Macular Retinal And Circumpapillary Retinal Nerve Fiber Layer Thickness In Parkinson’s Disease Evaluated By Optical Coherence Tomography

Objective:To analyze the characteristic changes of macular retinal thickness and circumpapillary retinal nerve fiber layer thickness in patients with Parkinson’s disease by cirrus High resolution optical coherence tomography(cirrus-HD OCT),and find out the association between macular thickness with its clinical characteristics including age,course of disease,Unified Parkinson’s Disease Rating Scale part III(UPDRS-III)scores,Hoehn-Yahr stage(H-Y),simple mental status scale(MMSE),Montreal Cognitive Assessment(MOCA)total scores,ability of daily living assessment(ADL),visual space and execution occurrence.To further discuss the changes of macular retinal and circumpapillary nerve fiber layer thickness in Parkinson’s disease dementia group and non-dementia group.Methods:25 patients(50 eyes)with PD from the neurology department of the first clinical hospital in Shanxi Medical University from November 2018 to October 2019 were selected as the group of Parkinson’s disease,and 15 healthy persons(30 eyes)matched with the age and sex were selected as the control group and the HD-OCT examination was performed.To analyze the changes of the macular retinal and circumpapillary retinal nerve fiber layer thickness in the parkinson’s disease group and the control group and the non-dementia and dementia group in the parkinson’s disease,and the retinal thickness of each quadrant in the macular region of the patients with Parkinson’s disease and itsclinical characteristics were analyzed,including the age,the course of the disease,the UPDRS-III score,the Hoehn-Yahr stage,simple mental status scale(MMSE),Montreal Cognitive Assessment(MOCA)total scores,ability of daily living assessment(ADL)and the visual space and the execution.The data of two groups of subjects were analyzed by using the spss 20.0 statistical software,and the difference of p <0.05 was of statistical significance.Results:Compared with the control group,the difference of the macular retinal thickness on the superior(t=-2.105,P=0.035),nasal(t=-2.140 l,P= 0.036),temporal quadrants(t=-2.339,P=0.019)of outer ring and the nasal(t=-2.072,P=0.042)quadrant of inner ring was of statistical significance.There was no significant difference between all quadrants and the average retinal thickness around the optic disc(P>0.05).In the PDD group and the n-PDD group,there was a significant difference in temporal thickness of the outer ring and all quardrants of the inner ring(superior,inferior,nasal,and temporal)of the macular region(P < 0.05),and In the PDD group,all quadrants of the macular thickness was generally thinner than that of the n-PDD and the control group.the macular retinal thickness of the superior,temporal quarants of outer ring and all quarants of inner ring(superior,inferior,nasal,temporal)in the PDD group was significantly different from that in the control group(P<0.05).The superior and the temporal quarants of the inner ring have good diagnostic value for Parkinson’s disease dementia,the area under the working characteristic curve of the subjects is 71.4%(95% 0.547~0.881)and74.7%(95% 0.582 ~ 0.911),respectively.Compared with n-PDD group,the thickness of temporal nerve fiber layer in PDD group was thinner than that in n-PDD group,and the difference was statistically significant.The age of Parkinson’s disease group was negatively correlated with all quadrants of retinal thickness,central fovea thickness and macular volume in macular area.In Parkinson’s disease group,the course of disease was negatively correlated with the inferior(r=-0.365,P=0.014)、nasal(r=-0.305,P=0.033)、temporal(r=-0.300,P=0.036)quadrants of the outer ring.UPDRS-III was negatively correlated with all quadrants(except the inner inferior quadrant and central fovea thickness)and macular volume(P < 0.05).H-Y grade was negatively correlated with all quadrants((superior(r=-0.435,P=0.002)、 inferior(r=-0.354,P=0.017)、nasal(r=-0.344,P=0.015)、 temporal(r=-0.347,P=0.015))of the outer ring and the superior(r=-0.379,P=0.007),the temporal quadrants(r=-0.297,P=0.036)of inner ring and macular volume(r=-0.328,P=0.020).The MMSE in PD group was positively correlated with the superior(r=0.431,P=0.004;r=0.300,P=0.048),temporal quadrants(r=0.390,P=0.009;r=0.468,P=0.001)of the inner and the outer rings,the inner inferior(r=0.375,P=0.012)and the outer nasal(r=0.340,P=0.026)quadrants.In the PD group,the MOCA and visuospatial and the execution were positively correlated with the superior(MOCA:r=0.453,P=0.002;r=0.329,P=0.029)(visuospatial and the execution:r=0.355,P=0.018;r=0.300,P=0.048),the temporal(MOCA: r=0.484,P=0.001;r=0.501,P=0.001)(visuospatial and the execution:r=0.436,P=0.003;r=0.364,P=0.015))quadrants of the inner and outer rings,and the inferior quadrants(r=0.405,P=0.006;r=0.406,P=0.006)of the inner ring of the macular thickness(P<0.05).There was a negatively correlation between the ADL of the PD group and the outer nasal quadrant(r=-0.311,P=0.043)and the inner superior(r=-0.405,P=0.006),temporal quadrants(r=-0.347,P=0.021)of the macular region.Conclusion:The macular retinal thickness in patients with Parkinson’s disease is significantly thinner than that in the control group,and the retinal thickness in the macular area in the Parkinson’s disease dementia group is significantly thinner than that in the non-dementia group and the control group.The macular thickness on the inner superior and the temporal quadrants is of good diagnostic value for Parkinson’s disease dementia.The thickness of optic disc temporal nerve fiber layer in Parkinson’s disease dementia group was significantly thinner than that in non-dementia group and control group.