Intraocular pressure and choroidal thickness postural changes in multiple system atrophy and Parkinson’s disease

Abstract

To evaluate intraocular pressure (IOP) and choroidal thickness (ChT) postural changes in multiple system atrophy (MSA), Parkinson’s disease (PD) patients and healthy controls (HC). 20 MSA patients, 21 PD patients and 14 HC, were examined. All subjects underwent a complete examination, including corneal thickness, ChT, IOP and axial length (AL) measurements. IOP measurement was performed in supine, sitting, and standing positions, whereas ChT in sitting and standing positions. Supine to standing IOP variations were significantly higher in MSA vs PD(p = 0.01) and in MSA vs HC (p < 0.0001), whereas no significant differences were observed between PD and HC (p = 0.397). Mean sub-foveal ChT in MSA was 240 ± 92 μm in sitting position, and 215 ± 94 μm in standing position with a significant reduction (p = 0.008). Mean sub-foveal ChT in PD was 258 ± 79 μm in sitting position, and 259 ± 76 μm in standing position (p = 0.887). In HC it was 244 ± 36 μm in sitting position, and 256 ± 37 μm in standing position with a significant increase (p = 0.007). The significant IOP and ChT postural changes can be considered additional hallmarks of autonomic dysfunction in MSA and further studies are needed to consider them as biomarkers in the differential diagnosis with PD.

Intraocular Pressure Variations in Postural Changes: Comparison Between Overweight and Normal BMI Controls

“…17 De Bernardo et al demonstrated how both healthy subjects and patients with MSA or PD showed IOP increase in supine position, this increase was higher in patients with MSA. 17 In addition, an IOP increase in obese patients in the supine positions compared to the sitting and the standing was rstly reported in 2015 by Geloneck et al in which, similarly to the present study, authors measured the IOP of obese patients in 3 different positions. 18 The results of the present study not only con rm that ΔIOPs between supine and other positions were statistically signi cant (P < 0.05) in both overweight subject and normal weight controls but, in addition to previous studies, they show that ΔIOP in supine and 5'standing positions was higher in overweight subject than in normal weight controls (P < 0.05).…”

“…16 An IOP increase in supine position was also reported in patients affected by multiple system atrophy (MSA) and Parkinson's disease (PD). 17 De Bernardo et al demonstrated how both healthy subjects and patients with MSA or PD showed IOP increase in supine position, this increase was higher in patients with MSA. 17 In addition, an IOP increase in obese patients in the supine positions compared to the sitting and the standing was rstly reported in 2015 by Geloneck et al in which, similarly to the present study, authors measured the IOP of obese patients in 3 different positions.…”

“…The increase of IOP in supine position has been previously described in several reports. 16,17 De Bernardo et al 16 measured the IOP with a rebound tonometer, the Icare PRO (Icare Finland Oy, Finland version 1.1) in 120 eyes of 60 normal weight individuals in sitting, supine, standing positions and again 5 min after standing. They found IOP in supine and standing positions, to be higher than in the sitting (mean ΔIOP = + 1.16mmHg, P < 0.001) and in the standing ones (mean ΔIOP = + 1.55mmHg, P < 0.001).…”

Retinal thinning in progressive supranuclear palsy: differences with healthy controls and correlation with clinical variables

“…But more importantly, our PSP and healthy controls showed comparable axial length, ensuring the reliability of retinal layers comparisons between groups. As a matter of fact, evidence demonstrates that axial length may influence the measurement of retinal and choroidal thickness [ 21 , 22 ], and none of the previously published studies on this topic compared patients and controls according to these parameters. Finally, all our patients and healthy controls were Caucasian.…”

Intraocular Pressure Measurements in Standing, Sitting, and Supine Position: Comparison between Tono-Pen Avia and Icare Pro Tonometers

“…It should be subject to systemic vascular monitoring, that could also explain the slight decrease when going from the supine to the standing position, that conversely becomes an increase 5 min after maintaining the standing position. [ 30 , 31 , 32 , 33 ].…”