Ahn Jong Hyeon, Kang Min Chae, Lee Dongyoung, Cho Jin Whan, Park Kyung-Ah, Youn Jinyoung
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
NPJ Parkinsons Dis. 2023 Mar 9;9(1):36. doi: 10.1038/s41531-023-00480-6.
Orthostatic hypotension (OH) is a common non-motor symptom in Parkinson's disease (PD). OH can cause cerebral and retinal hypoperfusion and is associated with microvascular damage in PD. Optical coherence tomography angiography (OCTA) is a non-invasive technology that can be used to visualize the retinal microvasculature and detect microvascular damage in PD. In the present study, 51 PD patients (OH+, n = 20, 37 eyes; OH-, n = 32, 61 eyes) and 51 healthy controls (100 eyes) were evaluated. The Unified Parkinson's Disease Rating Scale III, Hoehn and Yahr scale, Montreal Cognitive Assessment, levodopa equivalent daily dose, and vascular risk factors, including hypertension, diabetes, and dyslipidemia, were investigated. PD patients underwent a head-up tilt (HUT) test. The PD patients had a lower superficial retinal capillary plexus (SRCP) density in the central region than control patients. The PDOH+ group had lower vessel density in the SRCP of the central region compared with the control group and lower vessel density in the DRCP of the central region than the PDOH- and control groups. The changes in systolic and diastolic blood pressure during the HUT test in PD patients showed a negative correlation with the vessel density in the DRCP central region. The presence of OH was a critical factor associated with central microvasculature damage in PD. These findings indicate that OCTA can be a useful and non-invasive tool for detecting microvasculature damage in PD patients.
直立性低血压（OH）是帕金森病（PD）常见的非运动症状。OH可导致脑和视网膜灌注不足，并与PD中的微血管损伤有关。光学相干断层扫描血管造影（OCTA）是一种非侵入性技术，可用于可视化视网膜微血管并检测PD中的微血管损伤。在本研究中，对51例PD患者（OH+组，n = 20，37只眼；OH-组，n = 32，61只眼）和51名健康对照者（100只眼）进行了评估。调查了统一帕金森病评定量表III、Hoehn和Yahr分级、蒙特利尔认知评估、左旋多巴等效日剂量以及血管危险因素，包括高血压、糖尿病和血脂异常。PD患者进行了头高位倾斜（HUT）试验。PD患者中央区域的浅表视网膜毛细血管丛（SRCP）密度低于对照患者。与对照组相比，PDOH+组中央区域SRCP的血管密度较低，与PDOH-组和对照组相比，中央区域深层视网膜毛细血管丛（DRCP）的血管密度较低。PD患者HUT试验期间收缩压和舒张压的变化与DRCP中央区域的血管密度呈负相关。OH的存在是与PD中央微血管损伤相关的关键因素。这些发现表明，OCTA可以成为检测PD患者微血管损伤的一种有用且非侵入性的工具。
