Title: Study of Correlation of Retinal Layer Thickness with Duration and Severity of Parkinson’s Disease
Authors: Dr Kunal B Jadhav, Dr R Balakrishnan, Madhavi Karri
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.220
Abstract
PD is primarily a motor disorder associated with loss of dopaminergic neurons. Dopamine (DA) is also a major neurotransmitter in the retina. There is concurrent retinal DA neurons loss in in the inner nuclear &inner plexiform layers in PD. OCT is analogous to ultrasound & its provides detailed cross sectional images of retina.
Aim: To do the macular scans, parapapillary RNFL in vivo & to evaluate whether retinal structural changes are seen in PD &its relation to the clinical severity of the PD.
Materials & Method: Our prospective study was conducted in PSG Hospital IMS&R. Spectral OCT Was used to examined the RNFL thickness in all quadrants & Macular volume in PD patients without visual impairment (n=25) & compared them with healthy age, sex matched control (n=25). PD severity will be assessed using the Hoehn &Yahr scale.
Results: Compared to healthy control the thickness in the inferior quadrant of PD patients (149±6 microns) showed statistically significant thinning of the inferotemporal area (145±25 vs.190±20 microns).Significant differences were observed between controls and patients in relation to mean macular thickness PD duration & severity were inversely correlated
Conclusion: RNFL thickness & macular thickness could be a surrogate biomarker for PD diagnosis in early stage aid in monitoring treatment effectiveness & monitoring disease progression in PD.
Keywords- Parkinson’s disease Retina; Retinal nerve fiber layer; Optical coherence tomography.
References
1. 1. Spillantini MG Nature. 1997;388 (6645):839–840
2. Park A, Stacy M. Non-motor symptoms in Parkinson’s disease. J Neurol 2009; 256(Suppl 3): 293–298
3. Braak H, Del Tredici K, Bratzke H, Hamm-Clement J, Sandmann-Keil D, Ru¨b U. Staging of the intracerebral inclusion body pathology associated with idiopathic Parkinson’s disease (preclinical and clinical stages). J Neurol 2002; 249(Suppl 3): III/1–III/5
4. (Djamgoz, Hankins, Hirano, & Archer, 1997).
5. Harnois C, Di Paolo T. Decreased dopamine in the retinas of patients with Parkinson's disease. Invest Ophthalmol Vis Sci. 1990;31(11)
6. Bodis-Wollner I. Visual deficits related to dopamine deficiency in experimental animals and Parkinson's disease patients. Trends Neurosci. 1990;13(7):
7. Jackson GR, Owsley C. Visual dysfunction, neurodegenerative diseases, and aging. Neurol Clin. 2003;21(3)
8. Matsui H, Udaka F, Tamura A, Oda M, Kubori T, Nishinaka K, et al. Impaired
9. Bodis-Wollner I, Marx M, Mitra S, Bobak P, Mylin L, Yahr M. Visual dysfunction in Parkinson’s disease. Brain 1987;110:1675e98.
10. Price MJ, Feldman RG, Adelberg D, Kayne H. Abnormalities in color vision and contrast sensitivity in Parkinson’s disease. Neurology 1992;42:887e90.
11. Pieri V, Diederich NJ, Raman R, Goetz CG. Decreased colour discrimination and contrast sensitivity in Parkinson’s disease. Journal of the Neurological Sciences 2000;172:7e11.
12. Uc EY, Rizzo M, Anderson SW, Qian S, Rodnitzky RL, Dawson JD. Visual dysfunction in Parkinson disease without dementia. Neurology 2005;65: 1907e13.
13. Dyer RS, Howell WE, MacPhail RC. Dopamine depletion slows retinal transmission. Exp Neurol. 1981;71(2)
14. Onofrj M, Bodis-Wollner I. Dopaminergic deficiency causes delayed visual evoked potentials in rats. Ann Neurol. 1982;11(5):
15. Di Paolo T. Harnois C. and Daiglc M: Assay of dopamine and its metabolites in human and rai retina. Ncurosci Leu 74:250, 1987.
16. Parkinson’s disease patients. Eye. 2013;27:507–514.
17. Garcia-Martin E, Satue M, Fuertes I, et al. Ability and reproducibility of Fourier-domain optical coherence tomography to detect retinal nerve fiber layer atrophy in Parkinson’s disease. Ophthalmology. 2012;119:2161–2167.
18. Blumenthal EZ, Weinreb RN. Assessment of the retinal nerve fiber layer in clinical trials of glaucoma neuroprotection. Survey Ophthalmol. 2001;45:305–312. discussion 332–334
19. Inzelberg R, Ramirez JA, Nisipeanu P, Ophir A. Retinal nerve fi ber layer thinning in arkinson disease. Vision Res. 2004;44:2793 – 279
20. Moschos MM, Tagaris G, Markopoulos I, Margetis I, Tsapakis S, Kanakis M, Koutsandrea C. Morphologic changes and functional retinal impairment in patients with Parkinson disease without visual loss. Eur J Ophthalmol. 011:21;24 – 29
21. Altintas O, Iseri P, Ozkan B, Caglar Y. Correlation between retinal morphological and functional fi ndings and clinical severity in Parkinson ’ s disease. Doc Ophthalmol. 2008;116:137 – 146.
22. Jackson, G. R., & Owsley, C. (2003). Visual dysfunction, neurode- generative diseases and aging. Neurology Clinics of North America, 21, 709–728.).
23. Djamgoz MB, Hankins MW, Hirano J, Archer SN. Neurobiology of retina dopamine in relation to degenerative states of the tissue. Vision Res. 1997;37:3509–3529. [PubMed]