Archibald Neil K, Clarke Michael P, Mosimann Urs P, Burn David J
Clinical Research Fellow, Clinical Ageing Research Unit, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.
Brain. 2009 May;132(Pt 5):1128-45. doi: 10.1093/brain/awp068. Epub 2009 Mar 31.
As a more complete picture of the clinical phenotype of Parkinson's disease emerges, non-motor symptoms have become increasingly studied. Prominent among these non-motor phenomena are mood disturbance, cognitive decline and dementia, sleep disorders, hyposmia and autonomic failure. In addition, visual symptoms are common, ranging from complaints of dry eyes and reading difficulties, through to perceptual disturbances (feelings of presence and passage) and complex visual hallucinations. Such visual symptoms are a considerable cause of morbidity in Parkinson's disease and, with respect to visual hallucinations, are an important predictor of cognitive decline as well as institutional care and mortality. Evidence exists of visual dysfunction at several levels of the visual pathway in Parkinson's disease. This includes psychophysical, electrophysiological and morphological evidence of disruption of retinal structure and function, in addition to disorders of 'higher' (cortical) visual processing. In this review, we will draw together work from animal and human studies in an attempt to provide an insight into how Parkinson's disease affects the retina and how these changes might contribute to the visual symptoms experienced by patients.
随着帕金森病临床表型的全貌逐渐显现，对非运动症状的研究越来越多。这些非运动现象中突出的有情绪障碍、认知衰退和痴呆、睡眠障碍、嗅觉减退和自主神经功能衰竭。此外，视觉症状也很常见，从干眼和阅读困难的主诉，到知觉障碍（存在感和通过感）以及复杂的视幻觉。此类视觉症状是帕金森病发病的一个重要原因，就视幻觉而言，也是认知衰退以及机构护理和死亡率的重要预测指标。有证据表明帕金森病患者视觉通路的多个层面存在视觉功能障碍。这包括视网膜结构和功能破坏的心理物理学、电生理学和形态学证据，以及“高级”（皮质）视觉处理障碍。在这篇综述中，我们将综合动物和人体研究的成果，试图深入了解帕金森病如何影响视网膜，以及这些变化可能如何导致患者出现视觉症状。
