Research progress of Alzheimer's disease with visual impairment
JIN Zhao1, ZHANG Wei1,2,3,4
1. Center of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2. China National Clinical Research Center for Neurological Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
3. Key Laboratory for Neurodegenerative Disorders, Ministry of Education, Capital Medical University, Beijing 100069, China;
4. Beijing Institute for Brain Disorders, Beijing 100069, China
Abstract：The Alzheimer's disease (AD) is a common neurodegenerative disease among the elderly population with the memory impairment as the initial symptom, gradually followed by the progressive cognitive impairment and the behavioral and psychological symptoms, with heavy economic and care burdens to both family and society. The early symptoms of the AD are not obvious, which causes the poor therapeutic effect after diagnosis, thus early diagnosis is particularly important. Increasing investigations identified the visual impairment in the AD patients, but with no epidemiological data of the AD accompanied with the visual impairment. This paper mainly focuses on the clinical symptoms, the mechanism, the detection and the evaluation approaches of the visual impairment, including the optical coherence tomography, the visual evoked potential, the retinal microvascular examination and the neuroimaging so as to systemically assess the visual impairment, explore the specific, sensitive and simple methods of evaluation of the AD and provide evidence for early diagnosis and intervention of the AD. Comprehensive management of the AD includes non-drug intervention and drug therapy, however, the treatment of the visual impairment in the AD is an important issue.
[1] Prince M, Wimo A, Guerchet M, et al. World Alzheimer Report 2015. The global impact of dementia. An analysis of prevalence, incidence, cost and trends[M]. London:Alzheimer's Disease International (ADI), 2015.
[2] Trick G L, Trick L R, Morris P, et al. Visual field loss in senile demen-tia of the Alzheimer's type[J]. Neurology, 1995, 45(1):68-74.
[3] Cordeiro M F, Guo L, Coxon K M, et al. Imaging multiple phases of neurodegeneration:A novel approach to assessing cell death in vivo[J]. Cell Death & Disease, 2010, 1(1):e3.
[4] Tzekov R, Mullan M. Vision function abnormalities in Alzheimer disease[J]. Survey of Ophthalmology, 2014, 59(4):414-433.
[5] Uhlmann R F, Larson E B, Koepsell T D, et al. Visual impairment and cognitive dysfunction in Alzheimer's disease[J]. Journal of General In-ternal Medicine, 1991, 6(2):126-32.
[6] Jefferis J M, Mosimann U P, Clarke M P. Cataract and cognitive impair-ment:A review of the literature[J]. British Journal of Ophthalmology, 2011, 95(1):17-23.
[7] Kirby E, Bandelow S, Hogervorst E. Visual impairment in Alzheimer's disease:A critical review[J]. Journal of Alzheimer's Disease, 2010, 21(1):15-34.
[8] Salamone G, Lorenzo C D, Mosti S et al. Color discrimination perfor-mance in patients with Alzheimer's disease[J]. Dementia & Geriatric Cognitive Disorders, 2009, 27(6):501-507.
[9] Hendry S H, Hsiao S S. Fundamentals of sensory systems[M]//Funda-mental Neuroscience:Fourth Edition. Elsevier Inc., 2012.
[10] Valenti D A. Alzheimer's disease:Screening biomarkers using frequen-cy doubling technology visual field[J]. Isrn Neurology, 2013:989583-989583.
[11] Giovagnoli A R, Erbetta A. Visual contrast sensitivity in AD, MCI, & older adults with cognitive complaints[J]. Neuropsychologia., 2008, 46(5):1495-1504.
[12] Risacher S L, Wudunn D, Pepin S M, et al. Visual contrast sensitivity in Alzheimer's disease, mild cognitive impairment, and older adults with cognitive complaints[J]. Neurobiology of Aging, 2013, 34(4):1133-1144.
[13] Guo L, Duggan J, Cordeiro M F. Alzheimer's disease and retinal neuro-degeneration[J]. Current Alzheimer Research, 2010, 7(1):3-14.
[14] Poling A, Paisleymorgan K, Panos J J, et al. Oligomers of the amyloidbeta protein disrupt working memory:Confirmation with two behavior-al procedures[J]. Behavioural Brain Research, 2004, 69(193):230-234.
[15] Lee Y J, Han S B, Nam S Y, et al. Inflammation and Alzheimer's dis-ease[J]. Archives of Pharmacal Research, 2000, 21(3):383-421.
[16] Thomson K L, Jing M Y, Waddell B, et al. A systematic review and meta-analysis of retinal nerve fiber layer change in dementia, using optical coherence tomography[J]. Alzheimers & Dementia Diagnosis Assessment & Disease Monitoring, 2015, 1(2):136-143.
[17] Ikram M K, Cheung C Y, Wong T Y et al. Retinal pathology as bio-marker for cognitive impairment and Alzheimer's disease[J]. Journal of Neurology Neurosurgery & Psychiatry, 2012, 83(9):917-922.
[18] Blanks J C, Schmidt S Y, Torigoe Y, et al. Retinal pathology in Al-zheimer's diseaseII. Regional neuron loss and glial changes in GCL[J]. Neurobiology of Aging, 1996, 17(3):385-395.
[19] Cheung C Y, Ong Y T, Hilal S et al. Retinal ganglion cell analysis us-ing high-definition optical coherence tomography in patients with mild cognitive impairment and Alzheimer's disease[J]. Journal of Alzheimer's Disease, 2014, 45(1):45-56.
[20] Stothart G, Kazanina N, Tales A, et al. Early visual evoked potentials and mismatch negativity in Alzheimer's disease and mild cognitive impairment:cross-sectional findings and longitudinal follow-up[J]. Journal of Alzheimer's Disease, 2014, 44(2):397-408.
[21] Guo L, Duggan J, Cordeiro M F. Alzheimer's disease and retinal neuro-degeneration[J]. Current Alzheimer Research, 2010, 7(1):3-14.
[22] Cheung C Y, Ong Y T, Ikram M K, et al. Retinal microvasculature in Alzheimer's disease[J]. Journal of Alzheimer's Disease, 2014, 42(s4):S339-S352.
[23] Frost S, Kanagasingam Y, Sohrabi H, et al. Retinal vascular biomark-ers for early detection and monitoring of Alzheimer's disease[J]. Trans-lational psychiatry, 2013, 3(2):e233.
[24] Berisha F, Feke G T, Trempe C L, et al. Retinal abnormalities in early Alzheimer's disease[J]. Investigative Ophthalmology & Visual Sci-ence, 2007, 48(5):2285-2289.
[25] Bozzali M, Falini A, Franceschi M, et al. White matter damage in Alzheimer's disease assessed in vivo using diffusion tensor magnetic resonance imaging[J]. Journal of Neurology, Neurosurgery & Psychia-try, 2002, 72(6):742-746.
[26] Fellgiebel A, Schermuly I, Gerhard A, et al. Functional relevant loss of long association fibre tracts integrity in early Alzheimer's disease[J]. Neuropsychologia, 2008, 46(6):1698-1706.
[27] Stricker N H, Schweinsburg B C, Delano-Wood L, et al. Decreased white matter integrity in late-myelinating fiber pathways in Alzheim-er's disease supports retrogenesis[J]. Neuroimage, 2009, 45(1):10-16.
2017, Vol. 35 
