Inner Retinal Layer Thinning in Parkinson Disease

Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, NY 11203, USA.
Archives of ophthalmology (Impact Factor: 4.4). 07/2009; 127(6):737-41. DOI: 10.1001/archophthalmol.2009.106
Source: PubMed


To quantify retinal thickness in patients with Parkinson disease (PD).
Forty-five eyes of 24 PD patients and 31 eyes of 17 control subjects underwent a comprehensive ophthalmologic examination. We used optical coherence tomography to examine retinal thickness, separately quantifying the inner and outer retinal layers. Intraocular pressure was measured by Goldmann applanation tonometry.
The mean (SD) ages of the patients with PD and healthy subjects were 64.0 (6.5) years vs 63.5 (10.7) years (P = .77). The mean (SD) intraocular pressure was 13.6 (+/-2.7) mm Hg in the PD patients. No difference was found in either the superior or inferior outer retinal layer thickness of PD vs control eyes. The mean (SD) superior inner retinal layer thickness of PD vs control eyes was 88.79 (11.3) microm vs 103.5 (24.3) microm (P = .01), and the mean inferior inner retinal layer thickness was 89.83 (11.1) microm vs 104.0 (23.5) microm (P = .01).
The inner retinal layer is significantly thinner in PD patients than in healthy subjects. Idiopathic PD, distinct from glaucoma, needs to be considered in the differential diagnosis of retinal nerve fiber layer thinning.

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Available from: Ivan Bodis-Wollner
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    • "Visualizing retinal structures using a newly advanced noninvasive technology, optical coherence tomography (OCT), revealed thinning of the retinal nerve fiber layer (RNFL) and macula [13] [14] in PD. The thinned inner retina (IR) [15] [16], suggests involvement of ganglion cell layer and dopaminergic neurons and the inner plexiform layer in PD. IR thinning correlates with impaired CS in PD patients [17]. "
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    ABSTRACT: Background: Impaired vision and remodeled foveal pit have been demonstrated in Parkinson's disease (PD) patients using different techniques. Methods: Ten PD (20 eyes) and eight healthy controls (HC) subjects (16 eyes) were enrolled. Subjects were evaluated for N70 and P100 latencies using two-channel VEP with pattern reversal and on/off pattern; Contrast sensitivity (CS) using Pelli-Robson chart; macular thickness measured using Zeiss-HD optical coherence tomography (OCT). Results: PD patients had a significantly delayed N70 (reversal pattern) and P100 (on/off pattern), lower CS score, and decreased retinal thickness at temporal 1.5-2.5 mm from the foveola. N70 latency was negatively correlated with CS (R = -0.419, P = 0.01) and average GCL-IPL thickness (R = -0.529, P = 0.001). CS was positively correlated with parafoveal thickness (R = 0.490, P = 0.002). A combination of parafoveal thickness and CS score yielded an AUC of 0.784 for PD discrimination which increased to 0.844 when combined with N70 and P100 measures. Conclusion: A combination of pattern reversal VEP latency, CS score, and inner retinal foveal thickness measures has a high diagnostic yield for PD.
    Full-text · Article · Sep 2015 · Parkinsonism & Related Disorders
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    • "A significant reduction in central macular thickness (CMT) [14] [15] [24] and volume was found in patients with PD [10] [25]. Patients with PD were also found to have significantly thinner inner retinal layers (IRL) as compared to controls [10] [14] [15] [26] [27]. "
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    ABSTRACT: Though Parkinson's disease (PD) is primarily a disease of the basal ganglia, recent evidence suggests that PD affects the retina. The study was designed to evaluate the thickness of retinal nerve fiber layer (RNFL) and thickness and volume of the macula in PD and hence explore the utility of optical coherence tomography (OCT) in studying retinal changes in PD. A prospective, hospital based evaluation of 30 patients with PD and 30 healthy controls was carried out. Various parameters such as RNFL, central macular thickness (CMT), central and total macular volumes (TMV) and retinal thickness were analyzed using OCT. (a) RNFL thickness was not significantly different between the patients and controls. A significant negative correlation was found between the RNFL thickness in the right nasal superior sector and the UPDRS motor score. (b) CMT was found to be significantly reduced in the right eye and a negative correlation with the UPDRS motor score was noted. (c) TMV was significantly greater in patients compared to the controls. (d) The outer retinal layer in the right nasal quadrant and the right inferior quadrants were found to be significantly thinner in patients with PD. We did not find any significant abnormality in the RNFL thickness in patients with PD. Decreased CMT in patients with PD and a significant negative correlation of RNFL thickness and CMT with severity of PD suggest a remote possibility of dopaminergic depletion in the retina. However long term studies are warranted to validate our findings. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Aug 2015 · Parkinsonism & Related Disorders
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    • "In this context, optical coherence tomography (OCT), a non-invasive imaging technique, provides reproducible , high-resolution cross-sectional imaging of the retinal nerve fiber layer (RNFL) and optic nerve head topography, providing an objective tool to diagnose axonal damage and thus constituting a " window into the brain " (London et al., 2013). A significant reduction in peripapillary RNFL thickness has been reported in patients with various neurological disorders such as multiple sclerosis (Sergott et al., 2007; Thrower, 2007), Alzheimer's disease (Parisi et al., 2001; Berisha et al., 2007; Marziani et al., 2013; Larrosa et al., 2014; Ascaso et al., 2014) or Parkinson's disease (Inzelberg et al., 2004; Hajee et al., 2009; Garcia-Martin et al., 2014; Jimenez et al., 2014), suggesting that this technique may also prove to be useful in other neuropsychiatric disorders. Together with these neuroimaging findings, the impaired functioning of the visual system and the retinal alterations found in patients with schizophrenia support the use of OCT to investigate this disorder (Meier et al., 2013). "
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    ABSTRACT: Optical coherence tomography (OCT) has been recently used to investigate neuropsychiatric disorders. We aimed to study retinal OCT measures of patients with schizophrenia with respect to healthy controls, and to evaluate possible differences between recent illness episode (RIE) and non-recent illness episode (NRIE) patients. Thirty schizophrenia patients were classified as RIE (n=10) or NRIE (n=20), and compared with 30 matched controls. Statistical analyses included linear mixed-effects models to study the association between OCT measures and group membership. Multivariate models were used to control for potential confounders. In the adjusted linear mixed-effects regression model, patients had a significantly thinner retinal nerve fiber layer (RNFL) in overall measurements, and in the nasal, superior and inferior quadrants. Macular inner ring thickness and macular volume were also significantly smaller in patients than controls. Compared with controls, in the adjusted model only NRIE (but not RIE) patients had significantly reduced RNFL overall measures, superior RNFL, nasal RNFL, macular volume, and macular inner ring thickness. No significant correlation was found between illness duration and retinal measurements after controlling for age. In conclusion, retinal parameters observed using OCT in schizophrenia patients could be related to clinical status and merit attention as potential state biomarkers of the disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Jul 2015
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