Optical coherence tomography as a tool to evaluate retinal changes in Parkinson's disease.

BACKGROUND Though Parkinson's disease (PD) is primarily a disease of the basal ganglia, recent evidence suggests that PD affects the retina. OBJECTIVE The study was designed to evaluate the thickness of retinal nerve fiber layer (RNFL) and thickness and volume of the macula in PD and hence explore the utility of optical coherence tomography (OCT) in studying retinal changes in PD. METHODS A prospective, hospital based evaluation of 30 patients with PD and 30 healthy controls was carried out. Various parameters such as RNFL, central macular thickness (CMT), central and total macular volumes (TMV) and retinal thickness were analyzed using OCT. RESULTS (a) RNFL thickness was not significantly different between the patients and controls. A significant negative correlation was found between the RNFL thickness in the right nasal superior sector and the UPDRS motor score. (b) CMT was found to be significantly reduced in the right eye and a negative correlation with the UPDRS motor score was noted. (c) TMV was significantly greater in patients compared to the controls. (d) The outer retinal layer in the right nasal quadrant and the right inferior quadrants were found to be significantly thinner in patients with PD. CONCLUSIONS We did not find any significant abnormality in the RNFL thickness in patients with PD. Decreased CMT in patients with PD and a significant negative correlation of RNFL thickness and CMT with severity of PD suggest a remote possibility of dopaminergic depletion in the retina. However long term studies are warranted to validate our findings.

[1]  E. Cubo,et al.  Retina thickness in Parkinson's disease and essential tremor , 2010, Movement disorders : official journal of the Movement Disorder Society.

[2]  W. Paulus,et al.  Acquired colour deficiency in patients with Parkinson’s disease , 1998, Vision Research.

[3]  I. Bodis-Wollner,et al.  Correlation of Inner Retinal Thickness Evaluated by Spectral-Domain Optical Coherence Tomography and Contrast Sensitivity in Parkinson disease , 2013, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.

[4]  M. Yahr,et al.  Visual dysfunction in Parkinson's disease. Loss in spatiotemporal contrast sensitivity. , 1987, Brain : a journal of neurology.

[5]  A. Schnitzler,et al.  Optical Coherence Tomography in Parkinsonian Syndromes , 2012, PloS one.

[6]  F. Ascaso,et al.  Development of a prediction formula of Parkinson disease severity by optical coherence tomography , 2014, Movement disorders : official journal of the Movement Disorder Society.

[7]  G. Hadjigeorgiou,et al.  Perimetric and retinal nerve fiber layer findings in patients with Parkinson’s disease , 2012, BMC Ophthalmology.

[8]  L. Pablo,et al.  Electrophysiology and optical coherence tomography to evaluate Parkinson disease severity. , 2014, Investigative ophthalmology & visual science.

[9]  J. Nguyen‐Legros.  Functional neuroarchitecture of the retina: hypothesis on the dysfunction of retinal dopaminergic circuitry in Parkinson's disease , 2005, Surgical and Radiologic Anatomy.

[10]  I. Bodis-Wollner,et al.  Interocular Asymmetry of Foveal Thickness in Parkinson Disease , 2012, Journal of ophthalmology.

[11]  Shiv Saidha,et al.  Photoreceptor layer thinning in idiopathic Parkinson's disease , 2014, Movement disorders : official journal of the Movement Disorder Society.

[12]  I. McKeith,et al.  SIC Task Force appraisal of clinical diagnostic criteria for parkinsonian disorders , 2003, Movement disorders : official journal of the Movement Disorder Society.

[13]  Joshua R. Ehrlich,et al.  Detection of retinal changes in Parkinson’s disease with spectral-domain optical coherence tomography , 2010, Clinical ophthalmology.

[14]  R. Zeimer.  Application of the retinal thickness analyzer to the diagnosis and management of ocular diseases , 1998 .

[15]  M. Moschos,et al.  Morphologic Changes and Functional Retinal Impairment in Patients with Parkinson Disease without Visual Loss , 2011, European journal of ophthalmology.

[16]  Paul Witkovsky,et al.  Dopamine and retinal function , 2004, Documenta Ophthalmologica.

[17]  U. Mosimann,et al.  Retinal thickness in Parkinson's disease. , 2011, Parkinsonism & related disorders.

[18]  T. Di Paolo,et al.  Decreased dopamine in the retinas of patients with Parkinson's disease. , 1990, Investigative ophthalmology & visual science.

[19]  J. Jankovic.  Parkinson’s disease: clinical features and diagnosis , 2008, Journal of Neurology, Neurosurgery, and Psychiatry.

[20]  R. Inzelberg,et al.  Retinal nerve fiber layer thinning in Parkinson disease , 2004, Vision Research.

[21]  I. Bodis-Wollner,et al.  Inner retinal layer thinning in Parkinson disease. , 2009, Archives of ophthalmology.

[22]  L. Pablo,et al.  Use of Fourier-domain OCT to detect retinal nerve fiber layer degeneration in Parkinson’s disease patients , 2013, Eye.

[23]  G. Rizzo,et al.  Loss of temporal retinal nerve fibers in Parkinson disease: a mitochondrial pattern? , 2013, European journal of neurology.

[24]  M. Hankins,et al.  Neurobiology of retinal dopamine in relation to degenerative states of the tissue , 1997, Vision Research.

[25]  Akiko Tamura,et al.  Impaired Visual Acuity as a Risk Factor for Visual Hallucinations in Parkinson’s Disease , 2006, Journal of geriatric psychiatry and neurology.

[26]  J. Fujimoto,et al.  Optical Coherence Tomography , 1991 .

[27]  A. Tufekci,et al.  Retinal Nerve Fiber Layer Thickness in Parkinson Disease , 2013, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.

[28]  K. Chaudhuri,et al.  Non-motor symptoms of Parkinson's disease: diagnosis and management , 2006, The Lancet Neurology.

[29]  Y. Çağlar,et al.  Correlation between retinal morphological and functional findings and clinical severity in Parkinson’s disease , 2008, Documenta Ophthalmologica.

[30]  K. Falavarjani,et al.  Retinal nerve changes in patients with tremor dominant and akinetic rigid Parkinson’s disease , 2013, Neurological Sciences.