帕金森病与对照组视网膜微血管和脉络膜成像参数的纵向分析
Longitudinal Analysis of Retinal Microvascular and Choroidal Imaging Parameters in Parkinson's Disease Compared with Controls.
作者信息
Kundu Anita, Ma Justin P, Robbins Cason B, Pant Praruj, Gunasan Vithiya, Agrawal Rupesh, Stinnett Sandra, Scott Burton L, Moore Kathryn P L, Fekrat Sharon, Grewal Dilraj S
机构信息
Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
iMIND Research Group, Durham, North Carolina.
出版信息
Ophthalmol Sci. 2023 Sep 9;3(4):100393. doi: 10.1016/j.xops.2023.100393. eCollection 2023 Dec.
PURPOSE
To quantify rate of change of retinal microvascular and choroidal structural parameters in subjects with Parkinson's disease (PD) compared with controls using OCT and OCT angiography (OCTA).
DESIGN
Prospective longitudinal study.
PARTICIPANTS
Seventy-four eyes of 40 participants with PD and 149 eyes of 78 control individuals from the Eye Multimodal Imaging in Neurodegenerative Disease database.
METHODS
Subjects underwent OCT and OCTA imaging at 2 time points approximately 12 months apart.
MAIN OUTCOME MEASURES
Imaging parameters included central subfield thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, peripapillary retinal nerve fiber layer thickness, choroidal vascularity index, superficial capillary plexus perfusion density (PFD), vessel density (VD), and foveal avascular zone area.
RESULTS
Participants with PD had greater rate of yearly decrease in GC-IPL (PD = -0.403μm, control = + 0.128 μm; = 0.01), greater yearly decline in PFD in the 3 × 3 mm ETDRS circle (PD = -0.016, control = + 0.002; < 0.001) and ring (PD = -0.016, control = + 0.002; < 0.001); 6 × 6 mm ETDRS circle (PD = -0.021, control = 0.00; = 0.001), and outer ring (PD = -0.022, control = 0.00; = 0.001). Participants with PD had greater rate of yearly decline in VD in 3 × 3 mm circle (PD = -0.939/mm, control = + 0.006/mm; < 0.001) and ring (PD = -0.942/mm, control = + 0.013/mm; < 0.001); 6 × 6 mm circle (PD = -0.72/mm, control = -0.054/mm; = 0.006), and outer ring (PD = -0.746/mm, control = -0.054/mm; = 0.005). When stratified by PD severity based on Hoehn and Yahr stage, faster rates of decline were seen in Hoehn and Yahr stages 3 to 4 in the 3 × 3 mm circle PFD and VD as well as 3 × 3 mm ring VD.
CONCLUSIONS
Individuals with PD experience more rapid loss of retinal microvasculature quantified on OCTA and more rapid thinning of the GC-IPL than controls. There may be more rapid loss in patients with greater disease severity.
FINANCIAL DISCLOSURES
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的
使用光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA），对帕金森病（PD）患者与对照组相比的视网膜微血管和脉络膜结构参数的变化率进行量化。
设计
前瞻性纵向研究。
参与者
来自神经退行性疾病眼部多模态成像数据库的40名PD参与者的74只眼睛和78名对照个体的149只眼睛。
方法
受试者在相隔约12个月的两个时间点接受OCT和OCTA成像。
主要观察指标
成像参数包括中心子场厚度、神经节细胞-内丛状层（GC-IPL）厚度、视乳头周围视网膜神经纤维层厚度、脉络膜血管指数、浅表毛细血管丛灌注密度（PFD）、血管密度（VD）和黄斑无血管区面积。
结果
PD参与者的GC-IPL年下降率更大（PD = -0.403μm，对照组 = +0.128μm；P = 0.01），3×3 mm ETDRS圆（PD = -0.016，对照组 = +0.002；P < 0.001）和环（PD = -0.016，对照组 = +0.002；P < 0.001）、6×6 mm ETDRS圆（PD = -0.021，对照组 = 0.00；P = 0.001）以及外环（PD = -0.022，对照组 = 0.00；P = 0.001）的PFD年下降幅度更大。PD参与者3×3 mm圆（PD = -0.939/mm，对照组 = +0.006/mm；P < 0.001）和环（PD = -0.942/mm，对照组 = +0.013/mm；P < 0.001）、6×6 mm圆（PD = -0.72/mm，对照组 = -0.054/mm；P = 0.006）以及外环（PD = -0.746/mm，对照组 = -0.054/mm；P = 0.005）的VD年下降率更大。根据Hoehn和Yahr分期按PD严重程度分层时，在Hoehn和Yahr 3至4期，3×3 mm圆的PFD和VD以及3×3 mm环的VD下降速度更快。
结论
与对照组相比，PD患者的视网膜微血管在OCTA上的损失更快，GC-IPL变薄更快。疾病严重程度较高的患者可能损失更快。
财务披露
作者对本文讨论的任何材料均无专利或商业利益。
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