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帕金森病不同阶段患者视乳头周围视网膜神经纤维层厚度和视乳头周围血管密度的定量研究

Quantitative study of peripapillary retinal nerve fiber layer thickness and peripapillary vessel density in patients with different stages of Parkinson's disease.

作者信息

Yang Ting-Yu, Zhang Tian-Qi, Xie Lai-Qing, Zhang Ying, Liu Shi-Mei, Zeng Xin-Wei, Luo Wei-Feng, Xu Guo-Xu

机构信息

Department of Ophthalmology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China.

Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China.

出版信息

Int J Ophthalmol. 2023 May 18;16(5):762-769. doi: 10.18240/ijo.2023.05.14. eCollection 2023.

Abstract

AIM

To observe the changes in the thickness of peripapillary retinal nerve fiber layer (pRNFL) and peripapillary vessel density (pVD) in patients with different stages of Parkinson's disease (PD).

METHODS

Totally 47 patients (47 eyes) with primary PD were divided into the mild group and the moderate-to-severe group according to Hoehn & Yahr (H&Y) stage. Among them, there were 27 cases (27 eyes) in mild group and 20 cases (20 eyes) in moderate-to-severe group. And 20 cases (20 eyes) who were included in the control group were healthy people who came to our hospital for health screening at the same time. All participants underwent optical coherence tomography angiography (OCTA) examinations. The pRNFL thickness, total vessel density (tVD) and capillary vessel density (cVD) of the optic disc in average, superior half, inferior half, superior nasal (SN), nasal superior (NS), nasal inferior (NI), inferior nasal (IN), inferior temporal (IT), temporal inferior (TI), temporal superior (TS), and superior temporal (ST) were measured. One-way ANOVA was used to compare the differences of optic disc parameters among the three groups, and Pearson and Spearman correlations were used to analyze the correlation between pRNFL, pVD and the disease duration, H&Y stage and UPDRS-III score in patients with PD, respectively.

RESULTS

There were significant differences in pRNFL thickness in average, superior half, inferior half, SN, NS, IN, IT and ST quadrants among the three groups (<0.05). In PD group, the pRNFL thickness in average, superior half, inferior half, NS and IT quadrants were negatively correlated with H&Y stage and UPDRS-III score, respectively (<0.05). There were statistically significant differences in the cVD of whole image, inferior half, NI and TS quadrants, the tVD of the whole image, inferior half, and peripapillary among the three groups (<0.05). In PD group, the tVD of whole image and the cVD of NI and TS quadrants were negatively correlated with the H&Y stage, respectively (<0.05); the cVD of TS quadrant was negatively correlated with UPDRS-III score (<0.05).

CONCLUSION

The thickness of pRNFL in PD patients is significantly decreased, and it is negatively correlated with H&Y stage and UPDRS-III score. With the increase of the severity of the disease, the pVD parameters in PD patients increase at first in the mild group, and then decrease in the moderate-to-severe group, and negatively correlate with H&Y stage and UPDRS-III score.

摘要

目的

观察不同帕金森病(PD)分期患者视乳头周围视网膜神经纤维层(pRNFL)厚度及视乳头周围血管密度(pVD)的变化。

方法

将47例原发性PD患者(47只眼)根据Hoehn & Yahr(H&Y)分期分为轻度组和中重度组。其中,轻度组27例(27只眼),中重度组20例(20只眼)。选取同期来我院进行健康体检的20例健康人(20只眼)作为对照组。所有参与者均接受光学相干断层扫描血管造影(OCTA)检查。测量视盘平均、上半、下半、鼻上(SN)、鼻上(NS)、鼻下(NI)、下鼻(IN)、颞下(IT)、颞下(TI)、颞上(TS)和颞上(ST)区域的pRNFL厚度、总血管密度(tVD)和毛细血管密度(cVD)。采用单因素方差分析比较三组视盘参数的差异,分别采用Pearson和Spearman相关性分析PD患者pRNFL、pVD与病程、H&Y分期及统一帕金森病评定量表第三部分(UPDRS-III)评分之间的相关性。

结果

三组之间平均、上半、下半、SN、NS、IN、IT和ST象限的pRNFL厚度存在显著差异(<0.05)。在PD组中,平均、上半、下半、NS和IT象限的pRNFL厚度分别与H&Y分期和UPDRS-III评分呈负相关(<0.05)。三组之间全图、下半、NI和TS象限的cVD,全图、下半及视乳头周围的tVD存在统计学显著差异(<0.05)。在PD组中,全图的tVD以及NI和TS象限的cVD分别与H&Y分期呈负相关(<0.05);TS象限的cVD与UPDRS-III评分呈负相关(<0.05)。

结论

PD患者的pRNFL厚度显著降低,且与H&Y分期和UPDRS-III评分呈负相关。随着疾病严重程度的增加,PD患者的pVD参数在轻度组先升高,在中重度组后降低,且与H&Y分期和UPDRS-III评分呈负相关。

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