Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.
Miguel Servet Ophthalmology Research and Innovation Group (GIMSO), Aragon Institute for Health Research (IIS Aragón), Zaragoza University, Zaragoza, Spain.
Eye (Lond). 2023 May;37(7):1314-1319. doi: 10.1038/s41433-022-02112-4. Epub 2022 Jun 1.
BACKGROUND/OBJECTIVES: To evaluate the ability of swept-source optical coherence tomography (SS-OCT) implemented with angiography analysis (SS-OCTA) to detect neuro-retinal and vasculature changes in patients with Parkinson's disease (PD) and essential tremor (ET), and to distinguish between both pathologies.
SUBJECTS/METHODS: A total 42 PD and 26 ET patients and 146 controls underwent retinal evaluation using SS-OCT plus OCT-Angio™. The macular (m) and peripapillary (p) retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL), and macular vasculature were assessed. A Linear discriminant function (LDF) was calculated to evaluate the diagnostic ability of SS-OCTA in both PD and ET.
PD patients presented a reduction in mRNFL (p < 0.005), mGCL (all sectors, p < 0.05) and pRNFL (p < 0.005) vs healthy controls, and in mRNFL and pRNFL vs ET patients (p < 0.001). ET patients showed a significant reduction in mGCL vs controls (p < 0.001). No differences were observed in the macular vasculature between groups. Predictive diagnostic variables were significant only for PD and a LDF was obtained with an area under the ROC curve of 0.796.
Neuro-retinal thinning is present in both diseases, being greater in PD. While SS-OCT could be useful in diagnosing ET and PD, the diagnostic potential for SS-OCTA based on an LDF applies only to PD, not ET.
背景/目的:评估带有血管分析功能的扫频源光学相干断层扫描(SS-OCT)(SS-OCTA)检测帕金森病(PD)和特发性震颤(ET)患者神经视网膜和血管变化的能力,并区分这两种疾病。
受试者/方法:共有 42 名 PD 患者、26 名 ET 患者和 146 名对照者接受了 SS-OCT 加 OCT-AngioTM 的视网膜评估。评估了黄斑(m)和视盘周围(p)视网膜神经纤维层(RNFL)和节细胞层(GCL)以及黄斑血管。计算了线性判别函数(LDF)以评估 SS-OCTA 在 PD 和 ET 中的诊断能力。
PD 患者的 mRNFL(p < 0.005)、mGCL(所有象限,p < 0.05)和 pRNFL(p < 0.005)均低于健康对照者,且 mRNFL 和 pRNFL 均低于 ET 患者(p < 0.001)。ET 患者的 mGCL 与对照组相比显著降低(p < 0.001)。各组之间的黄斑血管无差异。只有 PD 有预测性诊断变量,LDF 获得的 ROC 曲线下面积为 0.796。
两种疾病均存在神经视网膜变薄,PD 更为明显。虽然 SS-OCT 可用于诊断 ET 和 PD,但基于 LDF 的 SS-OCTA 诊断潜力仅适用于 PD,不适用于 ET。