Quantitative Analysis Of Retinal Thickness And Microvasculature In Patients With Parkinson’s Disease

Objective:To observe the characteristic changes of retinal thickness and microvascular in macular area of Parkinson’s disease(PD)patients,and analyze the correlation between the ganglion cell layer(GCL)thickness,vascular density(VD),perfusion density(PD),foveal avascular zone(FAZ)and the disease duration,Hoehn and Yahr(H-Y)stage and Unified Parkinson’s Disease Rating Scale part Ⅲ(UPDRS-Ⅲ)scores.Methods:A total of 20 PD patients(40 eyes)diagnosed in the Department of Neurology of the First Hospital of Shanxi Medical University from September 2020 to January 2021 were collected as the Parkinson’s disease group,and 20 healthy people(40 eyes)matched with age and gender served as the normal control group.Optical coherence tomography(OCT)and vascular imaging technology(OCTA)were used for macular scanning of all the examined eyes.The average,minimum and 6-sectoral(superior,inferior,superonasal,inferonasal,superotemporal and inferotemporal)GCL thickness,vascular density,perfusion density and FAZ between two groups were comparatively observed,and the correlations between these measurement indicators and the disease duration,H-Y stage and UPDRS-Ⅲ scores were analyzed.the difference of P<0.05 was of statistical significance.Results:Compared with the normal control group,the macular average(Z=-2.197,P=0.028),minimum(t=-3.156,P=0.002),inferior(Z=-2.215,P=0.027),superonasal(t=-2.812,P=0.006)and inferonasal(t=-3.198,P=0.002)GCL thickness in the macular area of PD group were statistical thinner(P<0.05),while the superior,superotemporal and inferotemporal GCL thickness were not statistical thinner(P>0.05).The inferonasal GCL thickness has a good diagnostic value for PD,the area under the receiver operating characteristic(ROC)curve is 0.795(95%CI 0.578-0.809).There was no relationship between the average,minimum and 6-sectoral(superior,inferior,superonasal,inferonasal,superotemporal and inferotemporal)GCL thickness in PD patients and the disease duration,H-Y stage and UPDRS-Ⅲ scores(P>0.05).The vascular density of superficial capillaries in the central(t=-2.727,P=0.008),inner(Z=-2.642,P=0.008),outer(Z=-3.114,P=0.002)and full regions(Z=-3.162,P=0.002)and perfusion density in the central(t=-2.184,P=0.032),inner(t=-2.459,P=0.014),outer(t=-3.487,P=0.001)and full regions(t=-3.420,P=0.001)in PD patients were significantly decreased(P < 0.05),while the area of FAZ was not significantly larger.The vascular density in the full region has good diagnostic value for PD,the area under the ROC curve is 0.705(95%CI0.591-0.819).The vascular density and perfusion density in the central,inner,outer and full regions and the area of FAZ in PD patients had no relationship with the disease duration,H-Y stage and UPDRS-Ⅲ scores(P>0.05).Conclusion:In PD patiens,the macular GCL thickness was thinner,the vascular density and perfusion density was decreased.The inferonasal GCL thickness and vascular density in the full region had good diagnostic value for PD.There was no relationship between the GCL thickness,vascular density,perfusion density and the area of FAZ and the disease duration,H-Y stage and UPDRS-Ⅲ scores.The application of OCT and OCTA to detect the changes of GCL thickness,vascular density and perfusion density in PD patients can provide certain reference value for the disease.