Tomografía de coherencia óptica como diagnóstico precoz en pacientes con Alzhéimer: revisión sistemática
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2021-02-23
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El Alzheimer es una enfermedad degenerativa, progresiva e irreversible que se caracteriza por la pérdida neuronal y sináptica, y por la acumulación cerebral de agregados proteicos insolubles intra y/o extracelulares. Su tratamiento farmacológico se centra principalmente en los síntomas. La enfermedad de Alzheimer (EA) comienza mucho antes de que aparezcan los primeros síntomas, de ahí la necesidad de buscar un diagnóstico precoz. El objetivo principal de este trabajo fue realizar una revisión sistemática sobre la tomografía de coherencia óptica (TCO) como nuevo método diagnóstico no invasivo de la enfermedad de Alzheimer. Para ello, se tuvo en cuenta el grosor macular de la retina, la capa de fibras nerviosas de la retina (CFNR), la capa de células ganglionares (CCG), la capa coroidea y la densidad vascular.
Para ello, se realizaron varias búsquedas bibliográficas en las principales bases de datos de ciencias de la salud.
Tras aplicar los criterios de exclusión e inclusión, seleccionamos un total de 12 artículos. Los resultados fueron positivos, ya que se comprobó que el grosor macular disminuyó en pacientes con quejas subjetivas de memoria (QSM), deterioro cognitivo leve (DCL) y enfermedad de Alzheimer (EA) con respecto a pacientes sanos. También se redujo significativamente el espesor de la capa de fibras nerviosas de la retina (CFNR) y de la capa de células ganglionares (CCG). El único engrosamiento que se produjo fue en la zona avascular foveal (FAZ) en pacientes con EA. En conclusión, la TCO es eficaz para el diagnóstico precoz del EA, y se puede utilizar en etapas tempranas.
Alzheimer's disease is a degenerative, progressive and irreversible disease characterised by neuronal and synaptic loss and the deposition of insoluble intra- and/or extracellular protein aggregates in the brain. Pharmacological treatment is mainly symptomatic. Alzheimer's disease begins long before the first symptoms appear, so it is important to diagnose the disease at an early stage. The main objective was to perform a systematic review of optical coherence tomography (OCT) as a new non-invasive diagnostic tool for Alzheimer's disease. Macular thickness, retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), choroidal layer and vessel density were considered. For this purpose, several bibliographic searches were performed in the main health science databases. After applying the inclusion and exclusion criteria, a total of 12 articles were selected. The results were positive, it was found that macular thickness decreased in patients with subjective memory complaints (QSM), mild cognitive impairment (MCI) and Alzheimer's disease (AD) compared to healthy patients. The thickness of the CFNR and CCG was also significantly reduced. The only thickening that occurred was in the foveal avascular zone (FAZ) in patients with AD. In conclusion, OCT is effective in the early diagnosis of Alzheimer's disease and may be used as a future biomarker in the early stages of the disease.
Alzheimer's disease is a degenerative, progressive and irreversible disease characterised by neuronal and synaptic loss and the deposition of insoluble intra- and/or extracellular protein aggregates in the brain. Pharmacological treatment is mainly symptomatic. Alzheimer's disease begins long before the first symptoms appear, so it is important to diagnose the disease at an early stage. The main objective was to perform a systematic review of optical coherence tomography (OCT) as a new non-invasive diagnostic tool for Alzheimer's disease. Macular thickness, retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), choroidal layer and vessel density were considered. For this purpose, several bibliographic searches were performed in the main health science databases. After applying the inclusion and exclusion criteria, a total of 12 articles were selected. The results were positive, it was found that macular thickness decreased in patients with subjective memory complaints (QSM), mild cognitive impairment (MCI) and Alzheimer's disease (AD) compared to healthy patients. The thickness of the CFNR and CCG was also significantly reduced. The only thickening that occurred was in the foveal avascular zone (FAZ) in patients with AD. In conclusion, OCT is effective in the early diagnosis of Alzheimer's disease and may be used as a future biomarker in the early stages of the disease.