Detection of retinal changes in idiopathic Parkinson's disease using high‐resolution optical coherence tomography and heidelberg retina tomography

Abstract

ABSTRACT.Purpose: The study was performed to analyse the retina of patients with Parkinson's disease (PD) for morphological changes compared to healthy controls (HC) using spectral-domain optical coherence tomography (SD-OCT) and confocal scanning laser ophthalmoscopy. Methods: We enrolled 108 patients with idiopathic PD and 165 HC. All study participants underwent an ophthalmological examination to exclude ophthalmological disorder potentially interfering with the retinal analyses. Peripapillary retinal nerve fibre layer (RNFL) thickness and macular thickness and volume were measured by a SD-OCT device (Heidelberg Spectralis â ). Stereometric parameters of the optic disc were acquired by Heidelberg Retina Tomograph (HRT III). Results: The RNFL thickness did not significantly differ between patients with PD and HC. The thickness of the central minimum and the centre of the macular area were significantly reduced in patients with PD, while the total macular volume did not significantly differ between the groups. Furthermore, we noted an inverse correlation between the central minimum thickness and the disease severity (assessed by the Hoehn and Yahr scale). HRT data showed no significant differences. Conclusion: The HRT device and the RNFL measurements of the SD-OCT did not prove to be a clinically valid diagnostic tool to distinguish eyes of patients with PD and HC. However, the macular region and especially the foveola (central minimum) with the highest density of photoreceptor cells seem to be more sensitive and might be potential biomarkers.

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

“…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.…”

“…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.…”

Ophthalmologic Baseline Characteristics and 2-Year Ophthalmologic Safety Profile of Pramipexole IR Compared with Ropinirole IR in Patients with Early Parkinson’s Disease

“…After 2 years, RPE hypopigmentation prevalence was similar to baseline, 28.9%. We are not aware of previous clinical reports of RPE hypopigmentation in idiopathic PD, although PD perturbations of other retinal structures are documented (e.g., macular and retinal nerve fiber layer thinning [19] and inverse correlation of central minimum thickness with Hoehn–Yahr stage [20]). Retinal thickness distinguishes advanced PD patients from healthy persons [21].…”

A window to beyond the orbit: the value of optical coherence tomography in non‐ocular disease

“…In contrast, a large case–control study, which included 108 patients and 165 controls, found no difference in RNFL or macula volume (Bittersohl et al. ). Despite these conflicting results, a recent meta‐analysis concluded that OCT might be useful for monitoring PD progression (Yu et al.…”