Bittersohl Diana, Stemplewitz Birthe, Keserü Matthias, Buhmann Carsten, Richard Gisbert, Hassenstein Andrea
Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Acta Ophthalmol. 2015 Nov;93(7):e578-84. doi: 10.1111/aos.12757. Epub 2015 Jun 10.
The study was performed to analyse the retina of patients with Parkinson's disease (PD) for morphological changes compared to healthy controls (HC) using spectral-domain optical coherence tomography (SD-OCT) and confocal scanning laser ophthalmoscopy.
We enrolled 108 patients with idiopathic PD and 165 HC. All study participants underwent an ophthalmological examination to exclude ophthalmological disorder potentially interfering with the retinal analyses. Peripapillary retinal nerve fibre layer (RNFL) thickness and macular thickness and volume were measured by a SD-OCT device (Heidelberg Spectralis(®) ). Stereometric parameters of the optic disc were acquired by Heidelberg Retina Tomograph (HRT III).
The RNFL thickness did not significantly differ between patients with PD and HC. The thickness of the central minimum and the centre of the macular area were significantly reduced in patients with PD, while the total macular volume did not significantly differ between the groups. Furthermore, we noted an inverse correlation between the central minimum thickness and the disease severity (assessed by the Hoehn and Yahr scale). HRT data showed no significant differences.
The HRT device and the RNFL measurements of the SD-OCT did not prove to be a clinically valid diagnostic tool to distinguish eyes of patients with PD and HC. However, the macular region and especially the foveola (central minimum) with the highest density of photoreceptor cells seem to be more sensitive and might be potential biomarkers.
本研究旨在利用光谱域光学相干断层扫描(SD - OCT)和共焦扫描激光眼底镜检查,分析帕金森病(PD)患者与健康对照者(HC)的视网膜形态学变化。
我们招募了108例特发性PD患者和165例HC。所有研究参与者均接受眼科检查,以排除可能干扰视网膜分析的眼科疾病。使用SD - OCT设备(海德堡Spectralis(®))测量视乳头周围视网膜神经纤维层(RNFL)厚度、黄斑厚度和体积。通过海德堡视网膜断层扫描仪(HRT III)获取视盘的立体测量参数。
PD患者和HC的RNFL厚度无显著差异。PD患者黄斑区中央最小厚度和中心厚度显著降低,而两组之间的黄斑总体积无显著差异。此外,我们注意到中央最小厚度与疾病严重程度(通过Hoehn和Yahr量表评估)呈负相关。HRT数据无显著差异。
HRT设备和SD - OCT的RNFL测量结果并未证明是区分PD患者和HC眼睛的临床有效诊断工具。然而,黄斑区域,尤其是具有最高感光细胞密度的中央凹(中央最小处)似乎更敏感,可能是潜在的生物标志物。