Gunay Betul Onal, Usta Nuray Can
Department of Ophthalmology, University of Health Sciences,Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
Department of Neurology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
Photodiagnosis Photodyn Ther. 2023 Mar;41:103213. doi: 10.1016/j.pdpdt.2022.103213. Epub 2022 Nov 25.
To evaluate retinal pigment epithelium (RPE) changes in Parkinson's Disease (PD) and to compare choroidal thickness (CT) and retinal layers with healthy controls.
Parkinson's patients older than 18 and the age-sex match control group were included in this prospective observational study. The neurological and ophthalmological evaluation was performed. All participants were examined by spectral-domain optical coherence tomography. Focal RPE changes were defined as local RPE changes observed in any macula scan.
Forty (24 male, mean age 69.2 years) participants were included in the study group, and 44 (24 male, mean age 68.9 years) participants in the control group. There was no significant difference between groups in terms of age and sex. All patients were using oral dopaminergic and/or non-dopaminergic therapy. The RPE changes in the macular area were observed in 14/40 PD eyes (35%) and were significantly more frequent than in the control group (2/44, 4.5%, P = 0.001). All of the RPE changes were RPE thickening (±additional finding: subretinal deposit, subRPE deposit). The logistic regression model for possible factors that may affect RPE changes revealed statistical significance in prolonging disease duration; however, age, sex, and the presence of hypertension were not significant. Inferior 3-mm RPE layer thickness was found to be thicker in PD. There was no significant difference between groups in terms of CT, retinal layers, and peripapillary retinal nerve fiber layer thickness (RNFLT), except inferonasal RNFLT which was thinner in the study group.
The RPE changes are more frequent in patients with PD than in the control group in the macular area. The most frequent RPE change is the focal thickening of RPE, and RPE changes were associated with disease duration. We cannot distinguish a potential drug effect from a true potential effect of the disease in question.
评估帕金森病（PD）患者视网膜色素上皮（RPE）的变化，并将脉络膜厚度（CT）和视网膜各层与健康对照者进行比较。
本前瞻性观察性研究纳入了年龄大于18岁的帕金森病患者及年龄和性别匹配的对照组。进行了神经学和眼科评估。所有参与者均接受了频域光学相干断层扫描检查。局灶性RPE变化定义为在任何黄斑扫描中观察到的局部RPE变化。
研究组纳入了40名参与者（24名男性，平均年龄69.2岁），对照组纳入了44名参与者（24名男性，平均年龄68.9岁）。两组在年龄和性别方面无显著差异。所有患者均在使用口服多巴胺能和/或非多巴胺能疗法。在40只PD眼中，有14只（35%）观察到黄斑区RPE变化，其发生率显著高于对照组（44只眼中有2只，4.5%，P = 0.001）。所有RPE变化均为RPE增厚（±其他表现：视网膜下沉积物、RPE下沉积物）。对可能影响RPE变化的因素进行的逻辑回归模型显示，疾病持续时间延长具有统计学意义；然而，年龄、性别和高血压的存在并无显著意义。发现PD患者下方3 mm RPE层厚度更厚。除研究组鼻下视网膜神经纤维层厚度（RNFLT）较薄外，两组在CT、视网膜各层和视乳头周围视网膜神经纤维层厚度方面无显著差异。
PD患者黄斑区RPE变化比对照组更频繁。最常见的RPE变化是RPE局灶性增厚，且RPE变化与疾病持续时间相关。我们无法区分潜在的药物作用与所研究疾病的真正潜在作用。
