Sen Aysu, Tugcu Betul, Coskun Cigdem, Ekinci Cansu, Nacaroglu Senay Asik
1 Neurology Department, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul - Turkey.
Eur J Ophthalmol. 2014 Jan-Feb;24(1):114-9. doi: 10.5301/ejo.5000338. Epub 2013 Jul 3.
To evaluate the effects of levodopa on retina, we assessed retina with optical coherence tomography (OCT) in Parkinson disease (PD).
Thirty-five patients with PD (17 with levodopa monotherapy, 18 untreated) and 11 healthy controls were included in this cross-sectional study. Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn & Yahr (H&Y) staging scale were used for the evaluation of disease severity. All retinal scans were performed using OCT.
Total UPDRS and motor subscores were lower in untreated patients compared to patients with treated PD (p = 0.013, p = 0.033, respectively). There was no significant difference in the range of H&Y stages between the untreated and treated PD groups (p = 0.342). The average retinal nerve fiber layer thickness of the untreated (106.76 ± 10.55 µm) and treated (104.62 ± 8.23 µm) patients with PD were significantly thinner than those of controls (115.60 ± 9.11 µm) (p<0.005). However, there was no significant difference between the untreated and patients with treated PD (p = 0.780). No significant difference in mean values of average thickness of ganglion cell complex layer was observed among controls, patients with untreated PD, and patients with treated PD (p = 0.304).
Although the disease in patients with treated PD was more severe than in the untreated group, no significant difference in the thickness of retina was found between the 2 groups. Therefore, we thought that levodopa might have a protective effect on retina in patients with PD.
为评估左旋多巴对视网膜的影响,我们在帕金森病(PD)患者中采用光学相干断层扫描(OCT)对视网膜进行了评估。
本横断面研究纳入了35例PD患者(17例接受左旋多巴单药治疗,18例未治疗)和11名健康对照者。采用统一帕金森病评定量表(UPDRS)和霍恩&雅尔(H&Y)分期量表评估疾病严重程度。所有视网膜扫描均使用OCT进行。
与接受治疗的PD患者相比,未治疗患者的UPDRS总分及运动分项得分更低(分别为p = 0.013,p = 0.033)。未治疗和治疗的PD组之间H&Y分期范围无显著差异(p = 0.342)。未治疗(106.76±10.55μm)和治疗(104.62±8.23μm)的PD患者的平均视网膜神经纤维层厚度均显著薄于对照组(115.60±9.11μm)(p<0.005)。然而,未治疗患者与接受治疗的PD患者之间无显著差异(p = 0.780)。对照组、未治疗的PD患者和接受治疗的PD患者之间神经节细胞复合体层平均厚度的平均值无显著差异(p = 0.304)。
尽管接受治疗的PD患者的病情比未治疗组更严重,但两组之间视网膜厚度未发现显著差异。因此,我们认为左旋多巴可能对PD患者的视网膜具有保护作用。