| Objective: To explore the regularity of retinal structure changes in Parkinson's disease and provide guidance for early diagnosis and evaluation of Parkinson's disease.Methods: We collected 30 patients with Parkinson's disease from August 2017 to February 2018 in our outpatient department and inpatient department.20 age matched healthy controls was carried out in this study.All subjects underwent examinations such as vision,intraocular pressure,optometry,direct or indirect ophthalmoscope,slit lamp microscope,and OCT.Application of OCT to p RNFL thickness in both eyes(including nasal,temporal,superior nasal,superior temporal,inferior nasal,and inferior temporal quadrant thickness and average thickness)and macular retinal layers(including retinal,RNFL,GCL,IPL,INL,OPL,ONL,RPE,IRL,ORL)thickness and volume were measured and analyzed.All PD patients underwent H-Y scores and UPDRS III scores to assess the severity of the disease.All data were analyzed using SPSS22.0 statistical software.The data of normal distribution between the two groups were compared using two independent samples t test;Pearson correlation analysis method was used to analyze the correlation between retinal parameters of PD patients and PD disease course,UPDRS III score,and H-Y score.P?0.05 was considered statistically significant.Results: 1.In the optic disc area,compared with the control group,the thickness of p RNFL in the PD group was only thinned in the nasal quadrant and average thickness(82.38±10.90 vs 73.93±12.04,p=0.001;110.98±6.27 vs 106.50±7.87,p=0.002).while the temporal quadrant and upper and lower quadrant thicknesses were thiner compared with controls,but the difference was not statistically significant.2.In the macular area,Compared to healthy controls,PD group in the thickness of GCL,IPL,OPL,IRL were thinner and the volume of GCL,IPL,INL,OPL were smaller.And we found that GCL,IPL changes were most significant,with thicknesses of(44.60±3.08 vs 41.54±3.72,p<0.0001;36.61±2.46 vs 34.28±2.66,p<0.0001).The volumes were(1.14±0.08 vs 1.07±0.08,p<0.0001;0.94±0.07 vs 0.88±0.06,p=0.0001),respectively.The GCL and IPL were significantly thinner in the inner four-quadrant and outer four-quadrant than the control group,and the volume was smaller.On RNFL,ONL,RPE,the PD group was thicker than the control group and the volume was larger(p>0.05),but there was no significant difference between groups.3.The asymmetry of motor symptoms does not appear to be reflected in structural changes in the retina.There was no significant difference in retinal thickness and volume changes between the R-PD group and the L-PD group in the left and right eyes.4.The thickness of p RNFL in the TD group was thinner than that of the AR group except for the nasal quadrant in the AR group,but the difference was not statistically significant.5.The mean p RNFL thickness in patients with PD was not related to the course of disease,but negatively correlated with H-Y scores and UPDRS III scores(r=-517,p=0.003 and r=-0.572,p=0.001).The thickness and volume of GCL in the macular region of patients with PD,and the thickness and volume of IPL were negatively correlated with the disease course,H-Y scores,and UPDRS III scores.Conclusion: With the development of PD,the retinal structure will also show some changes.The thickness of p RNFL,the thickness and volume of GCL and IPL in the macular area are the main components.It can be found by non-invasive OCT.Changes in retinal thickness in patients with PD are not as non-contralateral as movement symptoms.In PD patients with different major motor symptoms,the structural changes in the retina may differ.The structural changes of the retina in patients with PD are related to the course of PD,H-Y scores,and UPDRSIII scores.With the progression of PD,the severity of the retinopathy will be further aggravated as the condition progresses.The use of OCT to monitor the changes of retinal structure in PD patients can provide some help for the early diagnosis,differential diagnosis and disease monitoring of the disease. |
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