Ekker Merel S, Janssen Sabine, Seppi Klaus, Poewe Werner, de Vries Nienke M, Theelen Thomas, Nonnekes Jorik, Bloem Bastiaan R
Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands.
Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands; University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Signal and Systems Group, Enschede, The Netherlands.
Parkinsonism Relat Disord. 2017 Jul;40:1-10. doi: 10.1016/j.parkreldis.2017.02.014. Epub 2017 Feb 21.
Patients with Parkinson's disease (PD) often compensate for their motor deficits by guiding their movements visually. A wide range of ocular and visual disorders threatens the patients' ability to benefit optimally from visual feedback. These disorders are common in patients with PD, yet they have received little attention in both research and clinical practice, leading to unnecessary - but possibly treatable - disability. Based on a literature search covering 50 years, we review the range of ocular and visual disorders in patients with PD, and classify these according to anatomical structures of the visual pathway. We discuss six common disorders in more detail: dry eyes; diplopia; glaucoma and glaucoma-like visual problems; impaired contrast and colour vision; visuospatial and visuoperceptual impairments; and visual hallucinations. In addition, we review the effects of PD-related pharmacological and surgical treatments on visual function, and we offer practical recommendations for clinical management. Greater awareness and early recognition of ocular and visual problems in PD might enable timely instalment of tailored treatments, leading to improved patient safety, greater independence, and better quality of life.
帕金森病（PD）患者常通过视觉引导运动来代偿其运动功能缺陷。多种眼部和视觉障碍威胁着患者从视觉反馈中获得最佳益处的能力。这些障碍在PD患者中很常见，但在研究和临床实践中都很少受到关注，从而导致了不必要的——但可能是可治疗的——残疾。基于一项涵盖50年的文献检索，我们回顾了PD患者眼部和视觉障碍的范围，并根据视觉通路的解剖结构对这些障碍进行分类。我们更详细地讨论六种常见障碍：干眼症；复视；青光眼及类似青光眼的视觉问题；对比敏感度和色觉受损；视觉空间和视觉感知障碍；以及视幻觉。此外，我们回顾了与PD相关的药物和手术治疗对视觉功能的影响，并为临床管理提供实用建议。提高对PD患者眼部和视觉问题的认识并早期识别，可能有助于及时进行针对性治疗，从而提高患者安全性、增强独立性并改善生活质量。
