The diagnostic value of functional and morphometric parameters of the retina and optic nerve in patients with Alzheimer’s disease

PURPOSE: To evaluate the diagnostic value of morphometric, morphological and functional and parameters characterizing the state of the retina and optic nerve head (ONH) in patients with Alzheimer’s disease (stage of mild dementia) using computerized static perimetry and optical coherence tomography. METHODS: We examined 17 patients (34 eyes) with Alzheimer’s disease aged 59-82 years (mean age 71 years). All patients underwent a standard eye examination including visometry, computerized static perimetry on the visual field analyzer Humphrey Field Analiser II (HFA II) 750i (Germany) with the use of screening and threshold programs, biomicroscopy, ophthalmoscopy, Goldmann tonometry. Morphometric parameters of the optic nerve and the retina were assessed by optical coherence tomography (OCT) on the RTVue-100 (Optovue, USA). RESULTS: The study of the visual field in the threshold program 30-2 and 60-4 in patients with Alzheimer’s disease revealed the following patterns: a diffuse decrease in sensitivity, concentric arrangement of defects in the peripheral zone of the test visual field (central and peripheral), and a discrepancy between the results of research on threshold and screening programs. The study of morphometric parameters of the retina and optic nerve with OCT revealed diffuse thinning of the retina in patients with Alzheimer’s disease and an increase in the level of complex GCS volume global loss (GLV). CONCLUSION: The discrepancy between the results of visual field function study and morphometric parameters of the retina and optic nerve demonstrates low diagnostic value of the threshold study of computerized static perimetry in examining dementia patients with visual impairments, and can itself serve as a marker for dementia.

Болезнь Альцгеймера, статическая компьютерная периметрия, оптическая когерентная томография, диффузное снижение светочувствительности, концентрическая депрессия светочувствительности, уровень глобальных потерь ГКС (GLV), Alzheimer’s disease, static computer perimetry, optical coherence tomography, diffuse decrease in visual field sensitivity, concentric depression of visual field sensitivity, GLV

1. Albert M.S., DeKosky S.T., Dickson D., Dubois B., Feldman H.H., Fox N.C., et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 2011; 7(3): 270-279.

2. Hardy J., Allsop D. Amyloid deposition as the central event in the aetiology of Alzheimer's disease. Trends Pharmacol Sci 1991; 12(10): 383-388.

3. Cronin-Golomb A., Corkin S., Rizzo J.F., Cohen J., Growdon J.H., Banks K.S. Visual dysfunction in Alzheimer's disease: relation to normal aging. Ann Neurol 1991; 29(1): 41-52.

4. Gilmore G.C., Whitehouse P.J. Contrast sensitivity in Alzheimer's disease: a 1-year longitudinal analysis. Optom Vis Sci 1995; 72(2): 83-91.

5. Graff-Radford N.R., Lin S.C., Brazis P.W., Bolling J.P., Liesegang T.J., Lucas J.A., et al. Tropicamide eyedrops cannot be used for reliable diagnosis of Alzheimer's disease. Mayo Clin Proc 1997; 72(6): 495-504.

6. Rizzo J.F. 3rd, Cronin-Colomb A., Growdon J.H., et al. Retinocalcarine function in Alzeimer's disease: a clinical and electrophysiological study. Arch Neurol 1992; 49(1): 93-101.

7. Trick G.L., Barris M.C., Bicker M. Abnormal pattern electroretinograms in patients with senile dementia of the Alzheimer type. Ann Neurol 1989; 26(2): 226-231.

8. Katz B., Rimmer S., Iragui V., Katzman R. Abnormal pattern electroretinigram in Alzheimer's disease: evidence for retinal ganglion cell degeneration? Ann Neurol 1989(2); 26: 221-225.

9. Parisi V., Restuccia R., Fattapposta F., Mina C., Bucci M.G., Pierelli F. Morphological and functional retinal impairment in Alzheimer's disease patients. Clin Neurophysiol 2001; 112(10): 1860-1867.

10. Armstrong R.A. Visual field defects in Alzheimer's disease patients may reflect differential pathology in the primary visual cortex. Optom Vis Sci 1996; 73(11): 677-682.

11. Hinton D.R., Sadun A.A., Blanks J.C., Miller C.A. Optic nerve degeneration in Alzheimer's disease. N Engl J Med 1986; 315(8): 485-487.

12. Blanks J.C., Hinton D.R., Sadun A.A., Miller C.A. Retinal ganglion cell degeneration in Alzheimer's disease. Brain Res 1989; 501(2): 364-372.

13. Blanks J.C., Torigoe Y., Hinton D.R., Blanks R.H. Retinal pathology in Alzheimer's disease. I. Ganglion cell loss in foveal/parafoveal retina. Neurobiol Aging 1996; 17(3): 377-384.

14. Sadun A.A., Bassi C.J. Optic nerve damage in Alzheimer's disease. Ophthalmology 1990; 97(1): 9-17.

15. Trick G.L., Trick L.R., Morris P., Wolf M. Visual field loss in senile dementia of the Alzheimer's disease type. Neurology 1995; 45(1): 68-74.

16. Valenti D.A. Alzheimer’s Disease: screening biomarkers using frequency doubling technology visual field. ISRN Neurology 2013 Article ID 989583, 9 pages, 2013. doi: 10.1155/2013/989583.

17. Iseri P.K., Altinas O., Tokay T., Yuksel N. Relationship between cognitive impairment and retinal morphological and visual functional abnormalities in Alzheimer's disease. J Neuro-Ophthal 2006; 26(1): 18-24.

18. Тиганов А.С., Акопян В.С., Гаврилова С.И., Семенова Н.С., Федорова Я.Б., Гурова Е.В. Нейроархитектоника сетчатки пациентов с болезнью Альцгеймера и синдромом мягкого когнитивного снижения (предварительные результаты). Офтальмология 2012; 9: 43-46.

19. Berisha F., et al. Localized retinal nerve fiber layer thinning in patients with early glaucoma or Alzheimer's disease. Invest Ophthal Vis Sci 2006; 47: 3379.

20. Berisha F., Feke G.T., Trempe C.L., McMeel J.W., Schepens C.L. Retinal abnormalities in early Alzheimer's disease. Invest Ophthalmol Vis Sci 2007; 48(5): 2285-2289.

21. Deng Y.L., Chen Y., Xie L.Q., et al. Morphological change of retina in mild Alzheimer's disease. Zhenduanxue Lilun Yu Shijian 2009; 8: 397-400.

22. Lu Y., Li Z., Zhang X. et al. Retinal nerve fiber layer structure abnormalities in early Alzheimer's disease: evidence in optical coherence tomography. Neurosci Letters 2010; 480(1): 69-72.

23. Parisi V., Restuccia R., Fattapposta F., Mina C., Bucci M.G., Pierelli F. Morphological and functional retinal impairment in Alzheimer's disease patients. Clin Neurophysiol 2001; 112(10): 1860-1867.

24. Шмырева В.Ф., Петров С.Ю., Козлова И.В., Антонов А.А. Применение препарата нобен в терапии глаукомной оптической нейропатии. Глаукома 2007; 3: 29-34.

25. Егоров Е.А., Астахов Ю.С., Щуко А.Г. Национальное руководство (путеводитель) по глаукоме для поликлинических врачей. Москва, Столичный бизнес, 2008; 136 c

26. Авдеев Р.В., Александров А.С., Басинский А.С., Блюм Е.А., Брежнев А.Ю., Волков Е.Н. и др. Клинико-эпидемиологическое исследование факторов риска развития и прогрессирования глаукомы. Российский офтальмологический журнал 2013; 6(3): 4-11

27. Еричев В.П., Панюшкина Л.А., Фомин А.В. Оптическая когерентная томография сетчатки и зрительного нерва в диагностике болезни Альцгеймера. Глаукома. Журнал НИИ ГБ РАМН 2013; 1: 5-10