Dynamic Research On Retina Observed With Optical Coherence Tomography In Parkinson's Disease Patients

Objective:To investigate the clinical characteristics of the changes of retinal morphological structure in early Parkinson's disease(PD)through measuring the thickness of retinal nerve fiber layer(RNFL)and macular,as well as the macular volume by optical coherence tomography(OCT),and then explore the changes of retinal morphological structure with the progress of PD.Methods: 43 PD patients were enrolled in the study who come from our Department of Neurology from July 2013 to May 2016.All patients underwent extensive clinical evaluations including the unified Parkinson's disease rating scale(UPDRS)and Hoehn-Yahr(H-Y)stage in “off” period.All eye examinations of PD patients were conducted in “on” period.37 of the 43 PD patients were chosen the case group.42 age,gender matched healthy controls were assessed in this study.Subjects of two groups undertook retina of retinal nerve fiber layer(RNFL)and macular examinations by high-definition OCT.A longitudinal study of 22 of the initial 37 PD patients were conducted the same evaluations with the same flow path.Differences between PD and control eyes were tested using independent sample t test,and paired t test were used to analyze the difference of the 22 follow-up PD patients.Pearson's correlations were used to analyze the correlations of retina damage and clinical characteristics.Results:A significant difference was found between the PD patients and controls in RNFL thickness and macular volume.Average RNFL thickness in patients with PD was significantly thinner than in healthy controls(P<0.001),the same results were also found in total macular thicknesses and macular volume(both P values are 0.001).In the longitudinal study,there was a remarkable reduction of the RNFL and macular thicknesses in PD patients,as well as macular volumes(P<0.05).A conspicuous negative correlation was found between the RNFL thickness in PD patients and the age,disease duration,H&Y stage as well as total UPDRS score(respectively P value is 0.001,0.029,0.001,0.041).Negative correlation still existed between RNFL thickness and disease duration,LEDD,H&Y stageafter adjusted for age and sex(all P<0.05).Conclusions: Early PD patients have thinner retinal thicknesses of RNFL and macular,smaller macular volume than those in normal controls,and they exhibit progressive reductions in the thickness of RNFL and total macular,as well as macular volume in the follow-up observation.The detection were associated with disease duration,which can be quantified by the noninvasive OCT technology.Specific patterns of retina damage may be a useful potential biomarker for evaluating the progression of PD.