Objective: This study aimed to evaluate the retinal nerve fiber layer (RNFL) thickness and macular thickness in Parkinson's disease (PD) patients.Methods: The present study is a comparative cross-sectional, hospital-based study. A total number of 64 PD patients and 64 controls were recruited. Candidates that fulfilled the criteria with normal ocular examinations were undergone optical coherent tomography (OCT) examinations of the right eye. RNFL and macular thickness were evaluated.Results: There was a statistically significant reduction in RNFL thickness in average (adjusted mean 84.32 vs 95.93, p ≤ 0.001), superior (adjusted mean 105.15 vs 118.13, p ≤ 0.010), and inferior (adjusted mean 104.95 vs 126.55, p ≤ 0.001) PD group compared to the control group. The macula thickness also was significantly reduced in average (adjusted mean 266.51 vs 281.34, p = 0.015), central (adjusted mean 236.37 vs 255.55, p = 0.001), outer superior (adjusted mean 269.16 vs 278.19, p = 0.014), outer inferior (adjusted mean 256.34 vs 272.24, p ≤ 0.001), and outer nasal (adjusted mean 287.64 vs 302.84, p = 0.001) PD group compared to the control group. There was a significant positive correlation between RNFL thickness and visual acuity among PD patients in the inferior segment with p = 0.020 and nasal segment with p ≤ 0.001. There was also a significant positive correlation between macular thickness and visual acuity among PD patients in the inner temporal segment with p = 0.006, outer superior segment with p = 0.003, and outer temporal segment with p ≤ 0.001. Conclusion:The mean of the average, superior, and inferior RNFL thickness was significantly lower in the PD group compared to the control. The mean of the average, central, outer superior, outer inferior, and outer nasal macular thickness was significantly lower in the PD group compared to the control.

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Background: Bartonella henselae is the most common organism responsible for infective neuroretinitis. Conversely, ocular leptospirosis rarely manifests as neuroretinitis. There is no reported case of neuroretinitis caused by co-infection of both organisms to date. Case Report: A 33 year old lady presented with painless, progressive blurring of vision of both eyes for 2 weeks. Her ocular examination revealed reduced visual acuity to 6/36 with swollen optic disc and macular star exudates in both eyes. Optical coherence tomography showed subretinal fluid causing local neurosensory retinal detachment at posterior pole. Bartonella serology was positive for both IgM and IgG. In addition, Leptospira IgM was also positive. She was then started on oral Doxycycline 100mg BD for 14 days. After 8 weeks, her visual acuity improved to 6/9 and fundus examination showed resolution of optic disc swelling and macula oedema in both eyes. Conclusion: Bartonella henselae is a well-known causative organism for infective neuroretinitis. However, the other rare organisms such as Leptospira should be considered especially in tropical countries. Co-infection of both Bartonella henselae and Leptospira can manifest as neuroretinitis.

Comprehensive clinical assessment with integrated team approach is crucial in managing cases of non‐organic visual loss. Apart from pharmacotherapy, psychosocial rehabilitation should also be adequately addressed.