Purpose To determine bioelectrical function and structural changes of the retina in patients with early stages of Parkinson’s disease (PD).Materials and methodsThirty-eight eyes of 20 patients with early idiopathic PD and 38 eyes of 20 healthy age- and sex-matched controls were ophthalmologically examined, including assessment of distance best-corrected visual acuity (DBCVA), slit lamp examination of the anterior and posterior segment of the eye, evaluation of the eye structures: paramacular retinal thickness (RT) and retinal nerve fiber layer (RNFL) thickness with the aid of OCT, and the bioelectrical function by full-field electroretinogram (ERG). Additionally, PD patients were interviewed as to the presence of dopamine-dependent visual functions abnormalities.ResultsIn patients with early PD, statistically significant changes in comparison with the control group were observed in ERG. They contained a reduction in mean amplitudes of the scotopic a-wave (rod–cone response), the scotopic oscillatory potentials (OPs)—OP2 and OP3, the photopic b-wave, and a reduction in the overall index (OP1 + OP2 + OP3) and a prolongation of mean peak times of the scotopic OP1, OP2, OP3, OP4 (p < 0.05). A questionnaire concerning abnormalities of dopamine-dependent visual functions revealed that PD patients with abnormal peak times of OP1, OP2, and OP3 reported non-specific visual disturbances more frequently in comparison with PD patients with normal peak times of OPs. Other analyzed parameters of ERG, DBCVA, RT, and RNFL did not significantly differ between patients with PD and the control group.ConclusionIn patients with early PD, bioelectrical dysfunction of the retina was observed in the ERG test, probably as a result of dopamine deficiency in the retina. The results of our study indicate that ERG may also be a useful tool for understanding the reason for non-specific visual disturbances occurring in PD patients.

BackgroundThe aim of this study was to determine the type and frequency of ophthalmologic changes occurring in patients with Parkinson disease (PD).Material/MethodsOne hundred consecutive patients (196 eyes) with idiopathic PD and a control group consisting of 100 healthy patients (196 eyes) matched for age and sex underwent a complete ophthalmological examination of both eyes, including assessment of patient medical history, dry eye questionare, and visual hallucinations questionnaire, distance and near best corrected visual acuity (DBCVA, NBCVA), color vision, distance photopic contrast sensitivity, near point of convergence, slit lamp examination of the eye anterior segment, tear film osmolarity and breakup time, aqueous tear production, and intraocular pressure, as well as fundus examination and evaluation of the perimacular retinal thickness (RT) and peripapillary retinal nerve fiber layer (RNFL) thickness.ResultsIn the eyes of PD patients DBCVA, NBCVA, contrast sensitivity, and color discrimination were significantly reduced. We also detected increased frequency of convergence insufficiency, seborrhoic blepharitis, meibomian gland disease (MGD), dry eye syndrome, nuclear and posterior subcapsular cataract, and glaucoma (p<0.05). However, intraocular pressure (IOP) was significantly lower in the PD group compared to controls. The frequency of visual hallucinations, age-related macular degeneration (ARMD), and other ophthalmological diseases, as well as RT and RNFL thickness, did not significantly differ between investigated groups.ConclusionsClinicians need to be aware of the association between PD and ophthalmological changes. Restoration of good-quality vision has a great impact on PD patients’ quality of life, reduction of costs of treatment and care, and rehabilitation.

PurposeTo evaluate macular function and structure in patients with diabetic macular edema prior to, as well as 3 and 6 months after intravitreal ranibizumab treatment.Patients and methodsSeventeen eyes of 17 patients with type 2 diabetes mellitus and diabetic macular edema (DME) were treated with intravitreal injections of 0.5 mg ranibizumab. Prior to the first injection, as well as after 3 and 6 months, the following examinations were performed: assessment of distance best-corrected visual acuity (log MAR), perception of metamorphopsia (M-Chart), slit lamp examination of the anterior and posterior segment of the eye (Volk 90D lens), evaluation of the retinal and choroidal circulation (fluorescein angiography), assessment of the structure and thickness of the macula (OCT), as well as evaluation of the macular function (PERG and mfERG). ResultsWe observed that ranibizumab significantly improved visual acuity after 3 and 6 months from the beginning of the treatment, which was a consequence of reduced macular edema and vascular leakage. There was a statistically significant decrease in metamorphopsia frequency at month 3; however, at month 6 it was a statistically insignificant when compared to the baseline. The results of electrophysiological examinations revealed no improvement in ranibizumab-treated patients.ConclusionImprovement of visual acuity and reduction in macular thickness were maintained up to the 6-month follow-up. The results of electrophysiological examinations revealed that ranibizumab injections tend to stabilize bioelectrical macular function of the outer, middle and inner retinal layers, which was impossible to recognize on the basis of visual acuity and OCT. Therefore, the electrophysiological examinations should be used as an additional objective tool for the evaluation of the anti-VEGF treatment effectiveness in DME.

Purpose To compare the structure and function of the retina and the optic nerve in patients with a history of multiple sclerosis (MS)-related demyelinating retrobulbar optic neuritis treated and not treated with systemic steroid therapy. Patients and Methods Thirty-two eyes of 32 MS patients with a past single episode of MS-related demyelinating retrobulbar ON were divided into 2 groups: S(+) consisting of 16 patients treated with intravenous methylprednisolone at a dose of 1g/day for 3 days during the acute stage of ON and S(-) consisting of 16 patients who did not receive any treatment. The following examinations were performed: distance best-corrected visual acuity (DBCVA) (Snellen), slit-lamp examination of the anterior and posterior segment of the eye (90D Volk lens), visual field analysis (Carl Zeiss Humphrey 750 Visual Field Analyzer, 24-2, W-W), macular thickness in the foveal (RT1) and parafoveal region (RT2), as well as peripapillary retinal nerve fiber layer thickness (RNFL) in the temporal, superior, nasal and inferior quadrants (Carl Zeiss Cirrus HD-OCT), assessment of the bioelectrical function of the visual pathway with an emphasis on the optic nerve – pattern visual evoked potentials (PVEP) and of macular ganglion cells and cone photoreceptors – pattern electroretinogram (PERG) (Roland Consult). Results No statistically significant differences were observed between the investigated groups in terms of DBCVA, mean deviation of visual field macular (RT1, RT2) and RNFL thickness in the temporal, superior, nasal and inferior quadrants, as well as of the bioelectrical function (PVEP, PERG). Conclusion The application of steroid therapy should be considered on an individual basis and not as a routine treatment for each patient.

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