Visual dysfunction in Parkinson’s disease

Weil, Rimona S; Schrag, Anette; Warren, Jason D.; Crutch, Sebastian J.; Lees, Andrew J.; Morris, Huw R.

doi:10.1093/brain/aww175

Cited by 339 publications

(323 citation statements)

References 233 publications

(301 reference statements)

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“…Given that there was a significant difference between the visual acuity scores at 100% contrast in both groups, it is possible that this reflects impaired color perception besides contrast sensitivity. Abnormalities in color vision are well known in PD . One possible explanation for no significant difference observed for yellow at low contrast could simply be the marked difficulty of seeing a lighter color (yellow) against a white background, as evidenced by the extremely low score in the control group (Table ).…”

Section: Discussionmentioning

confidence: 98%

Contrast Acuity With Different Colors in Parkinson's Disease

Gupta

Zhang

Driver‐Dunckley

et al. 2019

Movement Disord Clin Pract

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Background Abnormal color vision and contrast acuity may have significant impact on daily activities. Objective Evaluate color visual acuity, at high and low contrast, in Parkinson's disease (PD) and controls using an iPad application. Methods Color visual acuity was tested with the Variable Contrast Acuity Chart (King‐Devick Test LLC, Oakbrook Terrace, IL) on an iPad 2 at 40 cms using five colors (red, green, blue, yellow, and black) at low (2.5%) and high (100%) contrast. A numerical score (0–95) was assigned based on the number of correctly identified letters. Results Thirty‐six PD (mean ± standard deviation age 68 ± 10 years) and 36 controls (72 ± 11.2 years) were studied. PD disease duration was 6.4 ± 4.6 years; MDS‐UPDRS part II was 11.7 ± 7.0, and part III was 24.5 ± 9.9. After adjusting for age and sex, PD patients had significantly (P < 0.05) lower scores at high (100%) as well as low (2.5%) contrast for all five colors tested (red, green, blue, yellow, and black), except yellow low contrast (2.5%; P = 0.10). The largest effect size (0.88) was with yellow high contrast, and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy using a cut‐off score of 82 was 31%, 97%, 92%, 58%, and 64%, respectively. No correlation to disease duration was found. Conclusions This iPad application may be a simple‐to‐use biomarker for assessing color vision in PD. Further research is needed to determine disease specificity and whether there is a role in monitoring disease progression, treatment response, and identifying prodromal PD.

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Section: Discussionmentioning

confidence: 98%

Contrast Acuity With Different Colors in Parkinson's Disease

Gupta

Zhang

Driver‐Dunckley

et al. 2019

Movement Disord Clin Pract

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“…However, the relationship between color vision disturbances and motor disturbances is controversial and not confirmed. Some studies have reported that CV deteriorated along with the progress of the disease [13,14]. Other studies have demonstrated that there was no correlation between the degree of CV in PD and the dopaminergic nigral degeneration examined by single-photon emission tomography, which proves that the origin of visual disorders in PD is extranigral [15].…”

Section: IIImentioning

confidence: 99%

“…Farnsworth's multicolor tests with 15, 85 and 100 tones are widely used abroad. Studies based on these tests have revealed color discrimination disorders, mostly in the blue-green spectrum, in moderate and severe stages of PD, also a relationship has been found between the CV disturbances and deteriorating visuospatial orientation and cognitive functions [13]. However, the relationship between color vision disturbances and motor disturbances is controversial and not confirmed.…”

Section: IIImentioning

confidence: 99%

Clinical Significance and Pathogenesis of Visual Impairment in Parkinson’s Disease

Oa¹,

Sa²,

Oi³

2017

JNSK

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Among non-motor symptoms in patients with Parkinson's disease (PD) have a number of specific visual disturbances. This review describes the main visual problems associated with PD, referring to their basic anatomical aspects and pathophysiological mechanisms. A wide range of visual disorders includes changes in color vision and contrast sensitivity, change in the electrophysiological properties of the retina due to the insufficiency of the retinal dopaminergic system, features of visual field defects, visuospatial and visuoperceptual impairments. The use of modern electrophysiological, neurophysiological, psychophysiological and other research methods makes it possible to comprehensively assess the state of all parts of the visual analyzer from the retina to the higher cortical centers in patients with PD. The article discusses controversial questions about the relationship between changes in color vision, a decrease in the level of contrast sensitivity and severity of motor disorders in Parkinson's disease. Finally, we discuss the advantages of using threshold and blue-yellow perimetry as more sensitive methods in detecting visual field defects in patients with PD. Keywords:

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“…Retinal dopaminergic neuronal degeneration and alpha synuclein deposition are seen in the brainstem, occipital and parietal cortices, which can explain dysfunction with eye movement, visual perception and visuospatial ability [56].…”

Section: Non Motor Featuresmentioning

confidence: 99%

Glucocerebrosidase Mutations in Parkinson Disease

O’Regan

deSouza

Balestrino

et al. 2017

JPD

104

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Abstract.Following the discovery of a higher than expected incidence of Parkinson Disease (PD) in Gaucher disease, a lysosomal storage disorder, mutations in the glucocerebrocidase (GBA) gene, which encodes a lysosomal enzyme involved in sphingolipid degradation were explored in the context of idiopathic PD. GBA mutations are now known to be the single largest risk factor for development of idiopathic PD. Clinically, on imaging and pharmacologically, GBA PD is almost identical to idiopathic PD, other than certain features that can be identified in the specialist research setting but not in routine clinical practice. In patients with a known GBA mutation, it is possible to monitor for prodromal signs of PD. The clinical similarity with idiopathic PD and the chance to identify PD at a pre-clinical stage provides a unique opportunity to research therapeutic options for early PD, before major irreversible neurodegeneration occurs. However, to date, the molecular mechanisms which lead to this increased PD risk in GBA mutation carriers are not fully elucidated. Experimental models to define the molecular mechanisms and test therapeutic options include cell culture, transgenic mice and other in vivo models amenable to genetic manipulation, such as drosophilia. Some key pathological pathways of interest in the context of GBA mutations include alpha synuclein aggregation, lysosomal-autophagy axis changes and endoplasmic reticulum stress. Therapeutic agents that exploit these pathways are being developed and include the small molecule chaperone Ambroxol. This review aims to summarise the main features of GBA-PD and provide insights into the pathological relevance of GBA mutations on molecular pathways and the therapeutic implications for PD resulting from investigation of the role of GBA in PD.

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Visual dysfunction in Parkinson’s disease

Cited by 339 publications

References 233 publications

Contrast Acuity With Different Colors in Parkinson's Disease

Contrast Acuity With Different Colors in Parkinson's Disease

Clinical Significance and Pathogenesis of Visual Impairment in Parkinson’s Disease

Glucocerebrosidase Mutations in Parkinson Disease

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