsprong, anatomische eigenschappen deelt en fysiologische eigenschappen.  De vasculaire en neuronale structuur in het netvlies kan nu worden gevisualiseerde gemakkelijk en niet-gebeurt met retinal beeldvormende technieken, met inbegrip van de fundus fotografie en optische coherentie tomografie (OCT) en gekwantificeerd semi-automatisch met behulp van computer-assisted analyse programma’s. Bestuderen van de associaties tussen vasculaire en neuronale veranderingen in het netvlies en dementie kan verbeteren van onze kennis over dementie en, potentieel, steun in de diagnose en de risicobeoordeling.  Dit protocol is gericht op het beschrijven van een methode voor de kwantificering en analyseren van retinale therapieën en neuronale structuur, die mogelijk verband houden met dementie. Dit protocol ook geeft voorbeelden van retinale veranderingen in onderwerpen met dementie, en bespreekt technische kwesties en huidige beperkingen voor retinale imaging.

Introduction

Als gevolg van de stijging van de levensverwachting, dementie is uitgegroeid tot een belangrijke medische probleem, bij te dragen tot aanzienlijke sociale en economische gezondheid last wereldwijd1,2,,3,,4,5. Vandaag, ontwikkelt een persoon in de Verenigde Staten de ziekte van Alzheimer (AD), de meest voorkomende vorm van dementie, elke 66 s6. Er wordt geschat dat in het jaar 2050, 115 miljoen mensen zal worden beïnvloed door AD7.

Het netvlies biedt een unieke “venster” om te studeren van dementie te wijten aan haar vergelijkbare anatomische en fysiologische eigenschappen met de hersenen. In termen van therapieën delen de retinale arteriolen en venules, het meten van 100 tot 300 µm in diameter, gelijkaardige eigenschappen met cerebrale kleine vaartuigen, zoals einde arteriolen zonder auto-voorschrift8, , anastomoses en barrièrefunctie 9. in de termen van neuronale structuur, retinale ganglionaire cellen (RGCs) delen typische eigenschappen met neuronen in het centrale zenuwstelsel (CNS) 10. De RGCs zijn opvallend verbonden met de hersenen, als zij de oogzenuw en project visuele signalen van het netvlies naar de laterale geniculate kernen en de superieure colliculus vormen. De oogzenuw, vergelijkbaar met veel neuronale vezels in het VNV, is myelinated door oligodendrocyten en ensheathed in de meningeal lagen. Met name, een belediging voor de oogzenuw kan resulteren in soortgelijke reacties waargenomen in andere CNS axonen, zoals retrograde en anterograde degeneratie van het axon, littekenvorming, vernietiging van myeline, secundaire degeneratie en een abnormale hoeveelheid neurotrophic factoren en neurotransmitters11,12,13,14. Het uiterlijk van visuele symptomen bij sommige patiënten AD kan ook worden verklaard door de robuuste koppelingen tussen het netvlies en de hersenen15,16. Dientengevolge, is er gesuggereerd dat het netvlies de pathologische processen van dementie in de hersenen weerspiegelen kan en netvlies beeldvorming kan worden gebruikt voor het bestuderen van dementie.

Het netvlies therapieën en de neuronale structuur kunnen nu worden gevisualiseerd niet-gebeurt met behulp van retinale beeldvormingstechnieken. Bijvoorbeeld, retinale fundus foto’s kunnen worden vastgelegd met behulp van de fundus camera’s en kenmerken van de retinale therapieën (bijvoorbeeld een vaartuig kaliber, tortuosity en Fractale dimensie) kunnen dan worden gekwantificeerd aan de hand computerondersteunde analyse programma’s. Bovendien, de parameters van de retinale neuronale structuur (zoals de dikte van de ganglion cel-inner Meervormige laag [GC-IPL] en netvlies zenuw fiber [RNFL]) kunnen ook worden gemeten met behulp van optische coherentie tomografie (OCT) en gekwantificeerd aan de hand van de ingebouwde analyse algoritmen.

Gezien het belang van retinale imaging aan het bestuderen van dementie, wil dit protocol beschrijft een methode van imaging en analyseren van retinale therapieën en neuronale structuur in vivo met behulp van retinale beeldvormingstechnieken. Dit protocol ook geeft voorbeelden van retinale veranderingen in onderwerpen met dementie, en bespreekt technische kwesties en huidige beperkingen voor retinale imaging.

Protocol

alle methoden die hier worden beschreven zijn goedgekeurd door de ethische commissie van een lokale klinisch onderzoek in Hong Kong. Opmerking: omwille van de eenvoud, de uitrusting vermeld in de Tabel van materialen wordt gebruikt ter illustratie van de procedures van de retinale beeldvorming en latere analyse. Meting van retinale vasculaire parameters wordt geïllustreerd met behulp van de Singapore I vaartuig beoordeling programma (SIVA) 17 (versi…

Representative Results

Figuur 10: Een voorbeeld om te laten zien van de verschillen in netvlies therapieën tussen een normale onderwerp en een onderwerp AD. In vergelijking met de normale onderwerp, fundus foto van het onderwerp van AD bleek smaller vaartuig kalibers (LONELINE voor Zone B, 116.4 µm vs. 156,4 µm; CRVE voor Zone B, 186.9 µm vs. 207,5 µm; LONE…

Discussion

Dit protocol beschrijft de procedures voor het kwantificeren van de neuronale en vasculaire veranderingen in het netvlies in vivo. Zoals het netvlies soortgelijke embryologische oorsprong, anatomische eigenschappen en fysiologische eigenschappen met de hersenen deelt, kunnen deze netvlies veranderingen wijzigingen soortgelijke van therapieën en neuronale structuur in de hersenen.

Zoals aangetoond in Figuur 10 en tabel 1, toonde het onder…

Disclosures

The authors have nothing to disclose.

Acknowledgements

Met betrekking tot potentiële financiële banden is de auteur Tien Y. Wong een mede-uitvinder van de Singapore I vaartuig beoordeling (SIVA) wordt gebruikt in dit artikel.

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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