Alzheimer tipi senil demans hastalarında retina sinir lifi katmanındaki dejenerasyonun saptanmasında optik koherens tomografisinin kullanımı
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Date
2015
Authors
Poroy, Ceren
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Publisher
Uludağ Üniversitesi
Abstract
Önceleri Alzheimer hastalığındaki görme fonksiyon bozuklukları kortikal alanlardaki hasarla ilişkilendirilmişken, günümüzde retinal dejenerasyonun da etkili olduğu kabul görmüştür. Biz çalışmamızda optik koherens tomografisi (OCT) ile yapılmış peripapiller retina sinir lifi tabakası (pRSLT) kalınlığı, makula kalınlığı ve makula hacmi ölçümleri ile hafif-orta evre Alzheimer hastalarında retinal dejenerasyonun olup olmadığını göstermeyi hedefledik. Aralık 2011– Mayıs 2015 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı polikliniğinde muayene edilmiş 21 Alzheimer tipi demans hastasının 35 gözüyle benzer yaş grubundaki kognitif bozukluğu olmayan 56 hastanın 100 gözünün Stratus OCT ile yapılmış olan pRSLT kalınlığı, makula kalınlığı ve hacmi ölçümleri karşılaştırıldı. Alzheimer grubunda ortalama ve superior kadran pRSLT kalınlığı, kontrol grubuna göre anlamlı olarak daha inceydi (sırasıyla p=0,017 ve p=0,004). Diğer kadranlarda iki grupta anlamlı farklılık izlenmedi (p>0,05). Makula kalınlığı ve hacmi haritasında Alzheimer grubunda fovea kalınlığı ve hacmi kontrol grubuna göre anlamlı olarak daha kalın saptandı (her ikisi için de p=0,008). İç halkada inferior kadranda makula kalınlığı ve hacmi Alzheimer grubunda kontrol grubuna göre anlamlı olarak daha ince saptandı (sırasıyla p=0,003 ve p=0,004), diğer kadranlar iki grupta anlamlı farklılık göstermedi (p>0,05). Dış halkada makula kalınlığı ve hacminde Alzheimer ve kontrol grubunda anlamlı farklılık saptanmadı (p>0,05). Çalışmamızda saptanan pRSLT kalınlığı ile ilgili bulgular genelde literatürle uyumluluk gösterirken, makula kalınlığı ve hacim ölçümleri kısmen farklılık göstermiştir. OCT; pRSLT kalınlığı, makula kalınlığı ve hacmi ölçümleri ile Alzheimer hastalığındaki retinal dejenerasyon hakkında bilgi vermektedir. Bu nedenle Alzheimer hastalığında tanıyı kuvvetlendirmek için ve erken tanıda yardımcı metod olarak OCT'nin kullanılması önerilebilir.
Use of Optical Coherence Tomography in Detecting Retinal Nerve Fiber Layer Degeneration in Alzheimer Type Senil Dementia The deterioration in visual functions of Alzheimer's disease (AD) patients was attributed to nerve degeneration in visual cortex in previous researches. But today there is an increasing evidence of retinal degeneration effecting visual functions as well. The purpose of this study was to state retinal degeneration in mild and moderate AD using measurements of peripapillary retinal nerve fiber thickness (pRNFLT), macular thickness (MT) and macular volume (MV) with optical coherence tomography (OCT). Thirty five eyes of 21 AD patients and 100 eyes of 56 similar aged cognitively healthy controls who underwent ophthalmologic and OCT examination at University of Uludağ, Faculty of Medicine, Department of Ophthalmology between December 2011- May 2015 were inrolled in this study. Stratus OCT was used to asses pRNFLT, MT and MV in both AD patients and controls. There was a significant decrease in average and superior quadrant pRNFLT in AD patients compared to the control group (respectively p=0,017 and p=0,004). No significant difference was found between groups in other peripapillary quadrants (p>0,05). Foveal thickness and volume were significantly increased in AD patients comparision with controls (for both p=0,008). Macular thickness and MV of inferior inner quadrant were significantly decreased in AD patients compared with controls (respectively p=0,003 and p=0,004). Macular thickness and MV results of the other inner quadrants and all outer quadrants were statistically nonsignificant in both group (p>0,005). Our pRNFLT results are generally in accordance with previous reports, but our increased foveal thickness and volume results partially differ from other researches. Peripapillary RNFLT, MT and MV measurements of OCT indicates retinal degeneration in AD patients. Thus it can be recommended to use OCT for strengthening the diagnosis of AD. Furthermore OCT can be a usefull marker for early diagnosis in AD.
Use of Optical Coherence Tomography in Detecting Retinal Nerve Fiber Layer Degeneration in Alzheimer Type Senil Dementia The deterioration in visual functions of Alzheimer's disease (AD) patients was attributed to nerve degeneration in visual cortex in previous researches. But today there is an increasing evidence of retinal degeneration effecting visual functions as well. The purpose of this study was to state retinal degeneration in mild and moderate AD using measurements of peripapillary retinal nerve fiber thickness (pRNFLT), macular thickness (MT) and macular volume (MV) with optical coherence tomography (OCT). Thirty five eyes of 21 AD patients and 100 eyes of 56 similar aged cognitively healthy controls who underwent ophthalmologic and OCT examination at University of Uludağ, Faculty of Medicine, Department of Ophthalmology between December 2011- May 2015 were inrolled in this study. Stratus OCT was used to asses pRNFLT, MT and MV in both AD patients and controls. There was a significant decrease in average and superior quadrant pRNFLT in AD patients compared to the control group (respectively p=0,017 and p=0,004). No significant difference was found between groups in other peripapillary quadrants (p>0,05). Foveal thickness and volume were significantly increased in AD patients comparision with controls (for both p=0,008). Macular thickness and MV of inferior inner quadrant were significantly decreased in AD patients compared with controls (respectively p=0,003 and p=0,004). Macular thickness and MV results of the other inner quadrants and all outer quadrants were statistically nonsignificant in both group (p>0,005). Our pRNFLT results are generally in accordance with previous reports, but our increased foveal thickness and volume results partially differ from other researches. Peripapillary RNFLT, MT and MV measurements of OCT indicates retinal degeneration in AD patients. Thus it can be recommended to use OCT for strengthening the diagnosis of AD. Furthermore OCT can be a usefull marker for early diagnosis in AD.
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Keywords
Alzheimer hastalığı, Optik koherens tomografisi, Retina sinir lifi tabakası, Alzheimer’s disease, Optical coherence tomography, Retinal nerve fiber layer
Citation
Poroy, C. (2015). Alzheimer tipi senil demans hastalarında retina sinir lifi katmanındaki dejenerasyonun saptanmasında optik koherens tomografisinin kullanımı. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.