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Retinale Bildgebung von Makula und Papille bei neurodegenerativen Erkrankungen

Retinal imaging of the macula and optic disc in neurodegenerative diseases

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Zusammenfassung

Hintergrund

Aufgrund demografischer Trends steigen Prävalenz und Inzidenz von leichten kognitiven Störungen und Demenzen. Für potenzielle zukünftige Therapien müssten Betroffene bzw. Hochrisikogruppen frühzeitig identifiziert werden. Jedoch gibt es zurzeit kein bevölkerungsbasiertes Screening. Somit besteht ein dringender Bedarf, Biomarker, die sich für ein Screening eignen, zu identifizieren. Vor diesem Hintergrund wird die aktuelle Literatur zu Netzhautveränderungen, die im Rahmen neurodegenerativer Erkrankungen vorkommen, zusammengefasst.

Methoden

Es erfolgte eine Literatursuche in PubMed bis August 2016 mit den Suchbegriffen „mild cognitive impairment“, „dementia“, „eye“, „ocular biomarkers“, „OCT“ und „OCT angiography“. Relevante Publikationen wurden ausgewählt und qualitativ zusammengefasst.

Ergebnisse

In einer Reihe von Studien konnten unspezifische Netzhautveränderungen bei Patienten mit neurodegenerativen Erkrankungen wie leichter kognitiver Störung, Alzheimer- und Parkinson-Erkrankung mit der optischen Kohärenztomographie (OCT) aufgezeigt werden. Pathologische Veränderungen sind in der Mehrzahl der Studien eine Reduktion von Makulavolumen, Nervenfaserschichtdicke sowie Ganglienzellkomplex. Basierend auf den vorhandenen Studien, ist bislang kein spezifischer okulärer Biomarker für Neurodegeneration, der in der klinischen Routinediagnostik integriert werden könnte, definiert worden.

Schlussfolgerung

Die potenzielle Anwendung von OCT im Screening sowie zur Überwachung einer Progression von neurodegenerativen Erkrankungen muss in longitudinalen Studien mit großen Kohorten weiter untersucht werden.

Abstract

Background

Due to current demographic trends, the prevalence of mild cognitive impairment and dementia is expected to increase considerably. For potential new therapies it is important to identify patients at risk as early as possible. Currently, there is no population-based screening. Therefore, identification of biomarkers that will help screen the population at risk is urgently needed. Thus, a literature review on retinal pathology in neurodegenerative diseases was performed.

Methods

PubMed was searched for studies published up to August 2016 using the following keywords: “mild cognitive impairment”, “dementia”, “eye”, “ocular biomarkers”, “OCT” and “OCT angiography”. Relevant publications were selected and summarized qualitatively.

Results

Multiple studies using noninvasive in vivo optical coherence tomography (OCT) imaging showed nonspecific retinal pathological changes in patients with neurodegenerative diseases such as mild cognitive impairment, Alzheimer’s and Parkinson’s disease. Pathological changes in macular volume, optic nerve fiber layer thickness and the ganglion cell complex were observed. However, based on available evidence, no ocular biomarkers for neurodegeneration which could be integrated in routine clinical diagnostics have been identified.

Conclusion

The potential use of OCT in the early diagnostic workup and monitoring of progression of neurodegenerative diseases needs to be further explored in longitudinal studies with large cohorts.

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Authors and Affiliations

  1. Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland

    G. N. Turski, S. Schmitz-Valckenberg, F. G. Holz &  R. P. Finger PhD

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  1. G. N. Turski
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  2. S. Schmitz-Valckenberg
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  3. F. G. Holz
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  4. R. P. Finger PhD
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Correspondence to R. P. Finger PhD.

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Interessenkonflikt

G.N. Turski, S. Schmitz-Valckenberg, F.G. Holz und R.P. Finger geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Turski, G.N., Schmitz-Valckenberg, S., Holz, F.G. et al. Retinale Bildgebung von Makula und Papille bei neurodegenerativen Erkrankungen. Ophthalmologe 114, 114–119 (2017). https://doi.org/10.1007/s00347-016-0412-8

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  • DOI: https://doi.org/10.1007/s00347-016-0412-8

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