帕金森病、进行性核上性麻痹和伴或不伴痴呆的多系统萎缩患者视网膜神经纤维层的变化
Changes In The Retinal Nerve Fiber Layer In Patients With Parkinson's Disease, Progressive Supranuclear Palsy, And Multiple System Atrophy With And Without Dementia.
作者信息
Daraei Peyman, Taheri Morteza
机构信息
Department of Neurology, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Neurosurgery, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
出版信息
Med J Islam Repub Iran. 2025 Mar 3;39:33. doi: 10.47176/mjiri.39.33. eCollection 2025.
BACKGROUND
Several studies have evaluated RNFL thickness in PD, with only a few on other Parkinsonian syndromes. There is insufficient information on the pattern of changes in these patients who have dementia. Therefore, the present study examined the RNFL thickness in Parkinsonism patients with and without dementia.
METHODS
In this cross-sectional study, all patients diagnosed with PD, MSA, and PSP from March 2017 to February 2019 were evaluated. The severity of the disease and the presence of dementia were determined using the UPDRS and MMSE tests, respectively. The thickness of the RNFL was measured in the superior, inferior, nasal, and temporal quadrants using the 3D-OCT 1000 Mark II. Statistical methods, including the independent t-test, one-way analysis of variance (ANOVA), and the Pearson correlation coefficient, were used to analyze the data at a significance level of 0.05 using SPSS statistical software.
RESULTS
Fifty-three patients were examined. The mean age and mean UPDRS showed a significant difference between the groups, while gender and disease duration did not show. The mean RNFL thickness in the nasal sector had a significant difference among the three groups, with a thinner thickness in patients with MSA (<0.05). Patients with PD, PSP, and MSA with dementia showed a significantly greater reduction in RNFL thickness in the upper and temporal quadrants, nasal quadrant, and upper and temporal quadrants compared to PD, PSP, and MSA without dementia, respectively (<0.05).
CONCLUSION
Evaluating RNFL can be useful in predicting ocular involvement. Once validated in further studies, OCT may serve as a biomarker for predicting the presence or progression of movement disorders. OCT may also assist in predicting the presence of dementia in these patients by reflecting a more significant reduction in RNFL thickness compared to patients without dementia.
背景
多项研究评估了帕金森病（PD）患者的视网膜神经纤维层（RNFL）厚度，而针对其他帕金森综合征的研究较少。关于这些患有痴呆症的患者的变化模式，信息不足。因此，本研究检测了有或无痴呆症的帕金森综合征患者的RNFL厚度。
方法
在这项横断面研究中，对2017年3月至2019年2月期间所有诊断为PD、多系统萎缩（MSA）和进行性核上性麻痹（PSP）的患者进行了评估。分别使用统一帕金森病评定量表（UPDRS）和简易精神状态检查表（MMSE）测试来确定疾病的严重程度和痴呆症的存在情况。使用3D-OCT 1000 Mark II在上方、下方、鼻侧和颞侧象限测量RNFL的厚度。采用独立样本t检验、单因素方差分析（ANOVA）和Pearson相关系数等统计方法，使用SPSS统计软件在显著性水平为0.05时对数据进行分析。
结果
共检查了53例患者。各组之间的平均年龄和平均UPDRS存在显著差异，而性别和病程无显著差异。三组患者鼻侧象限的平均RNFL厚度存在显著差异，MSA患者的厚度较薄（<0.05）。与无痴呆症的PD、PSP和MSA患者相比，患有痴呆症的PD、PSP和MSA患者在上方和颞侧象限、鼻侧象限以及上方和颞侧象限的RNFL厚度分别显著降低（<0.05）。
结论
评估RNFL厚度有助于预测眼部受累情况。一旦在进一步研究中得到验证，光学相干断层扫描（OCT）可能作为预测运动障碍存在或进展的生物标志物。与无痴呆症的患者相比，OCT还可能通过反映RNFL厚度更显著的降低来协助预测这些患者中痴呆症的存在。
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