Clinical Ophthalmology (Oct 2021)

The Retinal Posterior Pole in Early Parkinson’s Disease: A Fundus Perimetry and SD-OCT Study

  • Cesareo M,
  • Di Marco E,
  • Giannini C,
  • Di Marino M,
  • Aiello F,
  • Pisani A,
  • Pierantozzi M,
  • Mercuri NB,
  • Nucci C,
  • Mancino R

Journal volume & issue
Vol. Volume 15
pp. 4005 – 4014

Abstract

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Massimo Cesareo,1 Ernesto Di Marco,1 Clarissa Giannini,1 Matteo Di Marino,1 Francesco Aiello,1 Antonio Pisani,2 Mariangela Pierantozzi,3 Nicola Biagio Mercuri,4,5 Carlo Nucci,1 Raffaele Mancino1 1Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy; 2Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; 3Parkinson’s Center, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; 4Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; 5Fondazione Santa Lucia I.R.C.C.S, Rome, ItalyCorrespondence: Massimo Cesareo; Ernesto Di MarcoOphthalmology Unit, Department of Experimental Medicine University of Rome “Tor Vergata”, via Montpellier, Rome, 100133, ItalyTel/Fax +39 0620902973Email [email protected]; [email protected]: To assess the structure and function of the retinal posterior pole in patients with early Parkinson’s disease (PD) and to identify possible biomarkers correlated with clinical features.Patients and Methods: A cross-sectional case-control study of 21 patients with PD and 22 age-matched healthy controls (HC) was conducted. All subjects underwent full ophthalmological examinations, fundus perimetry (FP) and spectral domain-OCT (SD-OCT) of the entire retinal posterior pole and peripapillary retinal nerve fiber layer (pRNFL).Results: We analyzed 41 eyes from 21 patients (14 males and 7 females) with early PD (Hoehn and Yahr scale (H&Y) equal to or less than stage 2) and 41 eyes from 22 HC (12 males and 10 females). We found no significant difference in the pRNFL thickness between patients with PD and HC. The statistical analysis of the SD-OCT posterior pole area, consisting of 64 values for each retinal layer, revealed a decrease in the outer nuclear layer (ONL) thickness in patients with PD (p < 0.0001). On the contrary, a significant increase in the thickness of the outer plexiform layer (OPL) (p < 0.0001) and of the retinal pigmented epithelium (RPE) (p= 0.002) compared to healthy controls was detected. Other retinal layers showed no significant statistical differences. The differential light sensitivity (DLS) values measured by FP were significantly lower in patients than the healthy controls (15 [13– 16.2] vs 17.95 [16.08– 18.96] p< 0.0001).Conclusion: Our results showed that DLS and retinal structure differed in the posterior pole between patients with early PD and controls. Thickening of the OPL may represent accumulation of α-synuclein in the OPL of patients with PD.Keywords: Parkinson’s disease, optical coherence tomography, retina, dopamine, alpha-synuclein

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