Retinal Thickness and Microvascular Pattern in Early Parkinson's Disease

Rascunà, Cristina; Russo, Andrea; Terravecchia, Claudio; Castellino, N; Avitabile, Teresio; Bonfiglio, Vincenza; Fallico, Matteo; Chisari, Clara Grazia; Cicero, Calogero Edoardo; Grillo, Marco; Longo, Antonio; Luca, Antonina; Mostile, Giovanni; Zappia, Mario; Reibaldi, Michele; Nicoletti, Alessandra

doi:10.3389/fneur.2020.533375

Cited by 39 publications

(40 citation statements)

References 49 publications

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“…They found that the retinal capillary skeleton and perfusion densities and capillary complexity of SCP were significantly lower in PD patients than in healthy controls ( Shi et al, 2020 ). Unlike our results, in the study by Rascunà et al (2020) no significant difference in microvascular density was observed between PD patients and healthy controls. These results were variable and inconsistent, possibly due to the study design, and patient selection.…”

Section: Discussioncontrasting

confidence: 99%

Visual Impairments Are Associated With Retinal Microvascular Density in Patients With Parkinson’s Disease

Zhou

et al. 2021

Front. Neurosci.

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ObjectiveThis study aimed to evaluate retinal microvascular density in patients with Parkinson’s disease (PD) and its correlation with visual impairment.MethodsThis cross-sectional study included 24 eyes of 24 patients with PD and 23 eyes of 23 healthy controls. All participants underwent ophthalmic examination, visual evoked potential (VEP) test, 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), and optical coherence tomography angiography (OCTA) examination. The correlation between retinal microvascular density and visual parameter was evaluated using Spearman correlation analysis, and the area under receiver operating characteristic curve (AUROC) was calculated.ResultsParkinson’s disease patients had prolonged P100 latency (P = 0.041), worse vision-related quality of life (composite score and 3 of 12 subscales in NEI VFQ-25), and decreased vessel density (VD) in all sectors of 3-mm-diameter region (all P < 0.05) compared with healthy controls. There were no statistical differences in the ganglion cell-inner plexiform layer (GCIPL) thickness and retinal nerve fiber layer (RNFL) thickness between the two groups. A negative correlation was found between P100 latency and nasal and superior sectors of macular VD in a 3-mm-diameter region (r = −0.328, P = 0.030; r = −0.302, and P = 0.047, respectively). Macular VD in a 3-mm-diameter region showed diagnostic capacities to distinguish PD patients from healthy controls (AUROCs, ranging from 0.655 to 0.723).ConclusionThis study demonstrated that decreased retinal microvascular density was correlated with visual impairment in PD patients. Retinal microvasculature change may occur earlier than visual decline and retinal structure change and has the potential to be a promising diagnostic marker for early PD.

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Section: Discussioncontrasting

confidence: 99%

Visual Impairments Are Associated With Retinal Microvascular Density in Patients With Parkinson’s Disease

Zhou

et al. 2021

Front. Neurosci.

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“…Furthermore, we found that the decrease in FAZ area was accompanied by an increase in microvascular parameters in the foveal zone, like skeleton and perfusion density, fractal dimension or lacunarity. This contrasts with the results of Zou et al who found less vessel length and perfusion in the central macula of PD patients and no changes in FAZ area ( Zou et al, 2020 ), and with the results of Rascunà et al who did not find vascular density changes in the foveal zone of early PD patients ( Rascunà et al, 2020 ). Some of these differences might be attributed to smaller sample sizes, differences in disease stage of patients and study design flaws of previous studies.…”

Section: Discussioncontrasting

confidence: 97%

“…Studying the morphometric variations of capillary networks in PD might provide key information about the regional neuronal structure, and the basis for investigating retinal vascular morphological features as potential biomarkers of cerebral microcirculation in PD. Although to date few studies have explored retinal vascular alterations in PD using OCT-A, the observations so far support the view that retinal vascular alterations are present in PD (Kromer et al, 2016;Kwapong et al, 2018;Rascunà et al, 2020;Shi et al, 2020;Zou et al, 2020;Robbins et al, 2021).…”

Section: Introductionmentioning

confidence: 62%

“…Nonetheless, part of their results coincides with ours, as we also found an association between the parafoveal microvascular density and GCIPL thickness, even after adjusting for confounding variables. Similarly, Rascunà et al (2020) , did not observe significant differences in the parafoveal microvascular density between early PD patients and controls but did find a correlation of inner retinal layer thickness and microvascular density. However, these correlations were mostly restricted to the foveal zone, and in the present study, we showed that such associations were not specific to PD, as they were also observed in controls.…”

Section: Discussionmentioning

confidence: 82%

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Foveal Remodeling of Retinal Microvasculature in Parkinson’s Disease

et al. 2021

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BackgroundRetinal microvascular alterations have been previously described in Parkinson’s disease (PD) patients using optical coherence tomography angiography (OCT-A). However, an extensive description of retinal vascular morphological features, their association with PD-related clinical variables and their potential use as diagnostic biomarkers has not been explored.MethodsWe performed a cross-sectional study including 49 PD patients (87 eyes) and 40 controls (73 eyes). Retinal microvasculature was evaluated with Spectralis OCT-A and cognitive status with Montreal Cognitive Assessment. Unified PD Rating Scale and disease duration were recorded in patients. We extracted microvascular parameters from superficial and deep vascular plexuses of the macula, including the area and circularity of foveal avascular zone (FAZ), skeleton density, perfusion density, vessel perimeter index, vessel mean diameter, fractal dimension (FD) and lacunarity using Python and MATLAB. We compared the microvascular parameters between groups and explored their association with thickness of macular layers and clinical outcomes. Data were analyzed with General Estimating Equations (GEE) and adjusted for age, sex, and hypertension. Logistic regression GEE models were fitted to predict diagnosis of PD versus controls from microvascular, demographic, and clinical data. The discrimination ability of models was tested with receiver operating characteristic curves.ResultsFAZ area was significantly smaller in patients compared to controls in superficial and deep plexuses, whereas perfusion density, skeleton density, FD and lacunarity of capillaries were increased in the foveal zone of PD. In the parafovea, microvascular parameters of superficial plexus were associated with ganglion cell-inner plexiform layer thickness, but this was mainly driven by PD with mild cognitive impairment. No such associations were observed in controls. FAZ area was negatively associated with cognition in PD (non-adjusted models). Foveal lacunarity, combined with demographic and clinical confounding factors, yielded an outstanding diagnostic accuracy for discriminating PD patients from controls.ConclusionParkinson’s disease patients displayed foveal microvascular alterations causing an enlargement of the vascular bed surrounding FAZ. Parafoveal microvascular alterations were less pronounced but were related to inner retinal layer thinning. Retinal microvascular abnormalities helped discriminating PD from controls. All this supports OCT-A as a potential non-invasive biomarker to reveal vascular pathophysiology and improve diagnostic accuracy in PD.

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“…Optical Coherence Tomography Angiography of the macula was carried out employing AngioVue XR Avanti (Optovue Inc, Fremont, California, United States) after pupil dilation with 1% Tropicamide. The technology of OCTA has been previously described in detail ( Querques et al, 2016 ; Moghimi et al, 2018 ; Bonfiglio et al, 2019 ; Rascunà et al, 2020 ). The rate of A-scan was 70,000 per second and the bandwidth was 50 nm.…”

Section: Methodsmentioning

confidence: 99%

Retinal Vascular Assessment in Psoriasis: A Multicenter Study

et al. 2021

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PurposeTo investigate the vascular status of the macula in psoriasis patients without history of ocular inflammation by Optical Coherence Tomography Angiography (OCTA).MethodsThis prospective cross-sectional multicenter study included 55 psoriasis patients and 55 control healthy subjects. A complete eye examination and 6 mm × 6 mm OCTA imaging were performed. Retinal vascular status was evaluated by analyzing vascular density (VD) of superficial vascular plexus (superficial wVD) and deep vascular plexuses (deep wVD) in a 6 mm × 6 mm area and in foveal (superficial fVD and deep fVD) and parafoveal sectors (superficial pVD and deep pVD). In addition, foveal thickness (FT) and foveal avascular zone (FAZ) and clinical variables, including best corrected visual acuity (BCVA), intraocular pressure and refractive condition, were collected.ResultsBCVA, intraocular pressure and refractive condition were comparable between cases and controls. OCTA imaging showed that superficial wVD and superficial pVD were lower in the psoriasis group in comparison with controls (p = 0.009 and p = 0.01, respectively). Similarly, deep wVD and pVD were lower in the psoriasis group in comparison with control subjects (p = 0.03 and p = 0.01, respectively). In a sub-analysis of 47 patients affected by psoriasis without psoriatic arthritis, lower values of wVD and pVD in both superficial and deep capillary plexuses were registered.ConclusionOCTA is a useful tool which provides data on vascular status of the retina in psoriasis with no ocular involvement. VD data may suggest that vascular changes may occur earlier than clinical onset of posterior inflammation.

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Retinal Thickness and Microvascular Pattern in Early Parkinson's Disease

Cited by 39 publications

References 49 publications

Visual Impairments Are Associated With Retinal Microvascular Density in Patients With Parkinson’s Disease

Visual Impairments Are Associated With Retinal Microvascular Density in Patients With Parkinson’s Disease

Foveal Remodeling of Retinal Microvasculature in Parkinson’s Disease

Retinal Vascular Assessment in Psoriasis: A Multicenter Study

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