帕金森病患者视网膜外层厚度与视力的关系

doi:10.3760/cma.j.cn115909-20190521-00144

摘要
图/表
参考文献(33)
相关文章 (15)

全文: PDF 4919KB HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：利用光学相干断层扫描（OCT）探究帕金森病（PD）患者视网膜外层结构的改变及与视力的关系，为PD患者的视力损害提供新的辅助检查手段。方法：系列病例研究。利用谱域光学相干断层扫描（SD-OCT）得到35例PD患者和39例年龄、性别匹配的健康对照者的视网膜外丛状层、外核层和感光细胞内外节层视网膜图像，并使用自动分层软件得到各层的平均厚度。采用广义估计方程比较2组视网膜外层各层厚度的差异。采用Pearson相关分析研究外层视网膜厚度与最佳矫正视力（BCVA）的相关性。结果：最终纳入35例（63眼）PD患者和39例（75眼）健康对照者进行分析。PD患者BCVA较健康对照者差（P<0.001），外丛状层和外核层厚度也较小（P=0.011；P=0.008），且外核层的厚度降低与BCVA下降相关（r=0.283，P=0.026）。结论：PD患者视觉系统受损及外层视网膜结构存在改变，并且外核层结构损害与视力损害相关，外核层结构指标可能可以作为监测PD患者视觉系统损害的影像学指标。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：帕金森病, 光学相干断层扫描, 视网膜, 外核层

Abstract：Objective: To detect changes in the outer retinal structure using optical coherence tomography and to study the correlation between outer retinal thickness and visual acuity in patients with Parkinson's disease (PD). Methods: This case-series study included 35 cases of PD and 39 age- and gender-matched healthy participants. Images of the outer plexiform layer (OPL), outer nuclear layer (ONL) and photoreceptor layer (PRL) were obtained by SD-OCT. The average thickness of each layer was analyzed by an automated layering software. A generalized estimating equation (GEE) was used to compare the differences in the thickness of the three layers (OPL, ONL, PRL) between patients with Parkinson's disease and healthy controls (HCs). Pearson correlation analysis was used to study the correlation between outer retinal thickness and best corrected visual acuity (BCVA). Results: Thirty-five patients with Parkinson's disease (63 eyes included) and the 39 HCs (75 eyes included) were included in final analysis. The BCVA was worse in PD patients than in HCs (P<0.001). The thickness of the OPL and ONL was thinner in PD patients (P=0.011, P=0.008, respectively). The thinning of the ONL thickness was correlated with worse BCVA (r=0.283 , P=0.026). Conclusions: The visual system and outer retinal structures in patients with Parkinson's disease are damaged. The index for the outer nuclear layer structure may be used as an image indicator to monitor the damage to the visual system in patients with Parkinson's disease.

Key words： Parkinson's disease optical coherence tomography retina outer nuclear layer

收稿日期: 2019-05-21

基金资助:国家重点研发项目（2016YFE0107000）；浙江省重点研发项目（2019C03045）

通讯作者: 瞿佳（ORCID：0000-0003-1678-966X），Email：jqu@wz.zj.cn

引用本文:

陈易弘1 周玥1 叶淑灵1 William Robert Kwapong1 叶华2 沈梅晓1 瞿佳1. 帕金森病患者视网膜外层厚度与视力的关系[J]. 中华眼视光学与视觉科学杂志, 2020, 22(5): 347-353. Yihong Chen1,Yue Zhou1,Shuling Ye1,William Robert Kwapong1,Hua Ye2,Meixiao Shen1,Jia Qu1. Correlation between Outer Retinal Thickness and Visual Acuity in Patients with Parkinson's Disease. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(5): 347-353. DOI: 10.3760/cma.j.cn115909-20190521-00144

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20190521-00144 或 https://www.cjoovs.com/CN/Y2020/V22/I5/347

[1]	de Lau LM, Breteler MM. Epidemiology of Parkinson's disease. Lancet Neurol, 2006, 5(6): 525-535. DOI: 10.1016/S1474- 4422(06)70471-9.
[2]	Dorsey ER, Constantinescu R, Thompson JP, et al. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology, 2007, 68(5): 384-386. DOI: 10.1212/01.wnl.0000247740.47667.03.
[3]	Braak H, Del TrediciI K, Bratzke H, et al. Staging of the intracerebral inclusion body pathology associated with idiopathic Parkinson's disease (preclinical and clinical stages). J Neurol, 2002, 249 Suppl 3: III/1-5.
[4]	Bodiss-Wollner I. Retinopathy in Parkinson disease. J Neural Transm (Vienna), 2009, 116(11): 1493-1501. DOI: 10.1007/ s00702-009-0292-z. DOI: 10.1212/01.WNL.0000103444.45882. D8.
[5]	Biousse V, Skibellb C, Wattsr L, et al. Ophthalmologic features of Parkinson's disease. Neurology, 2004, 62(2): 177-180.
[6]	Djamgoz MB, Hankins MW, Hirano J, et al. Neurobiology of retinal dopamine in relation to degenerative states of the tissue. Vision Res, 1997, 37(24): 3509-3529. DOI: 10.1016/S0042- 6989(97)00129-6.
[7]	Frederick JM, Rayborn ME, Laties AM, et al. Dopaminergic neurons in the human retina. J Comp Neurol, 1982, 210(1): 65- 79. DOI: 10.1002/cne.902100108.
[8]	Jackson GR, Owsley C. Visual dysfunction, neurodegenerative diseases, and aging. Neurol Clin, 2003, 21(3): 709-728. DOI: 10.1016/S0733-8619(02)00107-X.
[9]	Harnois C, Di Paolo T. Decreased dopamine in the retinas of patients with Parkinson's disease. Invest Ophthalmol Vis Sci, 1990, 31(11): 2473-2475.
[10]	Muller AK, Blasberg C, Sudmeyer M, et al. Photoreceptor layer thinning in parkinsonian syndromes. Mov Disord, 2014, 29(9): 1222-1223. DOI: 10.1002/mds.25939.
[11]	Inzelberg R, Ramirez JA, Nisipeanu P, et al. Retinal nerve fiber layer thinning in Parkinson disease. Vision Res, 2004, 44(24): 2793-2797. DOI: 10.1016/j.visres.2004.06.009.
[12]	Altintas O, Iseri P, Ozkan B, et al. Correlation between retinal morphological and functional findings and clinical severity in Parkinson's disease. Doc Ophthalmol, 2008, 116(2): 137-146. DOI: 10.1007/s10633-007-9091-8.
[13]	Moschos MM, Tagaris G, Markopoulos I, et al. Morphologic changes and functional retinal impairment in patients with Parkinson disease without visual loss. Eur J Ophthalmol, 2011, 21(1): 24-29. DOI: 10.5301/EJO.2010.1318.
[14]	Kwapong WR, Ye H, Peng C, et al. Retinal microvascular impairment in the early stages of Parkinson's disease. Invest Ophthalmol Vis Sci, 2018, 59(10): 4115-4122. DOI: 10.1167/ iovs.17-23230.
[15]	Tsironi EE, Dastiridou A, Katsanos A, et al. Perimetric and retinal nerve fiber layer findings in patients with Parkinson's disease. BMC Ophthalmol, 2012, 12: 54. DOI: 10.1186/1471- 2415-12-54.
[16]	Archibald NK, Clarke MP, Mosimann UP, et al. Retinal thickness in Parkinson's disease. Parkinsonism Relat Disord, 2011, 17(6): 431-436. DOI: 10.1016/j.parkreldis.2011.03.004.
[17]	Satue M, Obis J, Rodrigo MJ, et al. Optical coherence tomography as a biomarker for diagnosis, progression, and prognosis of neurodegenerative diseases. J Ophthalmol, 2016, 2016: 1-9. DOI: 10.1155/2016/8503859.
[18]	彭晨蕾, Kwapong WR, 周煜恒, 等. 运用高分辨SD-OCT探测视神经脊髓炎谱系疾病视网膜厚度变化. 中华眼视光学与视觉科学杂志, 2018, 20(7): 385-392. DOI: 10.3760/cma. j.issn.1674-845X.2018.07.001.
[19]	吴宇霏, 谭凡, 郑玥,等. 2型糖尿病患者早期黄斑区视网膜亚层及脉络膜的光学相干断层扫描成像特征. 中华眼视光学与视觉科学杂志, 2018, 20(11): 663-668. DOI: 10.3760/cma. j.issn.1674-845X.2018.11.005.
[20]	Li K, Wu X, Chen DZ, et al. Optimal surface segmentation in volumetric images--a graph-theoretic approach. IEEE Trans Pattern Anal Mach Intell, 2006, 28(1): 119-134. DOI: 10.1109/ TPAMI.2006.19.
[21]	Garvin MK, Abramoff MD, Wu X, et al. Automated 3-D intraretinal layer segmentation of macular spectraldomain optical coherence tomography images. IEEE Trans Med Imaging, 2009, 28(9): 1436-1447. DOI: 10.1109/ TMI.2009.2016958.
[22]	Quellec G, Lee K, Dolejsi M, et al. Three-dimensional analysis of retinal layer texture: identification of fluid-filled regions in SD-OCT of the macula. IEEE Trans Med Imaging, 2010, 29(6): 1321-1330. DOI: 10.1109/TMI.2010.2047023.
[23]	Antony B, Abramoff MD, Tang L, et al. Automated 3-D method for the correction of axial artifacts in spectral-domain optical coherence tomography images. Biomed Opt Express, 2011, 2(8): 2403-2416. DOI: 10.1364/BOE.2.002403.
[24]	Mendoza-Santiesteban CE, Palma JA, Martinez J, et al. Progressive retinal structure abnormalities in multiple system atrophy. Mov Disord, 2015, 30(14): 1944-1953. DOI: 10.1002/ mds.26360.
[25]	Hutton JT, Morris JL, Elias JW. Levodopa improves spatial contrast sensitivity in Parkinson's disease. Arch Neurol, 1993, 50(7): 721-724. DOI: 10.1001/archneur.1993.00540070041012.
[26]	Garcia-Martin E, Larrosa JM, Polo V, et al. Distribution of retinal layer atrophy in patients with Parkinson disease and association with disease severity and duration. Am J Ophthalmol, 2014, 157(2): 470-478. DOI: 10.1016/j.ajo.2013.09.028.
[27]	Bayhan HA, Aslan Bayhan S, Tanik N, et al. The association of spectral-domain optical coherence tomography determined ganglion cell complex parameters and disease severity in Parkinson's disease. Curr Eye Res, 2014, 39(11): 1117-1122. DOI: 10.3109/02713683.2014.894080.
[28]	Bittersohl D, Stemplewitz B, Keseru M, et al. Detection of retinal changes in idiopathic Parkinson's disease using highresolution optical coherence tomography and heidelberg retina tomography. Acta Ophthalmol, 2015, 93(7): 578-584. DOI: 10.1111/aos.12757.
[29]	Polo V, Satue M, Rodrigo MJ, et al. Visual dysfunction and its correlation with retinal changes in patients with Parkinson's disease: an observational cross-sectional study. BMJ Open, 2016, 6(5): 1-8. DOI: 10.1136/bmjopen-2015-009658.
[30]	Kim BJ, Irwin DJ, Song D, et al. Optical coherence tomography identifies outer retina thinning in frontotemporal degeneration. Neurology, 2017, 89(15): 1604-1611. DOI: 10.1212/WNL. 0000000000004500.
[31]	Roth NM, Saidha S, Zimmermann H, et al. Photoreceptor layer thinning in idiopathic Parkinson's disease. Mov Disord, 2014, 29(9): 1163-1170. DOI: 10.1212/WNL.0000000000004500.
[32]	Schneider M, Muller HP, Lauda F, et al. Retinal single-layer analysis in Parkinsonian syndromes: An optical coherence tomography study. J Neural Transm (Vienna), 2014, 121(1): 41- 47. DOI: 10.1007/s00702-013-1072-3.
[33]	Matsumoto H, Sato T, Kishi S. Outer nuclear layer thickness at the fovea determines visual outcomes in resolved central serous chorioretinopathy. Am J Ophthalmol, 2009, 148(1): 105-110. DOI: 10.1016/j.ajo.2009.01.018.