Chesnokova N B, Pavlenko T A, Ugrumov M V
Helmholtz Moscow Research Institute of Eye Diseases, Moscow, Russia.
Koltzov Institute of Developmental Biology, Russian of Sciences, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(9):124-131. doi: 10.17116/jnevro201711791124-131.
Parkinson's disease is a severe neurodegenerative disease accompanied with the degeneration of dopaminergic neurons in the central and peripheral nervous system. The diagnosis of Parkinson's disease can still be made only on the stage of irreversible and nearly total degeneration of the nigrostriatum dopaminergic system and exhaustion of brain compensatory mechanisms that explains the low efficacy of therapy. Ophthalmic pathology is one of the nonmotor symptoms of Parkinson's disease. This can be explained firstly by the fact that eye is a 'peripheral part of brain' and secondly by the involvement of dopaminergic neurons (dopamine-producing cells) that are subject to the selective degeneration during Parkinson's disease in the regulation of visual function in the eye and brain. Dopaminergic neurons and dopamine receptors are present in all structures of the eye. Parkinson's disease cause abnormalities not only in the retina but in the whole optic tract and can be considered as peripheral manifestations of the disease that precede the well-known motor dysfunctions. This review describes ophthalmological symptoms of Parkinson's disease, possible pathophysiological mechanisms of their development, optical disorders in experimental models of Parkinson's disease and also the perspectives of experimental and clinical studies of visual disorders for the development of preclinical diagnosis of Parkinson's disease.
帕金森病是一种严重的神经退行性疾病，伴有中枢和外周神经系统中多巴胺能神经元的退化。帕金森病的诊断仍只能在黑质纹状体多巴胺能系统发生不可逆且几乎完全退化以及脑代偿机制耗尽的阶段做出，这也解释了治疗效果不佳的原因。眼科病理是帕金森病的非运动症状之一。这首先可以通过眼睛是“脑的外周部分”这一事实来解释，其次是因为多巴胺能神经元（产生多巴胺的细胞）在帕金森病期间会发生选择性退化，而这些神经元参与了眼睛和大脑视觉功能的调节。眼睛的所有结构中都存在多巴胺能神经元和多巴胺受体。帕金森病不仅会导致视网膜异常，还会影响整个视路，可被视为该疾病在著名的运动功能障碍之前的外周表现。本文综述了帕金森病的眼科症状、其发生的可能病理生理机制、帕金森病实验模型中的视觉障碍，以及视觉障碍的实验和临床研究对于帕金森病临床前诊断发展的前景。
