Ocular features of patients with Parkinson’s disease examined at a Neuro-Optometry Clinic in a tertiary eye care center

Kwan, Singson C K; Atiya, Ayisha; Hussaindeen, Jameel Rizwana; Praveen, Smita; Selvakumar, Ambika

doi:10.4103/ijo.ijo_948_21

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…In another study performed by Naumann et al [20] , the presence of diplopia in patients with PD was associated with cognitive impairment in visuospatial and visuoperceptive function. Since convergence insufficiency with intermittent diplopia is a common finding in PD [27] , the results of Naumann et al's study [20] can also draw attention to the relationship between a receded NPC and cognitive impairment. To our best knowledge, the present report is the first one to investigate the association between NPC and MCI in a large sample of the general elderly population.…”

Section: Discussionmentioning

confidence: 95%

Receded near point of convergence as a predictor of mild cognitive impairment in the general geriatric population: results from a population-based study

Doostdar¹,

Nabovati²,

Asharlous³

et al. 2023

Int J Ophthalmol

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AIM: To investigate the relationship between near point of convergence (NPC) and mild cognitive impairment (MCI) in the general elderly population. METHODS: The present report is a part of the Tehran Geriatric Eye Study (TGES): a population-based cross-sectional study conducted on individuals 60 years of age and above living in Tehran, Iran using the multi-stage stratified random cluster sampling method. Cognitive status was assessed using the Persian version of the Mini-Mental State Examination (MMSE). All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity, objective and subjective refraction, cover testing, NPC measurement, and slit-lamp biomicroscopy. RESULTS: The data of 1190 individuals were analyzed for this report. The mean age of the participants analyzed was 66.82±5.42 (60-92y) and 728 (61.2%) of them were female. Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status (10.89±3.58 vs 7.76±2.71 cm, P<0.001). In the multivariable logistic regression model and in the presence of confounding variables, a receded NPC was statistically significantly associated with an increased risk of MCI (odds ratio: 1.334, 95% confidence interval: 1.263 to 1.410, P<0.001). According to receiver operating characteristic (ROC) analysis, a cut point NPC> 8.5 cm (area under the curve: 0.764, P<0.001) could predict the presence of MCI with a sensitivity and specificity of 70.9% and 69.5%, respectively. CONCLUSION: A receded NPC can be clinically proposed as a predictor of MCI in older adults. It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI. In this case, the necessary interventions can be carried out to slow down MCI progression to dementia.

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Section: Discussionmentioning

confidence: 95%

Receded near point of convergence as a predictor of mild cognitive impairment in the general geriatric population: results from a population-based study

Doostdar¹,

Nabovati²,

Asharlous³

et al. 2023

Int J Ophthalmol

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“…The rest of the articles were manually screened by the authors in order to meet the eligibility criteria. In the end, a total of seventeen articles remained: nine were observational cross-sectional studies [ 3 , 4 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ], two were prospective cohort studies [ 13 , 14 ], two were retrospective studies [ 15 , 16 ] and four were case reports [ 17 , 18 , 19 , 20 ]. Table 1 shows detailed information about the included studies on diplopia in Parkinson’s disease.…”

Section: Resultsmentioning

confidence: 99%

“…One study compared patients with PD, PD dementia, and healthy controls [ 11 ], two studies compared PD patients with diplopia, PD patients without diplopia, and healthy controls (HC) [ 12 , 13 ], four studies examined patients with PD compared to healthy controls [ 4 , 10 , 13 , 14 ], six studies examined PD patients with and without diplopia [ 3 , 6 , 7 , 8 , 15 , 16 ], and four were case reports of PD patients with diplopia [ 17 , 18 , 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

Diplopia in Movement Disorders: A Systematic Review of the Literature

Ungureanu,

Irincu,

Diaconu

et al. 2024

JPM

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Introduction: Although the reported frequency of diplopia is between 10 to 40% of patients with Parkinson’s disease (PD) and other movement disorders, it remains one of the most undiagnosed non-motor symptoms. Furthermore, it has a major impact on the quality of life of these patients. The aim of this study is to systematically review the literature regarding the frequency, causes, and implications of diplopia in movement disorders. Methodology: An electronic search was conducted in March and June 2023 using the PubMed database in order to identify appropriate studies. Studies that were written in English, that represented observational, analytical studies, and case reports, and that provided information regarding diplopia in movement disorders were included in the systematic review. Results: A total of 686 articles were identified out of which 43 met the inclusion criteria. The studies included in the systematic review ranged from descriptive studies (case reports and case series) to analytical–observational studies (cross-sectional studies, prospective and retrospective cohort studies, and case–control studies). In Parkinson’s disease, the incidence of diplopia ranged from 10 to 38%. In these patients, diplopia was linked to the presence of visual hallucinations and cognitive decline but also to convergence insufficiency and the presence of motor fluctuations. Cases of diplopia secondary to deep brain stimulation were also reported. Diplopia was associated with longer disease duration and worse motor and non-motor scores. Diplopia was also reported in other movement disorders such as multiple system atrophy (frequency as high as 18%) and progressive supranuclear palsy (frequency as high as 39%) and was associated with increased mortality and shorter duration in life span. Conclusions: Diplopia occurs in up to 38% of patients with movement disorders and has a negative impact on their health-related quality of life. Treating physicians should actively ask about diplopia and other ophthalmological symptoms, as many patients do not spontaneously report them. The pathophysiology of diplopia is complex, and it involves heterogeneous peripheral and central mechanisms. The management of these patients should involve a multidisciplinary team of health professionals in order to provide appropriate, tailored management.

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“…It is known that occupational therapy can improve visual functioning of people with movement disorders [27]. However, little has been reported on the availability and effectiveness of reading interventions for people with PD, beyond, for example, prism glasses and home vision therapy [28]. Hence, we will provide an overview of all reading aids and advice provided in neurovisual rehabilitation, along with how this has been received by people with PD.…”

Section: Introductionmentioning

confidence: 99%

Reading Difficulties in Parkinson’s Disease: A Stepped Care Model for Neurovisual Rehabilitation

van der Lijn,

de Haan,

van der Feen

et al. 2023

JPD

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Background: People with Parkinson’s disease (PD) frequently experience reading difficulties. Little is known about what functional impairments distinguish people with PD with and without reading difficulties and how these should guide rehabilitation. Objective: To provide concrete advice for an efficient stepped care model for reading difficulties in PD, based on extensive functional assessments. Methods: This study included 74 people with PD in a neurovisual rehabilitation setting who underwent assessment of visual, visuoperceptual, and cognitive functions. Outcomes were compared between those with frequent (RD+; N = 55) and infrequent reading difficulties (RD–; N = 19). Aids and advice provided during rehabilitation were registered. Results: Only a few functions appeared to distinguish RD+ and RD–. Visual functions (i.e., contrast sensitivity, g = 0.76; reading acuity, g = 0.66; visual acuity, g = 0.54) and visuoperceptual functions (i.e., visual attention, g = 0.58, visual motor speed, g = 0.56) showed significant worse scores in RD+ compared to RD–. Aids and advice applied consisted mainly of optimizing refraction, improving lighting, and optimizing text size and spacing. Conclusion: The test battery showed significant differences between RD+ and RD–on only a few tests on visual and visuoperceptual functions. The applied aids and advice matched well with these impairments. Therefore, we recommend a stepped care model, starting with a short test battery on these functions. If this battery indicates functional impairments, this can be followed by standard aids and advice to improve reading. Only in case of insufficient effect additional testing should take place.

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Ocular features of patients with Parkinson’s disease examined at a Neuro-Optometry Clinic in a tertiary eye care center

Cited by 5 publications

References 16 publications

Receded near point of convergence as a predictor of mild cognitive impairment in the general geriatric population: results from a population-based study

Receded near point of convergence as a predictor of mild cognitive impairment in the general geriatric population: results from a population-based study

Diplopia in Movement Disorders: A Systematic Review of the Literature

Reading Difficulties in Parkinson’s Disease: A Stepped Care Model for Neurovisual Rehabilitation

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