Nowacka Barbara, Lubiński Wojciech, Honczarenko Krystyna, Potemkowski Andrzej, Safranow Krzysztof
Department of Ophthalmology, Pomeranian Medical University, Powstancow Wlkp. 72, 70-111, Szczecin, Poland.
Department of Neurology, Pomeranian Medical University, Szczecin, Poland.
Doc Ophthalmol. 2015 Oct;131(2):95-104. doi: 10.1007/s10633-015-9503-0. Epub 2015 May 14.
To determine bioelectrical function and structural changes of the retina in patients with early stages of Parkinson's disease (PD).
Thirty-eight eyes of 20 patients with early idiopathic PD and 38 eyes of 20 healthy age- and sex-matched controls were ophthalmologically examined, including assessment of distance best-corrected visual acuity (DBCVA), slit lamp examination of the anterior and posterior segment of the eye, evaluation of the eye structures: paramacular retinal thickness (RT) and retinal nerve fiber layer (RNFL) thickness with the aid of OCT, and the bioelectrical function by full-field electroretinogram (ERG). Additionally, PD patients were interviewed as to the presence of dopamine-dependent visual functions abnormalities.
In patients with early PD, statistically significant changes in comparison with the control group were observed in ERG. They contained a reduction in mean amplitudes of the scotopic a-wave (rod-cone response), the scotopic oscillatory potentials (OPs)--OP2 and OP3, the photopic b-wave, and a reduction in the overall index (OP1 + OP2 + OP3) and a prolongation of mean peak times of the scotopic OP1, OP2, OP3, OP4 (p < 0.05). A questionnaire concerning abnormalities of dopamine-dependent visual functions revealed that PD patients with abnormal peak times of OP1, OP2, and OP3 reported non-specific visual disturbances more frequently in comparison with PD patients with normal peak times of OPs. Other analyzed parameters of ERG, DBCVA, RT, and RNFL did not significantly differ between patients with PD and the control group.
In patients with early PD, bioelectrical dysfunction of the retina was observed in the ERG test, probably as a result of dopamine deficiency in the retina. The results of our study indicate that ERG may also be a useful tool for understanding the reason for non-specific visual disturbances occurring in PD patients.
确定帕金森病(PD)早期患者视网膜的生物电功能和结构变化。
对20例早期特发性PD患者的38只眼和20例年龄及性别匹配的健康对照者的38只眼进行眼科检查,包括评估最佳矫正远视力(DBCVA)、眼部前段和后段的裂隙灯检查、借助光学相干断层扫描(OCT)评估眼部结构:黄斑旁视网膜厚度(RT)和视网膜神经纤维层(RNFL)厚度,以及通过全视野视网膜电图(ERG)评估生物电功能。此外,对PD患者就多巴胺依赖性视觉功能异常的存在情况进行访谈。
在早期PD患者中,与对照组相比,ERG观察到统计学上的显著变化。这些变化包括暗视a波(视杆 - 视锥反应)、暗视振荡电位(OPs)——OP2和OP3、明视b波的平均振幅降低,总体指数(OP1 + OP2 + OP3)降低,以及暗视OP1、OP2、OP3、OP4的平均峰值时间延长(p < 0.05)。一份关于多巴胺依赖性视觉功能异常的问卷显示,与OPs峰值时间正常的PD患者相比,OP1、OP2和OP3峰值时间异常的PD患者更频繁地报告非特异性视觉障碍。PD患者和对照组之间,ERG、DBCVA、RT和RNFL的其他分析参数没有显著差异。
在早期PD患者中,ERG测试观察到视网膜生物电功能障碍,可能是视网膜多巴胺缺乏的结果。我们的研究结果表明,ERG也可能是理解PD患者发生非特异性视觉障碍原因的有用工具。