Repka M X, Claro M C, Loupe D N, Reich S G
Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Pediatr Ophthalmol Strabismus. 1996 May-Jun;33(3):144-7. doi: 10.3928/0191-3913-19960501-04.
Parkinson's disease is associated with multiple abnormalities of both the afferent and efferent visual systems. Blepharospasm, paucity of blinking, apraxia of lid opening, visual neglect, reduced vergence, reduced upgaze, and blurred vision are reported findings in these patients. The association of these findings with the disease, and their duration, severity, and treatment have not been systematically investigated.
Patients with Parkinson's disease were prospectively examined. An age-matched control group was recruited from accompanying family members and volunteers. Data recorded included presence of visual complaint, the severity of the Parkinson's disease by Hoehn and Yahr Stage (scale = 1 to 5), duration of disease, pharmacologic therapy, visual acuity, ocular motility, accommodation, convergence amplitudes, and the near point of convergence.
Thirty-nine patients were entered into each group, each with 21 men and 18 women. The average patient had had the disease for 8.9 years with a severity index of 2.6. Asthenopia, upgaze deficiency, and convergence insufficiency were significantly more common in the patients with Parkinson's disease than in the controls. Mean geometric visual acuity was poorer in the Parkinson's patients (20/39 compared with 20/28); P < .001).
Visual complaints were significantly more common in the Parkinson's patients than in the age-matched controls. The frequency of ocular abnormalities was not related to the duration of the disease. Increasing severity seemed to be correlated with the presence of convergence insufficiency and a decline in acuity.
帕金森病与传入和传出视觉系统的多种异常有关。睑痉挛、眨眼减少、睁眼失用、视觉忽视、辐辏减少、上视减少和视力模糊是这些患者的报告发现。这些发现与该疾病的关联及其持续时间、严重程度和治疗方法尚未得到系统研究。
对帕金森病患者进行前瞻性检查。从陪同的家庭成员和志愿者中招募年龄匹配的对照组。记录的数据包括视觉主诉的存在、根据霍恩和雅尔分期评估的帕金森病严重程度（范围 = 1至5）、疾病持续时间、药物治疗、视力、眼球运动、调节、辐辏幅度和辐辏近点。
每组纳入39名患者，每组中有21名男性和18名女性。患者平均患病8.9年，严重程度指数为2.6。与对照组相比，帕金森病患者中视疲劳、上视不足和辐辏不足明显更常见。帕金森病患者的平均几何视力较差（20/39对比20/28）；P <.001）。
与年龄匹配的对照组相比，帕金森病患者的视觉主诉明显更常见。眼部异常的频率与疾病持续时间无关。严重程度增加似乎与辐辏不足的存在和视力下降有关。
