Journal of Neurology ( IF 4.8 ) Pub Date : 2024-08-26 , DOI: 10.1007/s00415-024-12634-4 Mahdi Gouravani 1 , Sepehr Fekrazad 1, 2 , Asma Mafhoumi 1 , Moein Ashouri 1 , Delia Cabrera DeBuc 3
|
Background
A connection has been established between ocular structural changes and various neurodegenerative diseases. Several studies utilizing optical coherence tomography (OCT) have detected signs of ocular structural alterations among individuals with Huntington's disease (HD). The inconsistent results reported in the literature regarding alterations in the retina and choroid encouraged us to conduct this systematic review and meta-analysis to accumulate the findings.
Methods
A systematic search was carried out in three electronic databases (PubMed, Embase, Scopus) to find studies reporting OCT measurements in HD cases compared with healthy controls (HC). A fixed-effects or random-effects meta-analysis was conducted according to the detected heterogeneity level. Furthermore, subgroup and sensitivity analyses, meta-regression, and quality assessment were performed.
Results
Eleven studies were included in the systematic review and 9 studies with a total population of 452 participants (241 cases, and 211 HC) underwent meta-analysis. Results of the analysis denoted that subfoveal choroid had a significantly reduced thickness in HD eyes compared to HC (p < 0.0001). Moreover, our analysis indicated that HD cases had a significantly thinner average (p = 0.0130) and temporal peripapillary retinal nerve fiber layer (pRNFL) (p = 0.0012) than HC. However, subjects with pre-HD had insignificant differences in average (p = 0.44) and temporal pRNFL thickness (p = 0.33) with the HC group.
Conclusion
Results of the current systematic review and meta-analysis revealed the significant thinning of average and temporal pRNFL and subfoveal choroid in HD compared to HC. However, OCT currently might be considered insensitive to be applied in the pre-HD population at least until further longitudinal investigations considering variables such as the duration between OCT measurement and disease onset validating OCT as a routine diagnostic tool in HD clinics.
中文翻译：
亨廷顿病的光学相干断层扫描测量：系统评价和荟萃分析
背景
眼部结构变化与各种神经退行性疾病之间已建立联系。几项利用光学相干断层扫描 (OCT) 的研究已经检测到亨廷顿病 (HD) 患者眼部结构改变的迹象。文献中关于视网膜和脉络膜改变的不一致结果鼓励我们进行系统评价和荟萃分析以积累研究结果。
方法
在三个电子数据库（PubMed、Embase、Scopus）中进行了系统检索，以查找报告 HD 病例与健康对照 (HC) 相比的 OCT 测量结果的研究。根据检测到的异质性水平进行固定效应或随机效应荟萃分析。此外，还进行了亚组和敏感性分析、荟萃回归和质量评估。
结果
系统评价纳入了 11 项研究，其中 9 项研究进行了荟萃分析，总共 452 名参与者（241 例病例和 211 名 HC）。分析结果表明，与 HC 眼相比，HD 眼的中心凹下脉络膜厚度显着减小 ( p < 0.0001)。此外，我们的分析表明，HD 病例的平均厚度 ( p = 0.0130) 和颞侧视乳头周围视网膜神经纤维层 (pRNFL) ( p = 0.0012) 比 HC 明显更薄。然而，HD 前期受试者的平均 pRNFL 厚度 ( p = 0.44) 和颞部 pRNFL 厚度 ( p = 0.33) 与 HC 组无显着差异。
结论
目前的系统评价和荟萃分析结果显示，与 HC 相比，HD 中的平均 pRNFL 和颞叶 pRNFL 以及中心凹下脉络膜显着变薄。然而，目前 OCT 可能被认为在 HD 前期人群中应用不敏感，至少在进一步纵向研究考虑 OCT 测量和疾病发作之间的持续时间等变量之前，验证 OCT 作为 HD 诊所的常规诊断工具。
京公网安备 11010802027423号