Progressive Changes in the Retinal Structure of Patients with Parkinson’s Disease

Ma, Li; Xu, Linfeng; Mao, Cheng‐Jie; Fu, Yunting; Ji, Xiaoyan; Shen, Yun; Chen, Jing; Yang, Yaping; Liu, Chun‐Feng

doi:10.3233/jpd-171184

Cited by 33 publications

(35 citation statements)

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“…Despite that early evidence on retinal thinning in iPD, several subsequent studies have provided conflicting results. Whereas some authors have reported that iPD patients have a significant and marked thinning of the macula and its inner retinal layers, others have evidenced outer retinal layer thinning, or even thickening, and some have failed to find any differences . The variability in scanning protocols, acquisition parameters and built‐in segmentation algorithms across different OCT systems is a well‐established limitation for comparing the results of different studies and could account for the discrepancies found in the literature regarding retinal alterations in iPD.…”

Section: Discussionmentioning

confidence: 99%

“…A recent landmark histopathological study demonstrated that in iPD there is a preferential degeneration of neurons within inner retinal layers (ganglion cell layer [GCL], inner plexiform layer and inner nuclear layer [INL]) associated with anomalous α‐synuclein deposits . Consistent with these findings, several in vivo imaging studies with spectral‐domain optical coherence tomography (OCT) have demonstrated an atrophy of macular GCL and the inner plexiform layer in iPD . Nevertheless, macular OCT studies in iPD have yielded conflicting results because of the diversity of OCT machines, image acquisition protocols, and segmentation algorithms used.…”

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confidence: 99%

“…6 Consistent with these findings, several in vivo imaging studies with spectral-domain optical coherence tomography (OCT) have demonstrated an atrophy of macular GCL and the inner plexiform layer in iPD. [7][8][9][10][11][12][13][14] Nevertheless, macular OCT studies in iPD have yielded conflicting results because of the diversity of OCT machines, image acquisition protocols, and segmentation algorithms used. Interestingly, when applying mathematical models to analyze macular morphology, Bodis-Wollner and colleagues found that iPD patients had a specific pattern of macular thinning 0.5-to 2-mm eccentric to the foveola.…”

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Parafoveal thinning of inner retina is associated with visual dysfunction in Lewy body diseases

et al. 2019

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Background Retinal optical coherence tomography findings in Lewy body diseases and their implications for visual outcomes remain controversial. We investigated whether region‐specific thickness analysis of retinal layers could improve the detection of macular atrophy and unravel its association with visual disability in Parkinson's disease. Methods Patients with idiopathic Parkinson's disease (n = 63), dementia with Lewy bodies (n = 8), and E46K mutation carriers in the α‐synuclein gene (E46K‐SNCA) (n = 4) and 34 controls underwent Spectralis optical coherence tomography macular scans and a comprehensive battery of visual function and cognition tests. We computed mean retinal layer thicknesses of both eyes within 1‐, 2‐, 3‐, and 6‐mm diameter macular discs and in concentric parafoveal (1‐ to 2‐mm, 2‐ to 3‐mm, 1‐ to 3‐mm) and perifoveal (3‐ to 6‐mm) rings. Group differences in imaging parameters and their relationship with visual outcomes were analyzed. A multivariate logistic model was developed to predict visual impairment from optical coherence tomography measurements in Parkinson's disease, and cutoff values were determined with receiver operating characteristic analysis. Results When compared with controls, patients with dementia with Lewy bodies had significant thinning of the ganglion cell–inner plexiform layer complex within the central 3‐mm disc mainly because of differences in 1‐ to 3‐mm parafoveal thickness. This parameter was strongly correlated in patients, but not in controls, with low contrast visual acuity and visual cognition outcomes (P < .05, False Discovery Rate), achieving 88% of accuracy in predicting visual impairment in Parkinson's disease. Conclusion Our findings support that parafoveal thinning of ganglion cell–inner plexiform complex is a sensitive and clinically relevant imaging biomarker for Lewy body diseases, specifically for Parkinson's disease. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Section: Discussionmentioning

confidence: 99%

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Parafoveal thinning of inner retina is associated with visual dysfunction in Lewy body diseases

et al. 2019

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“…Interestingly, our group found that visual dysfunction in PD is selectively associated with the thinning of GCIPL in the 1‐ to 3‐mm diameter ring area around the fovea (parafoveal GCIPL), 20 an OCT feature that has also been identified in patients with idiopathic rapid eye movement sleep behavior disorder—the earliest (prodromal) phase of LBD 24 . So far, only few OCT studies have prospectively evaluated the progression of retinal thinning in PD patients, 25–27 and none has specifically looked at the rate of macular GCIPL atrophy and its relationship with disease worsening.…”

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confidence: 99%

Retinal Thickness Predicts the Risk of Cognitive Decline in Parkinson Disease

Murueta‐Goyena

Pino

Galdós

et al. 2020

Annals of Neurology

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Objective This study was undertaken to analyze longitudinal changes of retinal thickness and their predictive value as biomarkers of disease progression in idiopathic Parkinson's disease (iPD). Methods Patients with Lewy body diseases were enrolled and prospectively evaluated at 3 years, including patients with iPD (n = 42), dementia with Lewy bodies (n = 4), E46K‐SNCA mutation carriers (n = 4), and controls (n = 17). All participants underwent Spectralis retinal optical coherence tomography and Montreal Cognitive Assessment, and Unified Parkinson's Disease Rating Scale score was obtained in patients. Macular ganglion cell–inner plexiform layer complex (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thickness reduction rates were estimated with linear mixed models. Risk ratios were calculated to evaluate the association between baseline GCIPL and pRNFL thicknesses and the risk of subsequent cognitive and motor worsening, using clinically meaningful cutoffs. Results GCIPL thickness in the parafoveal region (1‐ to 3‐mm ring) presented the largest reduction rate. The annualized atrophy rate was 0.63μm in iPD patients and 0.23μm in controls (p < 0.0001). iPD patients with lower parafoveal GCIPL and pRNFL thickness at baseline presented an increased risk of cognitive decline at 3 years (relative risk [RR] = 3.49, 95% confidence interval [CI] = 1.10–11.1, p = 0.03 and RR = 3.28, 95% CI = 1.03–10.45, p = 0.045, respectively). We did not identify significant associations between retinal thickness and motor deterioration. Interpretation Our results provide evidence of the potential use of optical coherence tomography–measured parafoveal GCIPL thickness to monitor neurodegeneration and to predict the risk of cognitive worsening over time in iPD. ANN NEUROL 2021;89:165–176

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“…First of all the most recent OCT case-control meta-analysis in glaucoma patients [69], including both TD-OCT and SD-OCT studies, showed a similar pattern compared to our meta-analysis in Parkinson's patients, with relative sparing of the nasal sector of the pRNFL. This might indicate a common underlying pathophysiology, with a more progressive variant indicating glaucoma and a milder variant related to Parkinson's patients [38,44]. In Alzheimer's disease, slightly different findings were reported, existing of, the most recent OCT case control meta-analysis [70], including both TD-OCT and SD-OCT studies, reported a significant thinning in all (superior, inferior, nasal and temporal) quadrants of the pRNFL.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Retinal layers in Parkinson's disease: A meta-analysis of spectral-domain optical coherence tomography studies

Chrysou

Jansonius²,

Laar³

2019

Parkinsonism & Related Disorders

104

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Progressive Changes in the Retinal Structure of Patients with Parkinson’s Disease

Abstract: PD progression is associated with pronounced retinal structure changes, which can be quantified by OCT. Patterns of RNFL and macular damage detected by the noninvasive technology of OCT can be a useful biomarker for evaluating the progression of PD.

Cited by 33 publications

References 30 publications

Parafoveal thinning of inner retina is associated with visual dysfunction in Lewy body diseases

Parafoveal thinning of inner retina is associated with visual dysfunction in Lewy body diseases

Retinal Thickness Predicts the Risk of Cognitive Decline in Parkinson Disease

Retinal layers in Parkinson's disease: A meta-analysis of spectral-domain optical coherence tomography studies

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