Towards seeing the visual impairments in Parkinson’s disease: protocol for a multicentre observational, cross-sectional study

Abstract

Background Visual disorders are common in Parkinson’s disease (PD) but their exact frequency and severity are unknown. Good visual functioning is crucial for patients with PD, because of their need to compensate for loss of automated motor control and their postural instability, forcing patients to guide their movements visually. Here, we describe the study design of a cross-sectional, multi-centre study aiming to: (1) validate the Visual Impairment screening questionnaire (VIPD-Q, which aims to identify PD patients who should be referred to an ophthalmologist for further assessment); (2) study the prevalence of visual disorders in PD; (3) study the severity and clinical impact of different types of visual disorders in PD; and (4) explore treatment options for ophthalmologic disorders in PD, as a basis for future guideline development. Methods This study consists of two phases. In phase one, 750 PD patients and 250 healthy controls will be recruited to complete the VIPD-Q. In phase two, a subgroup of responders ( n = 100) (with the highest and lowest scores on the VIPD-Q) will be invited for an extensive neurological and ophthalmological assessment. The in-depth ophthalmologic examination will serve as the “gold standard” for validating the VIPD-Q. Moreover, these assessments will be used to study associations between visual disorders and clinical presentation, in order to gain more insight in their clinical impact. Discussion Our study will heighten the awareness of visual problems in PD and offers a robust starting point to systematically approach this subject. In current daily practice, the association between visual problems and PD is far from obvious to both patients and clinicians. Consequently, patients may not adequately report visual problems themselves, while clinicians miss potentially treatable visual disorders. Routinely asking patients to complete a simple screening questionnaire could be an easy solution leading to timely identification of visual problems, tailored treatment, restored mobility, greater independence and improved quality of life. Trial registration Dutch Trial Registration, NL7421 , Registered on 4 December 2018 – Retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s12883-019-1365-8) contains supplementary material, which is available to authorized users.

Ophthalmologic problems correlates with cognitive impairment in patients with Parkinson's disease

“…Based on a previous study (Borm et al, 2019 ), we reran tests to identify the sensitivity and specificity of the VIPD-Q in the Chinese population. A receiver operating characteristic (ROC) curve indicated good sensitivity and specificity (AUC = 0.918, p < 0.001; Figure 1C ); this result was verified using the Hosmer–Lemeshow test ( p = 0.247).…”

Ophthalmologic problems correlates with cognitive impairment in patients with Parkinson's disease

“…Based on a previous study (Borm et al, 2019 ), we reran tests to identify the sensitivity and specificity of the VIPD-Q in the Chinese population. A receiver operating characteristic (ROC) curve indicated good sensitivity and specificity (AUC = 0.918, p < 0.001; Figure 1C ); this result was verified using the Hosmer–Lemeshow test ( p = 0.247).…”

The integration of technology into a home-based visuo-cognitive training intervention for people with Parkinson’s: Is the future digital?

“…Current literature suggests that in order to evaluate a novel technology, consideration must be given to the health need that the technology is intended to address [ 38 ]. In the field of PD, visuo-cognitive impairments remain under-recognised in research as well as in clinical practice [ 39 ] which may explain why participants lacked awareness of how technology might benefit them personally in the context of visual or cognitive dysfunction.…”

Self-Reported Visual Complaints in People with Parkinson’s Disease: A Systematic Review

“…In addition, Martinez-Martin et al (2007) argued that these complaints may not be recognized unless detected by a questionnaire [60]. Recently developed visual self-report questionnaires may be used to improve the visual care for people with PD [157, 158].…”

Ophthalmologic problems correlates with cognitive impairment in patients with Parkinson's disease

“…Based on a previous study (Borm et al, 2019 ), we reran tests to identify the sensitivity and specificity of the VIPD-Q in the Chinese population. A receiver operating characteristic (ROC) curve indicated good sensitivity and specificity (AUC = 0.918, p < 0.001; Figure 1C ); this result was verified using the Hosmer–Lemeshow test ( p = 0.247).…”

The integration of technology into a home-based visuo-cognitive training intervention for people with Parkinson’s: Is the future digital?

“…Current literature suggests that in order to evaluate a novel technology, consideration must be given to the health need that the technology is intended to address [ 38 ]. In the field of PD, visuo-cognitive impairments remain under-recognised in research as well as in clinical practice [ 39 ] which may explain why participants lacked awareness of how technology might benefit them personally in the context of visual or cognitive dysfunction.…”

Self-Reported Visual Complaints in People with Parkinson’s Disease: A Systematic Review

“…In addition, Martinez-Martin et al (2007) argued that these complaints may not be recognized unless detected by a questionnaire [60]. Recently developed visual self-report questionnaires may be used to improve the visual care for people with PD [157, 158].…”

Ophthalmologic problems correlates with cognitive impairment in patients with Parkinson's disease

“…Based on a previous study (Borm et al, 2019 ), we reran tests to identify the sensitivity and specificity of the VIPD-Q in the Chinese population. A receiver operating characteristic (ROC) curve indicated good sensitivity and specificity (AUC = 0.918, p < 0.001; Figure 1C ); this result was verified using the Hosmer–Lemeshow test ( p = 0.247).…”

The integration of technology into a home-based visuo-cognitive training intervention for people with Parkinson’s: Is the future digital?

“…Current literature suggests that in order to evaluate a novel technology, consideration must be given to the health need that the technology is intended to address [ 38 ]. In the field of PD, visuo-cognitive impairments remain under-recognised in research as well as in clinical practice [ 39 ] which may explain why participants lacked awareness of how technology might benefit them personally in the context of visual or cognitive dysfunction.…”

Self-Reported Visual Complaints in People with Parkinson’s Disease: A Systematic Review

“…In addition, Martinez-Martin et al (2007) argued that these complaints may not be recognized unless detected by a questionnaire [60]. Recently developed visual self-report questionnaires may be used to improve the visual care for people with PD [157, 158].…”