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初发帕金森病患者的视网膜变薄呈现出一种独特的模式,与青光眼不同。

Reduced Thickness of the Retina in de novo Parkinson's Disease Shows A Distinct Pattern, Different from Glaucoma.

机构信息

Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

J Parkinsons Dis. 2024;14(3):507-519. doi: 10.3233/JPD-223481.

Abstract

BACKGROUND

Parkinson's disease (PD) patients experience visual symptoms and retinal degeneration. Studies using optical coherence tomography (OCT) have shown reduced thickness of the retina in PD, also a key characteristic of glaucoma.

OBJECTIVE

To identify the presence and pattern of retinal changes in de novo, treatment-naive PD patients compared to healthy controls (HC) and early primary open angle glaucoma (POAG) patients.

METHODS

Macular OCT data (10×10 mm) were collected from HC, PD, and early POAG patients, at the University Medical Center Groningen. Bayesian informative hypotheses statistical analyses were carried out comparing HC, PD-, and POAG patients, within each retinal cell layer.

RESULTS

In total 100 HC, 121 PD, and 78 POAG patients were included. We showed significant reduced thickness of the inner plexiform layer and retinal pigment epithelium in PD compared to HC. POAG patients presented with a significantly thinner retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, outer plexiform layer, and outer photoreceptor and subretinal virtual space compared to PD. Only the outer segment layer and retinal pigment epithelium were significantly thinner in PD compared to POAG.

CONCLUSIONS

De novo PD patients show reduced thickness of the retina compared to HC, especially of the inner plexiform layer, which differs significantly from POAG, showing a more extensive and widespread pattern of reduced thickness across layers. OCT is a useful tool to detect retinal changes in de novo PD, but its specificity versus other neurodegenerative disorders has to be established.

摘要

背景

帕金森病(PD)患者会出现视觉症状和视网膜变性。使用光学相干断层扫描(OCT)的研究表明,PD 患者的视网膜变薄,这也是青光眼的一个关键特征。

目的

与健康对照组(HC)和早期原发性开角型青光眼(POAG)患者相比,确定初发、未经治疗的 PD 患者是否存在并识别其视网膜变化模式。

方法

在格罗宁根大学医学中心,从 HC、PD 和早期 POAG 患者中采集黄斑 OCT 数据(10×10 mm)。在每个视网膜细胞层内,对 HC、PD 和 POAG 患者进行贝叶斯信息假设统计分析。

结果

共纳入 100 名 HC、121 名 PD 和 78 名 POAG 患者。与 HC 相比,PD 患者的内丛状层和视网膜色素上皮厚度明显变薄。与 PD 相比,POAG 患者的视网膜神经纤维层、节细胞层、内丛状层、外丛状层以及外光感受器和视网膜下虚拟空间明显变薄。与 POAG 相比,仅 PD 患者的外节层和视网膜色素上皮厚度明显变薄。

结论

与 HC 相比,初发 PD 患者的视网膜变薄,尤其是内丛状层,与 POAG 明显不同,后者表现出更广泛和广泛的各层变薄模式。OCT 是一种检测初发 PD 患者视网膜变化的有用工具,但需要确定其与其他神经退行性疾病的特异性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a06/11091560/6f5d672adf2f/jpd-14-jpd223481-g001.jpg

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