Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness in patients with Alzheimer's disease (AD).Methods Twenty eyes of 40 patients with mild and (or) moderate AD confirmed by clinical examination (AD group) were included in the study. There were 11 males and 9 females with an average age of (72.75±8.25) years. Age and gender-matched normal 20 objectives were in the normal control group. Among them, there were 11 males and 9 females with a mean age of (71.05±7.08) years. There was no significant difference in gender composition, age and intraocular pressure between the two groups (P>0.05). There were significant differences in visual acuity, cup disc ratio and mini-mental state examination score (P<0.05). All eyes underwent high-resolution optical coherence tomography (OCT) examination. With a diameter of 3.4 mm and a center on the center of the optic disc, circular fast scans on optic disc were performed to obtain an average disc RNFL thickness, signal threshold>6. Computer image analysis system was used to measure the RNFL thickness from superior, inferior, temporal and nasal quadrants, and the average RNFL thickness. The changes of RNFL thickness between the two groups and between different eyes of the same group were compared.Results Compared with the normal control group, the average (t=5.591), superior (t=8.169, 8.053) and inferior (t=12.596, 11.377) thickness of RNFL in both eyes in AD group were thinner, the differences were significant (P<0.05); the temporal (t=1.966, 0.838)and nasal (t=2.071, 0.916) thickness of RNFL in both eyes of AD group were thinner, but the difference was not statistically significant (P>0.05). There was no significant difference of the mean and different quadrant RNFL thickness between different eyes in AD group and normal control group (AD group:t=0.097, 0.821, 0.059, 0.020, 0.116; normal control group:t=0.791, 1.938,1.806, 2.058, 1.005;P>0.05).Conclusion The RNFL thickness around the optic disc in AD patients is thinner; This occurs first in superior and inferior quadrants of the optic disc.%目的 观察阿尔茨海默病(AD)患者视网膜神经纤维层(RNFL)厚度变化.方法 临床检查确诊的轻度和(或)中度AD患者20例40只眼(AD组)纳入研究.其中,男性11例,女性9例;平均年龄(72.75±8.25)岁.选取同期性别、年龄匹配的正常者20名作为正常对照组.其中,男性11名,女性9名;平均年龄(71.05±7.08)岁.两组受检者视力(t=5.077、3.760)、杯/盘比(t=2.876、2.466)、简易智能精神状态检查量表评分(t=11.412)比较,差异有统计学意义(P=0.000、0.001、0.007、0.018、0.000).所有受检眼均行高清光相干断层扫描检查.以视盘中心为圆心,直径为3.4 mm的环形快速扫描视盘,获取视盘旁平均RNFL厚度,信号阈值>6.利用计算机图像分析系统进行视盘RNFL切面上方、下方、颞侧、鼻侧4个象限及其平均RNFL厚度的测量.测量3次,取平均值.比较两组受检眼以及组内不同眼别之间RNFL厚度变化.结果 与正常对照组比较,AD组患者双眼上方(t=8.169、8.053)、下方(t=12.596、11.377)、平均(t=5.591)RNFL厚度变薄,差异有统计学意义(P<0.05);颞侧(t=1.966、0.838)、鼻侧(t=2.071、0.916)RNFL厚度降低,但差异无统计学意义(P>0.05).AD组、正常对照组受检者两眼之间平均及不同象限RNFL厚度比较,差异均无统计学意义(AD组:t=0.097、0.821、0.059、0.020、0.116,正常对照组:t=0.791、1.938、1.806、2.058、1.005;P>0.05).结论 AD患者视盘周围RNFL厚度较正常同龄人变薄;其首先出现在视盘上、下方象限.
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