Retinal changes in Parkinson's disease and glaucoma

Matlach, Juliane; Wagner, Martin; Malzahn, Uwe; Schmidtmann, Irene; Steigerwald, Frank; Musacchio, Thomas; Volkmann, Jens; Grehn, Franz; Göbel, Werner; Klebe, Stephan

doi:10.1016/j.parkreldis.2018.06.016

Cited by 37 publications

(38 citation statements)

References 25 publications

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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%

“…Whereas some authors have reported that iPD patients have a significant and marked thinning of the macula 10,12-14 and its inner retinal layers, 8,9,11,[21][22][23][24][25][26] others have evidenced outer retinal layer thinning, 27 or even thickening, 11,24 and some have failed to find any differences. [28][29][30][31][32][33][34] 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 35 and could account for the discrepancies found in the literature regarding retinal alterations in iPD. Specifically, the differences in acquisition speed and axial resolution between time-domain and spectral-domain OCTs might explain why studies using older time-domain OCT devices (eg, Stratus) only detected significant differences between iPD patients and controls when absolute differences in thickness were greater than 10 μm, 20,36 whereas studies using spectraldomain OCTs have yielded significant results with differences from 2 to 7 μm in thickness regardless of the area analyzed, 7,9,12,24,25,27,34,[37][38][39][40] which is consistent with the magnitude of inner retinal thinning observed in our E46K-SNCA cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the differences in OCT devices and acquisition protocols, our findings are consistent with the results of several other studies, supporting the view that the parafoveal region of the macula is specifically affected in iPD and the hypothesis of foveal pit remodeling in iPD. 7,15,16,39,42 Intriguingly, in all of the studies that have failed to find differences between iPD patients and controls, the analyses were limited to computing whole macular thickness, 28,29,32,37 overall macular volumes, 27,31 or average inner retinal layer thickness 24,[29][30][31][32][33] in a 6-mm diameter disc without further topographical analysis, which may have masked significant focal retinal differences. Spund and colleagues 7 reported that the major difference in retinal thickness between controls and iPD patients was found between 0.5-and 2-mm eccentric to the foveola.…”

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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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%

Section: Discussionmentioning

confidence: 99%

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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“…Visual field defects can be caused by a broad variety of diseases (e.g., opticopathy, retinal disease, glaucoma). Two small studies suggested an increased risk of glaucoma in PD patients (16-24% compared to 7% in healthy controls) [9,58,59]. Central visual field defects can be screened using the Amsler grid [60].…”

Section: Optic Nerve/retinamentioning

confidence: 99%

The Neuro-Ophthalmological Assessment in Parkinson’s Disease

Borm

Śmiłowska

Vries

et al. 2019

JPD

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Visual disorders like double vision, dry eyes, and visual field deficits are common but frequently missed in Parkinson’s disease. Here, we aim to increase awareness for these visual disorders in Parkinson patients by discussing several common problems that can be easily diagnosed using comprehensive history taking and a basic neuro-ophthalmological examination. We offer practical guidance for the patient interview and physical exam that can facilitate a timelier recognition of visual disorders. Such recognition has immediate therapeutic relevance, because Parkinson patients are strongly dependent on an adequate vision, for example to optimally benefit from visual cueing strategies.

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“…While the consensus regarding peripapillary RNFL thinning in Parkinson's disease (PD) is solid, the analysis of macular atrophy in PD has yielded conflicting results. As we pointed out in our study, this might be attributed, in part, to the variability in image acquisition methods of previous studies and to the lack of specificity of the analyzed macular parameters.…”

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confidence: 99%