Observation And Analysis Of Retinal Thickness In Macular Area And Nerve Fiber Layer Around Optic Disc In Parkinson’s Disease With REM Sleep Behavior Disorder

Objective:High-resolution optical coherence tomography(HD-OCT)was used to measure retinal thickness in Parkinson’s disease(PD)with or without Rapid eye movement sleep behavior disorder(RBD).Patients’ macular retinal thickness and peripapillary retinal nerve fibre layer thickness(RNFL)were observed to characterise the changes and to compare retinal thickness with age,Unified Parkinson’s Disease Rating Scale Part III(UPDRS-III)scores,Hoehn-Yahr staging,equivalent levodopa dose(LEED),Rapid Eye Movement Sleep Behaviour Disorder-Hong Kong version Rating Scale(RBDQ-HK),Montreal Cognitive Assessment Scale(MOCA),and Assessment of Ability to Perform Daily Living(ADL)correlations to provide insight into the factors associated with altered retinal thickness in PD patients.Methods:Fifty-three patients with Parkinson’s disease who were hospitalized in the Department of Neurology of the First Hospital of Shanxi Medical University from October 2020 to December 2021 were recruited as the Parkinson’s disease group,while 15 normal individuals matched with the age and gender of the patients in this group were collected as the normal control group.The correlation between macular retinal and peripapillary retinal nerve fibre layer thickness and the severity of the disease(including UPDRS-III score,Hoehn-Yahr stage,MOCA,ADL and RBDQ-HK)was also analysed.The SPSS 26.0software was used for statistical analysis of the two groups of subjects,and differences were considered statistically significant at P < 0.05.Results:Compared with normal control group,Parkinson’s disease group showed the upper part of external ring in macular area(t=3.743,P < 0.001),the lower part of external ring(t=3.509,P < 0.001),the nasal part of external ring(t=3.052,P=0.002),the temporal part of external ring(t =2.773,P=0.006),and the upper part of internal ring(t=2.066,P=0.039),the lower part of the inner ring(t=2.557,P=0.011),the nasal part of the inner ring(t=2.982,P=0.003),and the temporal part of the inner ring(t=2.273,P=0.023)showed statistically significant differences in retinal thickness and macular volume(t=3.063,P=0.02).Thickness of nerve fiber layer above optic disc(t=-5.534,P < 0.001),below optic disc(t=-6.27,P < 0.001),nasal side of optic disc(t=-2.919,P=0.04),temporal side of optic disc(t=2.555,P=0.011)and average nerve fiber thickness(t=-6.449,P < 0.001),the differences were statistically significant.Compared to the PD-RBD group,the thickness of the retina and the volume of the macula in the four quadrants of the outer macular ring,nose,and temporal region,and the thickness of the nerve fiber layer on the temporal side of the optic disc were measured in PD.It was significantly thinner PD-RBD group,statistical significance(P <0.05).The MOCA score of PD group was significantly positively correlated with the upper part of macular area(r=0.351,P=0.010),the nasal side of macular area(r=0.287,P=0.037),the temporal side of macular area(r=0.332,P=0.015)and macular volume(r=0.304,P=0.027).RBDQ-HK score was associated with the upper part of the outer ring(r=-0.350,P=0.010),the nasal part of the outer ring(r=-0.393,P=0.004),the temporal part of the outer ring(r=-0.362,P=0.008),the upper part of the inner ring(r=-0.372,P=0.006),and the lower part of the inner ring(r=-0.381,P=0.004)in macular area.P=0.005),nasal inner ring(r=0.-303,P=0.028),temporal inner ring(r =-0.296,P=0.032),fovea(r=-0.288,P=0.036)and macular volume(r=-0.391,P=0.004)were significantly negatively correlated.After removing confounding factors,RBDQ-HK scores were negatively and statistically significant(P< 0.05)correlated with outer ring nasal,outer ring temporal,inner ring superior,inner ring inferior,inner ring temporal retinal thickness and macular volume and optic disc temporal RNFL thickness in the macula.Conclusions:Macular retina thickness(4 quadrants of inner and outer rings),macular volume,and perpapillary nerve fiber layer thickness(4 quadrants and mean RNFL)of patients with Kinson’s disease were significantly higher than in normal controls.It was thin.Parkinson’s disease with REM sleep behavior disorder Retina thickness,macular volume,and temporal optic disc nerve in the macula region(upper,lower,nose,and temporal)compared to patients without REM sleep behavior disorder All fiber thickness decreased.