Changes of Retina Are Not Involved in the Genesis of Visual Hallucinations in Parkinson’s Disease

Kopal, Aleš; Mejzlíková, E; Preiningerová, Jana Lízrová; Brebera, David; Ulmanová, Olga; Ehler, E; Roth, Jan

doi:10.1155/2015/709191

Cited by 9 publications

(7 citation statements)

References 28 publications

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“…However, some studies reported that there was no macular thinning in PD. Kopal et al did not show any significant difference in RNFL thickness and macular thickness between PD patients and healthy controls [12]. They concluded that functional and structural changes in the retina are not related to visual symptoms in PD.…”

Section: Discussionmentioning

confidence: 91%

“…Some studies demonstrated a significant reduction in RNFL thickness among PD patients [8][9][10][11]. Some studies, however, reported that there is no difference in RNFL thickness between those two groups [7,12,13]. Controversial results may be predetermined by the subject selection, small sample sizes, or variable sensitivity of optical coherent tomography (OCT) instruments.…”

Section: Introductionmentioning

confidence: 99%

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Retinal Nerve Fiber Layer and Macular Thickness in Parkinson's Disease Patients

Hamid¹,

Hitam²,

Halim³

2021

Cureus

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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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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Retinal Nerve Fiber Layer and Macular Thickness in Parkinson's Disease Patients

Hamid¹,

Hitam²,

Halim³

2021

Cureus

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“…Evidence for such a pathological compensatory process has been observed in Charles Bonnet syndrome (152). In Parkinson's disease, one study demonstrated a relationship between RNFL thinning and VH ( 153), but a second study found no evidence for such a link (154). A recent study in schizophrenia (155,156) indicated that four separate samples of patients with both auditory and visual hallucinations of at least moderate severity were characterized by significant macula and RNFL thinning relative to a control group.…”

Section: Potential Retinal Contributions To Vh and Visual Distortions In Schizophreniamentioning

confidence: 99%

The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update

Silverstein

Lai

2021

Front. Psychiatry

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Schizophrenia is characterized by visual distortions in ~60% of cases, and visual hallucinations (VH) in ~25–50% of cases, depending on the sample. These symptoms have received relatively little attention in the literature, perhaps due to the higher rate of auditory vs. visual hallucinations in psychotic disorders, which is the reverse of what is found in other neuropsychiatric conditions. Given the clinical significance of these perceptual disturbances, our aim is to help address this gap by updating and expanding upon prior reviews. Specifically, we: (1) present findings on the nature and frequency of VH and distortions in schizophrenia; (2) review proposed syndromes of VH in neuro-ophthalmology and neuropsychiatry, and discuss the extent to which these characterize VH in schizophrenia; (3) review potential cortical mechanisms of VH in schizophrenia; (4) review retinal changes that could contribute to VH in schizophrenia; (5) discuss relationships between findings from laboratory measures of visual processing and VH in schizophrenia; and (6) integrate findings across biological and psychological levels to propose an updated model of VH mechanisms, including how their content is determined, and how they may reflect vulnerabilities in the maintenance of a sense of self. In particular, we emphasize the potential role of alterations at multiple points in the visual pathway, including the retina, the roles of multiple neurotransmitters, and the role of a combination of disinhibited default mode network activity and enhanced state-related apical/contextual drive in determining the onset and content of VH. In short, our goal is to cast a fresh light on the under-studied symptoms of VH and visual distortions in schizophrenia for the purposes of informing future work on mechanisms and the development of targeted therapeutic interventions.

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“…Since the axons of the ganglion cells form the retinal nerve fibre layer (RNFL), ganglion cell loss may subsequently result in RNFL thinning 13 , 14 . Although RNFL thinning has been associated with the occurrence of VH 15 , this observation has been contradicted by others 16 . In a very recent study, that included all retinal layers, the combined GCL-IPL correlated best with reduced low contrast visual acuity and visual cognition outcomes in Lewy body disease 17 .…”

Section: Introductionmentioning

confidence: 90%

Visual hallucinations in Parkinson’s disease are associated with thinning of the inner retina

Visser

Apostolov

Vlaar

et al. 2020

Sci Rep

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Visual hallucinations (VH) are common in patients with Parkinson’s disease (PD), yet the underlying pathophysiological mechanisms are still unclear. We aimed to explore the association of the presence of VH with inner retinal thinning and, secondarily, with visual acuity. To this end, we included 40 PD patients in this exploratory study, of whom 14 had VH, and 22 age- and sex-matched healthy controls. All participants were interviewed for the presence of VH by a neurologist specialized in movement disorders and underwent a thorough ophthalmologic examination, including measurement of the best-corrected visual acuity (BCVA) and optical coherence tomography to obtain macular scans of the combined ganglion cell layer and inner plexiform layer (GCL-IPL). Patients with VH had a thinner GCL-IPL than patients without VH, which persisted after correction for age, disease stage, levodopa equivalent daily dose (LED) and cognitive function. Furthermore, BCVA was lower in the PD group with VH than in the PD group without VH, although only a trend remained after correction for age, disease stage, LED and cognitive function. Taken together, in patients with PD, visual hallucinations appear to be associated with a thinning of the inner retinal layers and, possibly, with reduced visual acuity. Further research using a longitudinal design is necessary to confirm these findings and to establish the causality of these relationships.

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Changes of Retina Are Not Involved in the Genesis of Visual Hallucinations in Parkinson’s Disease

Cited by 9 publications

References 28 publications

Retinal Nerve Fiber Layer and Macular Thickness in Parkinson's Disease Patients

Retinal Nerve Fiber Layer and Macular Thickness in Parkinson's Disease Patients

The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update

Visual hallucinations in Parkinson’s disease are associated with thinning of the inner retina

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