Kassubek J, Danek A, Del Tredici-Braak K, Greenlee M W, Pinkhardt E H
Klinik für Neurologie, Universitätsklinikum Ulm, Oberer Eselsberg 45, 89081, Ulm, Deutschland.
Nervenarzt. 2013 Aug;84(8):909-17. doi: 10.1007/s00115-013-3754-3.
Although dysfunction of the visual system and dysfunctional eye movements during sporadic Parkinson's disease have been reported for more than 40 years, they have never been the focus of early and/or differential diagnosis. To date Parkinson's disease-related α-synuclein aggregates, i.e., Lewy pathology, are not known to develop either in the retina or in other components of the visual system. In a clinical context it is currently possible to test the involvement of the respective functional systems by means of optical coherence tomography and video oculography. Moreover, non-motor-related abnormalities are detectable both during psychophysical testing of visuospatial function as well as in the form of measurable deficits of color perception. These deficits of the visual and oculomotor systems could prove to be suitable candidates for diagnosing sporadic Parkinson's disease in its early phase in a non-invasive manner. This article is intended to provide an overview of the fundamental pathophysiological principles and clinical aspects of visual system involvement in sporadic Parkinson's disease together with currently available differential diagnostic options.
尽管在过去40多年里，人们已报道过散发性帕金森病患者存在视觉系统功能障碍和眼球运动功能异常，但它们从未成为早期诊断和/或鉴别诊断的重点。迄今为止，尚未发现帕金森病相关的α-突触核蛋白聚集体，即路易氏病理改变，会在视网膜或视觉系统的其他组成部分中出现。在临床环境中，目前可以通过光学相干断层扫描和视频眼动图来检测各个功能系统是否受累。此外，在视觉空间功能的心理物理学测试过程中以及以可测量的颜色感知缺陷形式，均能检测到与非运动相关的异常。视觉和眼球运动系统的这些缺陷可能被证明是以非侵入性方式在散发性帕金森病早期进行诊断的合适指标。本文旨在概述散发性帕金森病中视觉系统受累的基本病理生理原理和临床方面，以及目前可用的鉴别诊断方法。
