Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, People's Republic of China.
Aging Clin Exp Res. 2022 Oct;34(10):2355-2361. doi: 10.1007/s40520-022-02211-y. Epub 2022 Sep 1.
A quantitative analysis was performed to evaluate the morphologic changes of the retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) in patients with Parkinson's disease (PD).
Thirty PD patients were enrolled, and they were allocated to the mild-to-moderate PD group (n = 15) or severe PD group (n = 15) according to the severity of PD. Twenty healthy volunteers (20 eyes) were included as controls. Optical coherence tomography (OCT) was used to measure the thickness of mean RNFL and each of the sectors: temporal-upper (TU), superior-temporal (ST), superior-nasal (SN), nasal-upper (NU), nasal-lower (NL), inferior-nasal (IN), inferior-temporal (IT), temporal-lower (TL). The thickness of macular GCC, superior GCC, and inferior GCC was also measured.
No difference was found between the three groups with respect to age, sex and disease course (p > 0.05). The mean RNFL thickness was 118.15 ± 10.25 µm in the control group, 96.12 ± 9.45 µm in the mild-to-moderate PD group, and 80.48 ± 10.35 µm in the severe PD group. Significant differences were found in the mean RNFL thickness and thickness of TU, IN, IT and TL sectors among the three groups (p < 0.05). These values, mean RNFL, TU, IN, IT, and TL, were lower in both the PD groups than those in the control, among them the severe PD group had the lowest values. A quantitative analysis of the macula GCC was also performed. Overall, there were significant differences in mean macula, superior, and inferior GCC thickness among the three groups (p < 0.05). The two PD groups had lower values of mean macula, superior, and inferior GCC thickness than that in the controls (p < 0.05); and the severe PD group had lowest values of these parameters.
In this study, significant thinning of RNFL and macular GCC was found in PD patients. The more serious the illness, the more the thickness becomes thinner. The OCT measurement was found useful in detecting the structural alterations in the retina of PD. The technique may be useful in follow-up of the disease progression after further validation.
通过定量分析评估帕金森病(PD)患者视网膜神经纤维层(RNFL)和黄斑神经节细胞复合体(GCC)的形态变化。
纳入 30 例 PD 患者,根据 PD 严重程度分为轻度至中度 PD 组(n=15)和重度 PD 组(n=15)。纳入 20 名健康志愿者(20 只眼)作为对照组。采用光学相干断层扫描(OCT)测量平均 RNFL 厚度和颞上(TU)、上颞(ST)、上鼻(SN)、鼻上(NU)、鼻下(NL)、下鼻(IN)、下颞(IT)、颞下(TL)各象限的厚度。还测量了黄斑 GCC、上 GCC 和下 GCC 的厚度。
三组间年龄、性别和病程比较差异均无统计学意义(p>0.05)。对照组平均 RNFL 厚度为 118.15±10.25µm,轻度至中度 PD 组为 96.12±9.45µm,重度 PD 组为 80.48±10.35µm。三组间平均 RNFL 厚度及 TU、IN、IT 和 TL 象限厚度比较差异均有统计学意义(p<0.05)。PD 两组的平均 RNFL 及 TU、IN、IT 和 TL 厚度均低于对照组,其中重度 PD 组最低。对黄斑 GCC 也进行了定量分析。总体而言,三组间平均黄斑、上和下 GCC 厚度比较差异均有统计学意义(p<0.05)。PD 两组的平均黄斑、上和下 GCC 厚度均低于对照组(p<0.05);且重度 PD 组这些参数的最低值。
本研究发现 PD 患者的 RNFL 和黄斑 GCC 明显变薄。病情越严重,厚度越薄。OCT 测量发现对 PD 患者视网膜结构改变有一定的检测作用。该技术可能有助于进一步验证后对疾病进展进行随访。