Ivan Bodis-Wollner

Publications (171) View all

• Article: Correlation of Inner Retinal Thickness Evaluated by Spectral-Domain Optical Coherence Tomography and Contrast Sensitivity in Parkinson disease.

  Christopher R Adam, Eric Shrier, Yin Ding, Sofya Glazman, Ivan Bodis-Wollner
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  ABSTRACT: BACKGROUND:: To compare inner retinal layer (IRL) thickness measured by spectral-domain optical coherence tomography (SD-OCT) and contrast sensitivity (CS) in patients with Parkinson disease (PD) and in healthy control (HC) subjects. METHODS:: Consecutive patients with and without PD were prospectively analyzed using SD-OCT and Pelli-Robson CS testing. SD-OCT IRL (ganglion-cell complex) thickness, consisting of the nerve fiber layer, ganglion cell layer, and inner plexiform layer, was segmented using an RTVue Model-RT100 with an EMM5 scan parameter covering a 5.0 × 5.0 mm cube centered on the fovea. Thickness voxel measurements at 0.25-mm intervals at sequential radial distances from the foveola were acquired horizontally and vertically. SD-OCT thickness raw data files were imported and analyzed within MATLAB (version 7.10.0). A database of CS scores and IRL thickness values by foveal location was constructed and statistically evaluated using JMP 10 (SAS Institute, Inc, Cary, NC). RESULTS:: The results were compared between 28 eyes of 14 patients with PD and 28 eyes of 14 HC subjects. Controlling for age, mean CS scores of monocular right and randomized eyes were statistically lower in PD eyes (P < 0.05). IRL was significantly thinner in PD eyes than in HC eyes at several distances from the foveola (P < 0.05). The most numerous and significant thickness differences by diagnosis were located in the superior quadrant at a distance of 1.00-1.75 mm from the foveal center (17 μm; P < 0.01, maximum significant thickness difference and P value). Correlation was demonstrated between monocular CS and IRL thickness by diagnosis at multiple foveal locations for HC eyes as follows: nasal quadrant, 0.75-1.00 mm (P < 0.02); temporal quadrant, 0.50-1.00 mm (P < 0.05); superior quadrant, 1.00 mm (P < 0.05); and inferior quadrant, 1.00 mm (P < 0.03). No significant correlation was found between monocular CS and IRL thickness within PD subjects (P > 0.05 for each foveal location measured). CONCLUSION:: CS and foveal IRL thickness are decreased in patients with PD. CS and IRL thickness correlated in HC subjects; however, no such correlation was demonstrated in PD. The functional deficit of dopaminergic interneurons, including amacrine cells, may outstrip the anatomic structural changes in the inner retina of PD patients. Inner retinal atrophic changes may underlie the pathogenesis of CS deficit and IRL thinning in PD.
  Journal of neuro-ophthalmology: the official journal of the North American Neuro-Ophthalmology Society 04/2013; · 1.09 Impact Factor
• Article: Fovea and Foveation in Parkinson's Disease.

  Ivan Bodis-Wollner, Sofya Glazman, Sushma Yerram
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  ABSTRACT: Nondemented Parkinson's disease (PD) patients report problems on nonmotor tasks that depend on visual or visuospatial abilities. In PD, foveal vision is impaired. Experimental studies in humans and monkeys established that foveal processing and visuospatial attention may be linked through saccadic eye movements. Saccadic eye movements "bring" eccentric targets to the direct sight line for closer scrutiny by foveal processing. This is called foveation. This review musters the arguments for impaired foveal vision and impaired cortical control of voluntary saccades in PD. Retinal impairment of spatial contrast vision is selective in PD. Thus, the reviewed literature includes a brief survey of the physiology of foveal pathways. This is necessary to understand the specificity of the retinopathy of PD, documented by clinical evidence, relying on psychophysical, electrophysiological, and imaging techniques. These have recently been supplanted by the results of retinal imaging using Optical Coherence Tomography (OCT). Studies of cortical mechanisms in PD reviewed here relied on neuropsychological, electrophysiological (EEG), and imaging techniques. Impaired functional anatomy and electrophysiology in PD are reviewed. The exact relationship of retinal foveal deficits and visuospatial attention and postural control impairment in PD remain challenging research questions. This review will hopefully will provide useful material for future studies. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
  Behavioral Neuroscience 01/2013; · 2.62 Impact Factor
• Article: Interocular asymmetry of foveal thickness in Parkinson disease.

  Eric M Shrier, Christopher R Adam, Brian Spund, Sofya Glazman, Ivan Bodis-Wollner
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  ABSTRACT: Purpose. To quantify interocular asymmetry (IA) of foveal thickness in Parkinson disease (PD) versus that of controls. Design. Prospective case-control series. Methods. In vivo assessment of foveal thickness of 46 eyes of 23 PD patients and 36 eyes of 18 control subjects was studied using spectral domain optical coherence tomography (SD-OCT). Inner versus outer layer retinal segmentation and macular volumes were quantified using the manufacturer's software, while foveal thickness was measured using the raw data from each eye in a grid covering a 6 by 6 mm area centered on the foveola in 0.25 mm steps. Thickness data were entered into MATLAB software. Results. Macular volumes differed significantly at the largest (Zone 3) diameter centered on the foveola (ETDRS protocol). By segmenting inner from outer layers, we found that the IA in PD is mostly due to changes on the slope of the foveal pit at the radial distances of 0.5 and 0.75 mm (1.5 mm and 1 mm diameter). Conclusions. About half of the PD patients had IA of the slope of the foveal pit. IA is a potentially useful marker of PD and is expected to be comparable across different SD-OCT equipment. Data of larger groups may be developed in future multicenter studies.
  Journal of Ophthalmology 01/2012; 2012:728457.
• Source

  Available from: Jorge Zamudio

  Article: Hospitalization in Parkinson disease: a survey of National Parkinson Foundation Centers.

  Kelvin L Chou, Jorge Zamudio, Peter Schmidt, Catherine C Price, Sotirios A Parashos, Bastiaan R Bloem, Kelly E Lyons, Chadwick W Christine, Rajesh Pahwa, Ivan Bodis-Wollner, Wolfgang H Oertel, Oksana Suchowersky, Michael J Aminoff, Irene A Malaty, Joseph H Friedman, Michael S Okun
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  ABSTRACT: To explore current practices and opinions regarding hospital management of Parkinson disease (PD) patients in specialized PD Centers. Fifty-one out of 54 National Parkinson Foundation (NPF) Centers worldwide completed an online survey regarding hospitalization of PD patients. Many Centers were concerned about the quality of PD-specific care provided to their patients when hospitalized. Primary concerns were adherence to the outpatient medication schedule and poor understanding by hospital staff of medications that worsen PD. Few Centers had a policy with their primary hospital that notified them when their patients were admitted. Rather, notification of hospitalization came often from the patient or a family member. Several Centers (29%) reported not finding out about a hospitalization until a routine clinic visit after discharge. Quick access to outpatient PD care following discharge was a problem in many Centers. Elective surgery, fall/fracture, infection, and mental status changes, were identified as common reasons for hospitalization. There is a perceived need for PD specialists to be involved during hospitalization of their patients. Improvement in communication between hospitals and PD Centers is necessary so that hospital clinicians can take advantage of PD specialists' expertise. Education of hospital staff and clinicians regarding management of PD, complications of PD, and medications to avoid in PD is critical. Most importantly, outpatient access to PD specialists needs to be improved, which may prevent unnecessary hospitalizations in these patients.
  Parkinsonism & Related Disorders 03/2011; 17(6):440-5. · 3.80 Impact Factor
• Article: Management of the hospitalized patient with Parkinson's disease: current state of the field and need for guidelines.

  Michael J Aminoff, Chad W Christine, Joseph H Friedman, Kelvin L Chou, Kelly E Lyons, Rajesh Pahwa, Bastian R Bloem, Sotirios A Parashos, Catherine C Price, Irene A Malaty, Robert Iansek, Ivan Bodis-Wollner, Oksana Suchowersky, Wolfgang H Oertel, Jorge Zamudio, Joyce Oberdorf, Peter Schmidt, Michael S Okun
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  ABSTRACT: To review the literature and to identify practice gaps in the management of the hospitalized Parkinson's disease (PD) patient. Patients with PD are admitted to hospitals at higher rates, and frequently have longer hospital stays than the general population. Little is known about outpatient interventions that might reduce the need for hospitalization and also reduce hospital-related complications. A literature review was performed on PubMed about hospitalization and PD between 1970 and 2010. In addition, in press peer-reviewed papers or published abstracts known to the authors were included. Information was reviewed by a National Parkinson Foundation workgroup and a narrative review article was generated. Motor disturbances in PD are believed to be a causal factor in the higher rates of admissions and complications. However, other conditions are commonly recorded as the primary reason for hospitalization including motor complications, reduced mobility, lack of compliance, inappropriate use of neuroleptics, falls, fractures, pneumonia, and other important medical problems. There are many relevant issues related to hospitalization in PD. Medications, dosages and specific dosage schedules are critical. Staff training regarding medications and medication management may help to avoid complications, particularly those related to reduced mobility, and aspiration pneumonia. Treatment of infections and a return to early mobility is also critical to management. Educational programs, recommendations, and guidelines are needed to better train interdisciplinary teams in the management of the PD patient. These initiatives have the potential for both cost savings and improved outcomes from a preventative and a hospital management standpoint.
  Parkinsonism & Related Disorders 03/2011; 17(3):139-45. · 3.80 Impact Factor