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Diaz-Torres S, Lee SSY, Ogonowski NS, Mackey DA, MacGregor S, Gharahkhani P, Renteria ME. Macular structural integrity estimates are associated with Parkinson's disease genetic risk. Acta Neuropathol Commun 2024; 12:130. [PMID: 39135092 PMCID: PMC11320880 DOI: 10.1186/s40478-024-01841-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/29/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Optical coherence tomography (OCT) is a non-invasive technique to measure retinal layer thickness, providing insights into retinal ganglion cell integrity. Studies have shown reduced retinal nerve fibre layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thickness in Parkinson's disease (PD) patients. However, it is unclear if there is a common genetic overlap between the macula and peripapillary estimates with PD and if the genetic risk of PD is associated with changes in ganglion cell integrity estimates in young adults. METHOD Western Australian young adults underwent OCT imaging. Their pRNFL, GCIPL, and overall retinal thicknesses were recorded, as well as their longitudinal changes between ages 20 and 28. Polygenic risk scores (PRS) were estimated for each participant based on genome-wide summary data from the largest PD genome-wide association study conducted to date. We further evaluated whether PD PRS was associated with changes in thickness at a younger age. To evaluate the overlap between retinal integrity estimates and PD, we annotated and prioritised genes using mBAT-combo and performed colocalisation through the GWAS pairwise method and HyPrColoc. We used a multi-omic approach and single-cell expression data of the retina and brain through a Mendelian randomisation framework to evaluate the most likely causal genes. Genes prioritised were analysed for missense variants that could have a pathogenic effect using AlphaMissense. RESULTS We found a significant association between the Parkinson's disease polygenic risk score (PD PRS) and changes in retinal thickness in the macula of young adults assessed at 20 and 28 years of age. Gene-based analysis identified 27 genes common to PD and retinal integrity, with a notable region on chromosome 17. Expression analyses highlighted NSF, CRHR1, and KANSL1 as potential causal genes shared between PD and ganglion cell integrity measures. CRHR1 showed consistent results across multiple omics levels. INTERPRETATION Our findings suggest that retinal measurements, particularly in young adults, could be a potential marker for PD risk, indicating a genetic overlap between retinal structural integrity and PD. The study highlights specific genes and loci, mainly on chromosome 17, as potential shared etiological factors for PD and retinal changes. Our results highlight the importance of further longitudinal studies to validate retinal structural metrics as early indicators of PD predisposition.
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Affiliation(s)
- Santiago Diaz-Torres
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
| | - Natalia S Ogonowski
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Puya Gharahkhani
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
| | - Miguel E Renteria
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Zhang Y, Li Y, Lai C, Wang X, Luo F, Niu Y, Qin Y, Zhang Y, Zhang H. Interocular asymmetry of retinal change in Parkinson's disease. Parkinsonism Relat Disord 2024; 125:107037. [PMID: 38878445 DOI: 10.1016/j.parkreldis.2024.107037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 07/29/2024]
Abstract
PURPOSE To investigate interocular asymmetry (IA) of retinal structure and vessel density in patients with Parkinson's disease (PD) and normal controls (NC). METHODS Seventy-eight subjects including 40 PD patients and 38 NC had completed optical coherence tomography angiography (OCTA) and neurological examinations for three rating scales (UPDRS-III, MMSE and MoCA). The IA was calculated by the absolute value of difference in right and left eyes. The IA of thickness in macular ganglion cell inner-plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and vessel density of superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) were obtained from OCTA. RESULTS The motor-symptom-onset side of eyes showed lower vessel density in parafovea of SCP (51.09 ± 3.46 vs 49.81 ± 4.16, P = 0.03) and superior hemi of perifovea DCP (49.55 ± 5.81 vs 47.33 ± 5.71, = 0.04). The PD patients showed larger IA in thickness of superior half of pRNFL (5.27 [2.67, 10.87] vs 3.08 [1.62, 5.61], P = 0.02) and parafovea GCIPL (2.40[1.25, 6.35] vs 1.40[0.50, 2.45], P = 0.02). No significant interocular asymmetry was found in vessel density between PD and NC. A higher UPDRS-III scale was associated with larger IA in GCIPL (β = 0.093, P = 0.001) and smaller IA in DCP (β = -0.065, P = 0.037). CONCLUSION The motor-symptom-onset side of eyes showed more severe loss of macular vessel density than the other side of eyes. The PD patients showed asymmetrical structural change in GCIPL and pRNFL, which showed the potential as the diagnostic biomarker for PD.
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Affiliation(s)
- Yuqiao Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yan Li
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Chunxin Lai
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China; Shantou University Medical College, Shantou, China
| | - Xinhao Wang
- Department of Neurology, Maoming People's Hospital, Maoming, China
| | - Fulong Luo
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yongyi Niu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China
| | - Yongjie Qin
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Hongyang Zhang
- Department of Ophthalmology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Terravecchia C, Mostile G, Chisari CG, Rascunà C, Terranova R, Cicero CE, Giuliano L, Donzuso G, Sciacca G, Luca A, Preux PM, Jankovic J, Zappia M, Nicoletti A. Retinal Thickness in Essential Tremor and Early Parkinson Disease: Exploring Diagnostic Insights: Response. J Neuroophthalmol 2024:00041327-990000000-00590. [PMID: 38466367 DOI: 10.1097/wno.0000000000002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Affiliation(s)
- Claudio Terravecchia
- Department "G.F. Ingrassia" (CT, GM, CGC, CR, RT, CEC, LG, GD, GS, AL, MZ, AN), Section of Neurosciences, University of Catania, Catania, Italy; Oasi Research Institute-IRCCS (GM), Troina, Italy; INSERM (P-MP), University of Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; and Parkinson's Disease Center and Movement Disorders Clinic (JJ), Department of Neurology, Baylor College of Medicine, Houston, Texas
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Terravecchia C, Mostile G, Chisari CG, Rascunà C, Terranova R, Cicero CE, Giuliano L, Donzuso G, Sciacca G, Luca A, Preux PM, Jankovic J, Zappia M, Nicoletti A. Retinal Thickness in Essential Tremor and Early Parkinson Disease: Exploring Diagnostic Insights. J Neuroophthalmol 2024; 44:35-40. [PMID: 37523235 PMCID: PMC10855993 DOI: 10.1097/wno.0000000000001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND Essential tremor (ET) represents a heterogeneous condition which may overlap with Parkinson disease (PD) even at early stages, by sharing some subtle clinical aspects. Longstanding ET demonstrated also higher risk of developing PD, especially with a Tremor-dominant (TD-PD) phenotype. Therefore, differential diagnosis between ET and early PD could be quite challenging. Optical coherence tomography (OCT) has been recognized as a reliable tool to assess the retina as a proxy of neurodegeneration. We aimed to explore the possible role of retinal assessment in differential diagnosis between ET and early PD. METHODS Macular layers and peripapillary retinal nerve fiber layer (RNFL) thickness among ET, early PD, and healthy controls (HCs) were assessed using OCT. RESULTS Forty-two eyes from 23 ET, 41 eyes from 21 early PD, and 33 eyes from 17 HCs were analyzed. Macular RNFL, ganglion cell layer, inner plexiform layer, and inner nuclear layer were thinner in PD as compared with ET and even more in HCs. Differences between ET and PD were more evident when considering the TD-PD subgroup, especially for RNFL. Among ET patients, thickness of the inner macular layers showed negative linear relationship with both age at onset and disease duration. Peripapillary temporal quadrant thinning was found in ET compared with HCs. CONCLUSIONS Macular inner retina was thinner in patients with ET and early PD compared with HCs. These findings suggest that the retinal assessment may have a utility in the differential diagnosis between ET and PD.
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Giachos I, Doumazos S, Tsiogka A, Manoli K, Tagaris G, Rotsos T, Kozobolis V, Iliopoulos I, Moschos M. Retinal capillary plexus in Parkinson's disease using optical coherence tomography angiography. Int J Ophthalmol 2024; 17:131-136. [PMID: 38239944 PMCID: PMC10754672 DOI: 10.18240/ijo.2024.01.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 11/07/2023] [Indexed: 01/22/2024] Open
Abstract
AIM To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson's disease (PD) using optical coherence tomography angiography (OCT-A). METHODS A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens, "Georgios Gennimatas" from March 2021 to March 2022 was conducted. Totally 44 patients with PD were included and 18 healthy controls were examined, hence a total of 124 eyes were enrolled in the study. The foveal and parafoveal superficial and deep capillary plexus vascular density (fSCP-VD, fDCP-VD, pSCP-VD, pDCP-CD) and foveal avascular zone (FAZ) were quantified with OCTA. Optical coherence tomography (OCT) was used to measure macular thickness. Our statistical analysis was conducted by using a mixed effect linear regression model. RESULTS After adjustment for age and gender, the mean parafoveal superficial capillary plexus vascular density (pSCP-VD) and mean parafoveal deep capillary plexus vascular density (pDCP-VD) were significantly decreased in individuals with PD (P<0.001 in both) by -2.35 (95%CI -3.3, -1.45) and -7.5 (95%CI -10.4, -4.6) respectively. fSCP-VD and fDCP-VD didn't approach statistical significance. The FAZ area and perimeter were significantly decreased (P<0.001 in both) by -0.1 mm2 (95%CI -0.13, -0.07) and -0.49 mm2 (95%CI -0.66, -0.32) respectively. Circularity didn't approach statistical significance. Central retinal thickness (CRT) was significantly decreased in individuals with PD (P<0.001) by -23.1 µm (95%CI -30.2, -16) and temporal retinal thickness (TRT) was decreased (P=0.025) by -11 µm (95%CI -22, -1.5) while nasal retinal thickness (NRT) only approached statistical significance (P=0.066). CONCLUSION The mean pSCP-VD, pDCP-VD, CRT and TRT are significantly decreased and FAZ is altered in individuals with PD. These findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.
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Affiliation(s)
- Ioannis Giachos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Spyridon Doumazos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Anastasia Tsiogka
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Konstantina Manoli
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - George Tagaris
- Department of Neurology, General Hospital of Athens, “Georgios Gennimatas”, Athens 11527, Greece
| | - Tryfon Rotsos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
| | - Vassilios Kozobolis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras 26504, Greece
| | - Ioannis Iliopoulos
- Neurology Department, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Marilita Moschos
- First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
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Salehi MA, Rezagholi F, Mohammadi S, Zakavi SS, Jahanshahi A, Gouravani M, Yazdanpanah G, Seddon I, Jabbehdari S, Singh RP. Optical coherence tomography angiography measurements in Parkinson's disease: A systematic review and meta-analysis. Eye (Lond) 2023; 37:3145-3156. [PMID: 36941403 PMCID: PMC10564940 DOI: 10.1038/s41433-023-02483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/06/2023] [Accepted: 02/28/2023] [Indexed: 03/23/2023] Open
Abstract
Optical coherence tomography angiography (OCT-A) is an ocular imaging technology that has emerged as a non-invasive tool to evaluate retinal microvascular changes in neurodegenerative diseases including Parkinson's disease (PD) and Alzheimer's disease. While several studies have reported on the presence of pathologic retinal microvascular alterations in PD, the utility of OCT-A as a biomarker for PD evaluation is still unclear. A systematic review and meta-analysis were performed to explore the current evidence for the role of OCT-A in PD published up until June 2022. PubMed, Scopus, and Web of Science databases were used to systematically identify relevant papers and a meta-analysis was conducted using Stata16 software according to the level of heterogeneity applying a random- or fixed-effect model. Thirteen studies of 925 eyes in the PD group and 1501 eyes in the control group assessing OCT-A findings in PD patients were included. The meta-analyses revealed that the foveal region of PD patients had a significantly lower vessel density in the superficial capillary plexus (SCP) compared to healthy controls but that there were no significant differences in the foveal avascular zone, the SCP in whole, parafoveal, and perifoveal regions, and deep capillary plexus. OCT-A metrics may act as a potential biomarker for a more accurate and early PD diagnosis. Still, the OCT-A algorithms and interchangeability between OCT-A devices require further standardization to draw clinical conclusions regarding their utility.
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Affiliation(s)
| | - Fateme Rezagholi
- School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Sina Zakavi
- School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Jahanshahi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahdi Gouravani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Yazdanpanah
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Ian Seddon
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Sayena Jabbehdari
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Rishi P Singh
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
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Katsimpris A, Papadopoulos I, Voulgari N, Kandarakis S, Petrou P, Karampitsakos T, Dimitropoulou AN, Katsimpras M, Karamaounas A, Sideri AM, Katsimpris J, Georgalas I, Kymionis G. Optical coherence tomography angiography in Parkinson's disease: a systematic review and meta-analysis. Eye (Lond) 2023; 37:2847-2854. [PMID: 36788361 PMCID: PMC10516969 DOI: 10.1038/s41433-023-02438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 12/09/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND To examine the association between optical coherence tomography angiography (OCTA) retinal measurements and Parkinson's disease (PD). METHODS We searched MEDLINE and EMBASE from inception up to November 5th, 2021 for studies examining the differences between OCTA retinal measurements in PD patients and healthy controls. We used the Hartung-Knapp-Sidik-Jonkman random-effects method to combine study-specific standardized mean differences (SMD) in pooled effect estimates and a meta-analytic extension of the E-value metric to quantify the confounding bias capable of nullifying the pooled estimates. RESULTS Nine eligible studies for our systematic review were identified through our search strategy. The pooled SMD between the retinal vessel density of PD patients and healthy participants in the whole superficial vascular plexus (SVP), foveal SVP, parafoveal SVP and foveal avascular zone (FAZ) was -0.68 (95% CI: -1.18 to -0.17, p value = 0.02, n = 7 studies), -0.14 (95% CI: -0.88 to 0.59, p value = 0.62, n = 5 studies), -0.59 (95% CI: -1.41 to 0.23, p value = 0.12, n = 5 studies) and -0.20 (95% CI: -0.79 to 0.38, p value = 0.39, n = 5 studies), respectively. An unmeasured confounder would need to be associated with a 3.01-fold, 1.54-fold, 2.81-fold and 1.70-fold increase in the risk of PD and OCTA retinal measurements, in order for the pooled SMD estimate of vessel density in whole SVP, parafoveal SVP and FAZ, respectively, to be nullified. CONCLUSIONS Our results provide evidence on an inverse association between whole SVP vessel density and PD.
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Affiliation(s)
- Andreas Katsimpris
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Iason Papadopoulos
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nafsika Voulgari
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stylianos Kandarakis
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Petrou
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Anna Nina Dimitropoulou
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marios Katsimpras
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Aristotelis Karamaounas
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Maria Sideri
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - John Katsimpris
- Department of Ophthalmology, General Hospital of Patras "Agios Andreas", Patras, Greece
| | - Ilias Georgalas
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Kymionis
- First Ophthalmology Department, "G.Gennimatas" Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Castellino N, Scuto S, Zanoli L, Toro MD, Avitabile T, Castellino P, Russo A. Regression of bilateral orbital inflammation with anti-CD20 in a patient with relapsing granulomatosis with polyangiitis: A case report. Eur J Ophthalmol 2023; 33:NP25-NP28. [PMID: 36112868 DOI: 10.1177/11206721221126266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
PURPOSE To describe a case of bilateral orbital inflammation in a patient with relapsing granulomatosis with polyangiitis as only sign of disease recurrency treated with anti-CD20 antibodies. METHODS A 62-year-old Caucasian man affected by Granulomatosis with polyangiitis (GPA) was admitted to our hospital showing bilateral orbital inflammation as the only signs of disease recurrency. In addition, eye visit detected severe visual loss in the left eye (light perception). Guidelines to manage severe orbital involvement in patients with GPA are lacking. The patient was treated with intravenous rituximab and glucocorticoids. RESULTS Complete regression of inflammatory signs by imaging were observed at three-year of follow-up after the treatment with anti-CD20. However, ocular multimodal imaging showed severe optic nerve damages in the left eye with irreversible visual loss. CONCLUSION Patients affected by GPA with inflammatory orbital involvement may benefit from anti-CD20 antibodies.
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Affiliation(s)
| | - Salvatore Scuto
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - Luca Zanoli
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - Mario Damiano Toro
- Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | | | - Pietro Castellino
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
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Zhang L, Zhuang C, Wang Y, Wang H, Cui G, Guo J. Clinical Observation of Macular Superficial Capillary Plexus and Ganglion Cell Complex in Patients with Parkinson's Disease. Ophthalmic Res 2023; 66:1181-1190. [PMID: 37562366 PMCID: PMC10614441 DOI: 10.1159/000533158] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 07/04/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION We investigated macular superficial capillary plexus (SCP) density and the thicknesses of the ganglion cell complex (GCC) in patients with Parkinson's disease (PD) and correlated them. We also observed the correlations between SCP density and clinical parameters of PD patients. The retina might be a novel biomarker of PD and will be useful in the future for the early diagnosis of PD and detecting disease progression. METHODS Seventy-four participants (38 patients with PD and 36 healthy controls) were recruited at the Affiliated Hospital of Xuzhou Medical University between January 2022 and June 2022 in this study. The macular SCP densities was measured by optical coherence tomography angiography (OCTA), and the GCC thickness was measured by optical coherence tomography (OCT). The parameters were compared between PD patients and healthy controls. The correlation between SCP and clinical parameters was tested. RESULTS Compared with the control group, PD patients showed reduced SCP densities in all areas of the macular region (parafovea-temporal: t = 3.053, p = 0.003; parafovea-superior: t = 3.680, p = 0.001; parafovea-nasal: t = 4.643, p < 0.001; parafovea-inferior: t = 2.254, p = 0.027; perifovea-temporal: t = 3.798, p < 0.001; perifovea-superior: t = 3.014, p = 0.004; perifovea-nasal: t = 2.948, p = 0.004; perifovea-inferior: t = 3.337, p = 0.021). The average GCC thickness in the PD patients was significantly reduced (t = 2.365, p = 0.021). There were positive correlations between the average GCC thickness and the SCP densities in most of the areas of the macular regions in PD patients (parafovea-temporal: r = 0.325, p = 0.005; parafovea-superior: r = 0.295, p = 0.011; parafovea-nasal: r = 0.335, p = 0.003; perifovea-superior: r = 0.362, p = 0.002; perifovea-nasal: r = 0.290, p = 0.012; perifovea-inferior: r = 0.333, p = 0.004). We found significant correlations between SCP densities and Hoehn and Yahr (H and Y) scales, UPDRS III scores, and MMSE scores. No significant correlation was observed between SCP density and PD disease duration (all p > 0.05). CONCLUSIONS We demonstrated that the macular SCP density was decreased, and the average GCC thickness was reduced in PD patients. The correlation between SCP density damage and GCC thinning also suggested that the retinal microvascular damage may be associated with retinal structural degeneration in PD patients. OCTA and OCT may be considered objective biomarkers for detecting microvascular impairment and neuronal damage in the early stages of PD in the future.
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Affiliation(s)
- Ling Zhang
- Department of Ophthalmology, Xuzhou Medical University, Xuzhou, China
| | - Chuchu Zhuang
- Department of Ophthalmology, Xuzhou Medical University, Xuzhou, China
| | - Yining Wang
- Department of Ophthalmology, Xuzhou Medical University, Xuzhou, China
| | - He Wang
- Department of Ophthalmology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jianxin Guo
- Department of Ophthalmology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Pérez-Acuña D, Rhee KH, Shin SJ, Ahn J, Lee JY, Lee SJ. Retina-to-brain spreading of α-synuclein after intravitreal injection of preformed fibrils. Acta Neuropathol Commun 2023; 11:83. [PMID: 37210559 PMCID: PMC10199563 DOI: 10.1186/s40478-023-01575-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/30/2023] [Indexed: 05/22/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by the aggregation of misfolded α-synuclein and progressive spreading of the aggregates from a few discrete regions to wider brain regions. Although PD has been classically considered a movement disorder, a large body of clinical evidence has revealed the progressive occurrence of non-motor symptoms. Patients present visual symptoms in the initial stages of the disease, and accumulation of phospho-α-synuclein, dopaminergic neuronal loss, and retinal thinning has been observed in the retinas of PD patients. Based on such human data, we hypothesized that α-synuclein aggregation can initiate in the retina and spread to the brain through the visual pathway. Here, we demonstrate accumulation of α-synuclein in the retinas and brains of naive mice after intravitreal injection of α-synuclein preformed fibrils (PFFs). Histological analyses showed deposition of phospho-α-synuclein inclusions within the retina 2 months after injection, with increased oxidative stress leading to loss of retinal ganglion cells and dopaminergic dysfunction. In addition, we found accumulation of phospho-α-synuclein in cortical areas with accompanying neuroinflammation after 5 months. Collectively, our findings suggest that retinal synucleinopathy lesions initiated by intravitreal injection of α-synuclein PFFs spread to various brain regions through the visual pathway in mice.
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Affiliation(s)
- Dayana Pérez-Acuña
- Department of Biomedical Sciences, Seoul National University College of Medicine, 103 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea
| | - Ka Hyun Rhee
- Department of Biomedical Sciences, Seoul National University College of Medicine, 103 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Soo Jean Shin
- Department of Biomedical Sciences, Seoul National University College of Medicine, 103 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea
| | - Jeeyun Ahn
- Department of Ophthalmology, College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University, Seoul, South Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Jae Lee
- Department of Biomedical Sciences, Seoul National University College of Medicine, 103 Daehak-Ro, Jongro-Gu, Seoul, 03080, Korea.
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
- Convergence Research Center for Dementia, Seoul National University College of Medicine, Seoul, South Korea.
- Neuramedy, Seoul, South Korea.
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Central retinal microvasculature damage is associated with orthostatic hypotension in Parkinson's disease. NPJ Parkinsons Dis 2023; 9:36. [PMID: 36894544 PMCID: PMC9998652 DOI: 10.1038/s41531-023-00480-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
Orthostatic hypotension (OH) is a common non-motor symptom in Parkinson's disease (PD). OH can cause cerebral and retinal hypoperfusion and is associated with microvascular damage in PD. Optical coherence tomography angiography (OCTA) is a non-invasive technology that can be used to visualize the retinal microvasculature and detect microvascular damage in PD. In the present study, 51 PD patients (OH+, n = 20, 37 eyes; OH-, n = 32, 61 eyes) and 51 healthy controls (100 eyes) were evaluated. The Unified Parkinson's Disease Rating Scale III, Hoehn and Yahr scale, Montreal Cognitive Assessment, levodopa equivalent daily dose, and vascular risk factors, including hypertension, diabetes, and dyslipidemia, were investigated. PD patients underwent a head-up tilt (HUT) test. The PD patients had a lower superficial retinal capillary plexus (SRCP) density in the central region than control patients. The PDOH+ group had lower vessel density in the SRCP of the central region compared with the control group and lower vessel density in the DRCP of the central region than the PDOH- and control groups. The changes in systolic and diastolic blood pressure during the HUT test in PD patients showed a negative correlation with the vessel density in the DRCP central region. The presence of OH was a critical factor associated with central microvasculature damage in PD. These findings indicate that OCTA can be a useful and non-invasive tool for detecting microvasculature damage in PD patients.
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12
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Christou EE, Konitsiotis S, Pamporis K, Giannakis A, Asproudis C, Stefaniotou M, Asproudis I. Inner retinal layers' alterations of the microvasculature in early stages of Parkinson's disease: a cross sectional study. Int Ophthalmol 2023:10.1007/s10792-023-02653-x. [PMID: 36869977 DOI: 10.1007/s10792-023-02653-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/19/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE To investigate microcirculation characteristics of the inner retinal layers at the macula and the peripapillary area using Optical Coherence Tomography Angiography (OCT-A) of patients in early stages of Parkinson's disease (PD). METHODS 32 PD patients and 46 age- and gender-matched healthy controls were included in this cross sectional study. OCT-A imaging was performed to analyze microcirculation characteristics at each separate macular region (fovea, parafovea, and perifovea) and the peripapillary area of the inner retinal layers. RESULTS Individuals with PD had significantly lower parafoveal, perifoveal and total vessel density (VD) in the superficial capillary plexus (SCP) than controls (all p < 0.001), while foveal VD was higher in PD eyes than that of controls, though not statistically significant. Similarly, individuals with PD had significantly lower parafoveal, perifoveal and total perfusion in the SCP than control eyes (all p < 0.001), while foveal perfusion was significantly higher in PD eyes than that of controls (p = 0.008). PD eyes had significantly smaller FAZ area and perimeter accompanied by decreased circularity at the SCP as compared to controls (all p < 0.001). Concerning the peripapillary area, individuals with PD had significantly lower radial peripapillary capillary perfusion density and flux index at the SCP than controls (all p < 0.001). All p values remained statistically significant even after using the Bonferroni correction for multiple comparisons, except for that of foveal perfusion. CONCLUSIONS Our study indicates alterations of the inner retinal layers at the macula and the peripapillary area at the preliminary stages of PD. OCT-A parameters could potentially comprise imaging biomarkers for PD screening and improve the diagnostic algorithms.
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Affiliation(s)
- Evita Evangelia Christou
- Department of Ophthalmology, Faculty of Medicine, University Hospital of Ioannina, 45110, Ioannina, Greece.
| | - Spiridon Konitsiotis
- Department of Neurology, Faculty of Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Konstantinos Pamporis
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Alexandros Giannakis
- Department of Neurology, Faculty of Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Christoforos Asproudis
- Department of Ophthalmology, Faculty of Medicine, University Hospital of Ioannina, 45110, Ioannina, Greece
| | - Maria Stefaniotou
- Department of Ophthalmology, Faculty of Medicine, University Hospital of Ioannina, 45110, Ioannina, Greece
| | - Ioannis Asproudis
- Department of Ophthalmology, Faculty of Medicine, University Hospital of Ioannina, 45110, Ioannina, Greece
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13
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The Role of Alpha-Synuclein Deposits in Parkinson's Disease: A Focus on the Human Retina. Int J Mol Sci 2023; 24:ijms24054391. [PMID: 36901822 PMCID: PMC10002434 DOI: 10.3390/ijms24054391] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative condition characterized by the progressive deterioration of dopaminergic neurons in the central and peripheral autonomous system and the intraneuronal cytoplasmic accumulation of misfolded α-synuclein. The clinical features are the classic triad of tremor, rigidity, and bradykinesia and a set of non-motor symptoms, including visual deficits. The latter seems to arise years before the onset of motor symptoms and reflects the course of brain disease. The retina, by virtue of its similarity to brain tissue, is an excellent site for the analysis of the known histopathological changes of PD that occur in the brain. Numerous studies conducted on animal and human models of PD have shown the presence of α-synuclein in retinal tissue. Spectral-domain optical coherence tomography (SD-OCT) could be a technique that enables the study of these retinal alterations in vivo. The objective of this review is to describe recent evidence on the accumulation of native or modified α-synuclein in the human retina of patients with PD and its effects on the retinal tissue evaluated through SD-OCT.
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14
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Edwards MM, McLeod DS, Grebe R, Bhutto IA, Dahake R, Crumley K, Lutty GA. Glial remodeling and choroidal vascular pathology in eyes from two donors with Choroideremia. FRONTIERS IN OPHTHALMOLOGY 2022; 2:994566. [PMID: 38983545 PMCID: PMC11182301 DOI: 10.3389/fopht.2022.994566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/26/2022] [Indexed: 07/11/2024]
Abstract
Choroideremia (CHM) is a recessive, X-linked disease that affects 1 in 50,000 people worldwide. CHM causes night blindness in teenage years with vision loss progressing over the next two to three decades. While CHM is known to cause progressive loss of retinal pigment epithelial (RPE) cells, photoreceptors and choroidal vessels, little attention has been given to retinal glial changes in eyes with CHM. In addition, while choroidal loss has been observed clinically, no histopathologic assessment of choroidal loss has been done. We investigated glial remodeling and activation as well as choriocapillaris changes and their association with RPE loss in postmortem eyes from two donors with CHM. Eyes were fixed and cryopreserved or the retina and choroid/RPE were processed as flatmounts with a small piece cut for transmission electron microscopy. A dense glial membrane, made up of vimentin and GFAP double-positive cells, occupied the subretinal space in the area of RPE and photoreceptor loss of both eyes. The membranes did not extend into the far periphery, where RPE and photoreceptors were viable. A glial membrane was also found on the vitreoretinal surface. Transmission electron microscopy analysis demonstrated prominence and disorganization of glial cells, which contained exosome-like vesicles. UEA lectin demonstrated complete absence of choriocapillaris in areas with RPE loss while some large choroidal vessels remained viable. In the far periphery, where the RPE monolayer was intact, choriocapillaris appeared normal. The extensive glial remodeling present in eyes with CHM should be taken into account when therapies such as stem cell replacement are considered as it could impede cells entering the retina. This gliosis would also need to be reversed to some extent for Müller cells to perform their normal homeostatic functions in the retina. Future studies investigating donor eyes as well as clinical imaging from carriers or those with earlier stages of CHM will prove valuable in understanding the glial changes, which could affect disease progression if they occur early. This would also provide insights into the progression of disease in the photoreceptor/RPE/choriocapillaris complex, which is crucial for identifying new treatments and finding the windows for treatment.
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Affiliation(s)
- Malia M Edwards
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - D Scott McLeod
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rhonda Grebe
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Imran A Bhutto
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Richa Dahake
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kelly Crumley
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Gerard A Lutty
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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15
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Zhang C, Wu QQ, Hou Y, Wang Q, Zhang GJ, Zhao WB, Wang X, Wang H, Li WG. Ophthalmologic problems correlates with cognitive impairment in patients with Parkinson's disease. Front Neurosci 2022; 16:928980. [PMID: 36278010 PMCID: PMC9583907 DOI: 10.3389/fnins.2022.928980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Visual impairment is a common non-motor symptom (NMS) in patients with Parkinson's disease (PD) and its implications for cognitive impairment remain controversial. We wished to survey the prevalence of visual impairment in Chinese Parkinson's patients based on the Visual Impairment in Parkinson's Disease Questionnaire (VIPD-Q), identify the pathogens that lead to visual impairment, and develop a predictive model for cognitive impairment risk in Parkinson's based on ophthalmic parameters. Methods A total of 205 patients with Parkinson's disease and 200 age-matched controls completed the VIPD-Q and underwent neuro-ophthalmologic examinations, including ocular fundus photography and optical coherence tomography. We conducted nomogram analysis and the predictive model was summarized using the multivariate logistic and LASSO regression and verified via bootstrap validation. Results One or more ophthalmologic symptoms were present in 57% of patients with Parkinson's disease, compared with 14% of the controls (χ2-test; p < 0.001). The visual impairment questionnaire showed good sensitivity and specificity (area under the curve [AUC] = 0.918, p < 0.001) and a strong correlation with MoCA scores (Pearson r = −0.4652, p < 0.001). Comparing visual impairment scores between pre- and post-deep brain stimulation groups showed that DBS improved visual function (U-test, p < 0.001). The thickness of the retinal nerve fiber layer and vessel percentage area predicted cognitive impairment in PD. Interpretation The study findings provide novel mechanistic insights into visual impairment and cognitive decline in Parkinson's disease. The results inform an effective tool for predicting cognitive deterioration in Parkinson's based on ophthalmic parameters.
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Affiliation(s)
- Chao Zhang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
| | - Qian-qian Wu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China
| | - Ying Hou
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Qi Wang
- Department of Gerontology, Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Guang-jian Zhang
- Department of Neurology, Weifang People's Hospital, Weifang, China
| | - Wen-bo Zhao
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
| | - Xu Wang
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
| | - Hong Wang
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China
| | - Wei-guo Li
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China
- *Correspondence: Wei-guo Li
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16
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Deng Y, Jie C, Wang J, Liu Z, Li Y, Hou X. Evaluation of retina and microvascular changes in the patient with Parkinson's disease: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:957700. [PMID: 36186761 PMCID: PMC9520292 DOI: 10.3389/fmed.2022.957700] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background Parkinson's disease (PD) is a multifaceted neurodegenerative disease. The optic nerve, as a window into the central nervous system (CNS), is known to be an important part of the CNS and can be detected non-invasively. With the widespread availability of optical coherence tomography (OCT) devices, an increasing number of studies have paid attention to the neuropathological disorders in the retina of PD patients in recent years. However, it is still controversial whether OCT can be used as a complementary tool for PD diagnosis. Methods This review is registered with PROSPERO, number CRD42022301258. The Embase, PUBMED, and The Cochrane Library databases were independently retrieved by 2 investigators to identify relevant papers published from 1 January 2017 to 24 January 2022. These studies used OCT or OCTA to evaluate the difference in the retinal nerve fiber layer (RNFL) thickness, ganglion cell layer(GCL) thickness, macula thickness, Cup and disk area superficial retinal capillary plexus (SCP), and deep retinal capillary plexus(DCP). The standard mean difference (SMD) with the 95% confidence interval (CI) was pooled for continuous outcomes. Results In total, 26 studies had been enrolled in this meta-analysis with a total number of 2,790 eyes, including 1,343 eyes from the PD group along with 1,447 eyes from the HC group. The results revealed that the RNFL thickness (SMD: -0.53; 95%CI, -0.71∼-0.35; P < 0.00001), GCL thickness (SMD: -0.43; 95%CI, -0.66 to -0.19; P = 0.0003), macula thickness (SMD: -0.22; 95%CI, -0.22 to -0.11; P < 0.0001) were significantly thinner in patients with PD. The SCP (SMD: -0.61; 95%CI, -1.31to -0.10; P = 0.02) was significantly lower in PD patients. The DCP (SMD: -0.48; 95%CI, -1.02 to -0.06; P = 0.08) is lower in PD patients, but the difference was statistically insignificant. Conclusion Retinal nerve fiber layer thickness, GCL thickness, macular thickness, and SVD of PD patients are lower than those of healthy control. OCT and OCTA could detect morphological retinal changes in PD and might be objective and reproducible auxiliary tools to assist clinician diagnosis. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022301258].
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Affiliation(s)
| | - Chuanhong Jie
- Eye Hospital China Academy of Chinese Medical Sciences, Beijing, China
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17
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Mello LGM, Paraguay IBB, Andrade TDS, Rocha AADN, Barbosa ER, Oyamada MK, Monteiro MLR. Electroretinography reveals retinal dysfunction in Parkinson's disease despite normal high-resolution optical coherence tomography findings. Parkinsonism Relat Disord 2022; 101:90-95. [PMID: 35810523 DOI: 10.1016/j.parkreldis.2022.06.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Parkinson's disease (PD)-associated inner retinal abnormalities, particularly the retinal ganglion cells (RGC) layer, on optical coherence tomography (OCT) have recently gained importance as a biomarker of non-motor involvement of the disease but functional RGC evaluation using photopic negative response (PhNR) has not yet been determined. This study aims to compare structural and functional findings of the retina and optic nerve in PD with healthy controls (CT) including PhNR and OCT. METHODS Forty-one eyes of 21 PD patients and 38 eyes of 19 CT underwent ophthalmic examination including visual contrast sensitivity test (CS), OCT, light-adapted full-field electroretinography (ffERG), and PhNR. OCT was used to measure the peripapillary retinal nerve fiber layer, the segmented macular layers, and the choroid. For functional parameters, CS, ffERG (oscillatory potentials, photopic response, 30 Hz-flicker), and PhNR waves were used. Measurements were compared using generalized estimating equation and significance was set at P ≤ 0.05. RESULTS The PD group presented a significantly lower mono- and binocular CS, oscillatory potentials amplitude, b-wave amplitude on ffERG (152.3[45.4] vs 187.1[32.7]μV; P = 0.002), and PhNR amplitude (135.0[35.0] vs 156.3[34.1]μV; P = 0.025). There was no statistically significant difference in OCT measurements between groups. No correlation was found between statistically significant measurements and clinical data. CONCLUSIONS Functional abnormalities on CS, ffERG, and PhNR can be detected in PD even when structural damages are not observed on OCT. PhNR represents a new potential biomarker in PD. Our findings indicate dysfunction of bipolar, amacrine, and retinal ganglion cells in PD, probably with a cellular dysfunction overcoming morphological damage.
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Affiliation(s)
- Luiz Guilherme Marchesi Mello
- Division of Ophthalmology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil; Department of Specialized Medicine, Centro de Ciências da Saúde (CCS), Universidade Federal do Espírito Santo, Vitória, Brazil.
| | | | - Thais de Souza Andrade
- Division of Ophthalmology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | - Egberto Reis Barbosa
- Division of Neurology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Kiyoko Oyamada
- Division of Ophthalmology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Augustin AJ, Atorf J. The Value of Optical Coherence Tomography Angiography (OCT-A) in Neurological Diseases. Diagnostics (Basel) 2022; 12:diagnostics12020468. [PMID: 35204559 PMCID: PMC8871393 DOI: 10.3390/diagnostics12020468] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/26/2022] [Accepted: 02/09/2022] [Indexed: 12/05/2022] Open
Abstract
Optical coherence tomography angiography (OCT-A) was commercially introduced in 2014. OCT-A allows a fast, non-invasive, three-dimensional analysis of the retinal vasculature from the vitreoretinal interface to the choriocapillaris. The results can be evaluated separately in automated or custom-defined retinal layers. Since its introduction, OCT-A has also been used in patients with neurological diseases in order to find and characterize retinal biomarkers. Many neurological diseases have retinal manifestations, often preceding the key symptoms of the neurological disease. Anatomically and developmentally, the retina is a part of the brain. In contrast to the brain, the retina is easily accessible for imaging methods; moreover, retinal imaging is more cost-effective than brain imaging. In this review, the current knowledge about OCT-A findings and possible OCT-A biomarkers in neurological diseases is summarized and discussed regarding the value of OCT-A as a diagnostic tool in neurological diseases.
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Ranjbar M, Plöttner P, Sochurek JAM, Lauermann JL, Alten F, Prasuhn J, Kasten M, Brüggemann N. The impact of motion artifacts on quantitative optical coherence tomography angiography analysis in Parkinson's disease. Parkinsonism Relat Disord 2022; 95:57-58. [PMID: 35032741 DOI: 10.1016/j.parkreldis.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 10/19/2022]
Abstract
We have previously shown that OCTA imaging in PD patients can be challenging. Our data suggest that retinal perfusion is reduced in both plexuses in PD, which may serve as a noninvasive biomarker in the future. Yet, control of motion artifacts in OCTA measurements is critical in this motor-impaired cohort.
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Affiliation(s)
- Mahdy Ranjbar
- Department of Ophthalmology, University of Lübeck, Germany; Laboratory for Angiogenesis and Ocular Cell Transplantation, University of Lübeck, Germany.
| | - Pauline Plöttner
- Laboratory for Angiogenesis and Ocular Cell Transplantation, University of Lübeck, Germany; Department of Neurology, University of Lübeck, Germany
| | - Jan A M Sochurek
- Laboratory for Angiogenesis and Ocular Cell Transplantation, University of Lübeck, Germany
| | | | - Florian Alten
- Department of Ophthalmology, University of Münster, Germany
| | - Jannik Prasuhn
- Department of Neurology, University of Lübeck, Germany; Institute of Neurogenetics, University of Lübeck, Germany; Center for Brain, Behavior and Metabolism (CBBM), University of Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Norbert Brüggemann
- Department of Neurology, University of Lübeck, Germany; Institute of Neurogenetics, University of Lübeck, Germany; Center for Brain, Behavior and Metabolism (CBBM), University of Lübeck, Germany
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20
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Christou EE, Asproudis I, Asproudis C, Giannakis A, Stefaniotou M, Konitsiotis S. Macular microcirculation characteristics in Parkinson's disease evaluated by OCT-Angiography: a literature review. Semin Ophthalmol 2021; 37:399-407. [PMID: 34612157 DOI: 10.1080/08820538.2021.1987482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Given the fact that retina may provide a window into the central nervous system, there has been interest in identifying retinal biomarkers as predicting factors of pathological processes in neurodegenerative disorders. Emerging evidence has suggested that macular microcirculation changes in Parkinson disease (PD) may indicate the alterations of cerebral microvasculature. The use of Optical Coherence Tomography Angiography (OCT-A) has attracted significant attention in recent years as this technique offers a detailed analysis of the existence of changes at the macular capillary plexus. METHODS A detailed review of the literature was performed in PubMed until June 2021. We identified all papers referring to the alterations of the macular capillary plexus in PD using OCT-A. RESULTS A comprehensive update indicates that microvasculature alterations of the macular capillary plexus utilizing OCT-A may comprise useful biomarkers regarding the cerebral vasculature in PD. Since the available evidence is limited, additional studies are warranted to establish the OCT-A parameters as predicting factors in clinical practice. CONCLUSIONS A review of the existing literature sheds light on the microvasculature changes of the macular capillary plexus as seen on OCT-A in PD patients. The current article discusses notable aspects of key publications on the topic, highlights the importance of the potential long-term effectiveness of OCT-A biomarkers in PD and proposes the need for further future research.
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Affiliation(s)
- Evita Evangelia Christou
- Faculty of Medicine, Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
| | - Ioannis Asproudis
- Faculty of Medicine, Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
| | - Christoforos Asproudis
- Faculty of Medicine, Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
| | - Alexandros Giannakis
- Faculty of Medicine, Department of Neurology, University Hospital of Ioannina, Ioannina, Greece
| | - Maria Stefaniotou
- Faculty of Medicine, Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece
| | - Spiridon Konitsiotis
- Faculty of Medicine, Department of Neurology, University Hospital of Ioannina, Ioannina, Greece
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21
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Zhou M, Wu L, Hu Q, Wang C, Ye J, Chen T, Wan P. Visual Impairments Are Associated With Retinal Microvascular Density in Patients With Parkinson's Disease. Front Neurosci 2021; 15:718820. [PMID: 34475812 PMCID: PMC8406760 DOI: 10.3389/fnins.2021.718820] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/14/2021] [Indexed: 11/28/2022] Open
Abstract
Objective This study aimed to evaluate retinal microvascular density in patients with Parkinson’s disease (PD) and its correlation with visual impairment. Methods This cross-sectional study included 24 eyes of 24 patients with PD and 23 eyes of 23 healthy controls. All participants underwent ophthalmic examination, visual evoked potential (VEP) test, 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), and optical coherence tomography angiography (OCTA) examination. The correlation between retinal microvascular density and visual parameter was evaluated using Spearman correlation analysis, and the area under receiver operating characteristic curve (AUROC) was calculated. Results Parkinson’s disease patients had prolonged P100 latency (P = 0.041), worse vision-related quality of life (composite score and 3 of 12 subscales in NEI VFQ-25), and decreased vessel density (VD) in all sectors of 3-mm-diameter region (all P < 0.05) compared with healthy controls. There were no statistical differences in the ganglion cell-inner plexiform layer (GCIPL) thickness and retinal nerve fiber layer (RNFL) thickness between the two groups. A negative correlation was found between P100 latency and nasal and superior sectors of macular VD in a 3-mm-diameter region (r = −0.328, P = 0.030; r = −0.302, and P = 0.047, respectively). Macular VD in a 3-mm-diameter region showed diagnostic capacities to distinguish PD patients from healthy controls (AUROCs, ranging from 0.655 to 0.723). Conclusion This study demonstrated that decreased retinal microvascular density was correlated with visual impairment in PD patients. Retinal microvasculature change may occur earlier than visual decline and retinal structure change and has the potential to be a promising diagnostic marker for early PD.
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Affiliation(s)
- Min Zhou
- Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Wu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qinyuan Hu
- Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Congyao Wang
- Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiacheng Ye
- Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tingting Chen
- Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pengxia Wan
- Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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22
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Moons L, De Groef L. Multimodal retinal imaging to detect and understand Alzheimer's and Parkinson's disease. Curr Opin Neurobiol 2021; 72:1-7. [PMID: 34399146 DOI: 10.1016/j.conb.2021.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/01/2021] [Accepted: 07/14/2021] [Indexed: 12/28/2022]
Abstract
Retinal neurodegeneration and visual dysfunctions have been reported in a majority of Alzheimer's and Parkinson's patients, and, in light of the quest for novel biomarkers for these neurodegenerative proteinopathies, the retina has been receiving increasing attention as an organ for diagnosing, monitoring, and understanding disease. Thinning of retinal layers, abnormalities in vasculature, and protein deposition can be imaged at unprecedented resolution, which offers a unique systems biology view on the cellular and molecular changes underlying these pathologies. It makes the retina not only a promising target for biomarker development, but it also suggests that novel fundamental insights into the pathophysiology of Alzheimer's and Parkinson's disease can be obtained by studying the retina-brain axis.
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Affiliation(s)
- Lieve Moons
- Neural Circuit Development and Regeneration Research Group, Biology Department, University of Leuven, Naamsestraat 61 Box 2464, Leuven, 3000, Belgium; Leuven Brain Institute, Leuven, 3000, Belgium.
| | - Lies De Groef
- Neural Circuit Development and Regeneration Research Group, Biology Department, University of Leuven, Naamsestraat 61 Box 2464, Leuven, 3000, Belgium; Leuven Brain Institute, Leuven, 3000, Belgium
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23
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Zhang Y, Zhang D, Gao Y, Yang L, Tao Y, Xu H, Man S, Zhang M, Xu Y. Retinal Flow Density Changes in Early-stage Parkinson's Disease Investigated by Swept-Source Optical Coherence Tomography Angiography. Curr Eye Res 2021; 46:1886-1891. [PMID: 34348531 DOI: 10.1080/02713683.2021.1933054] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Parkinson's Disease (PD) is the second-most common neurodegenerative disease affecting the elderly population. The eye has been referred to as a window to the brain due to its inseparable relationship with the central nervous system. The development of Swept-Source Optical Coherence Tomography (SS-OCT) and Optical Coherence Tomography Angiography (OCTA) technologies has offered us a better imaging modality to study the impact of PD on the retina.Method: Seventy-five eyes of 42 early-stage PD patients and 150 eyes of 75 matched healthy controls were enrolled in the current study. We performed SS-OCT and SS-OCTA to assess retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) + inner plexiform layer (IPL), internal nuclear layer (INL) thickness, and retinal flow density and flow ratio.Results: Our study indicates decreasing superficial and deep flow density in most regions of the retina. Superficial and deep flow parameters were also associated with RNFL, GCL+IPL, and INL thickness. ROC analysis reveals superficial flow density demonstrated an Area Under Curve (AUC) of 0.688, which is greater than deep flow density and retinal thickness measurements.Conclusion: To the best of our knowledge, we are the first study using SS-OCT and SS-OCTA to study superficial and deep retinal flow changes in early-stage PD patients. Our study suggests decreasing retinal flow density provides greater diagnostic power than retinal thickness measurements in the early stage of PD. SS-OCTA parameters could potentially serve as imaging biomarkers in PD diagnosis and staging.
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Affiliation(s)
- Yifan Zhang
- Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Dan Zhang
- Department of Neurology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yuzhu Gao
- Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Li Yang
- Department of Neurology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yunhan Tao
- Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Hanyue Xu
- Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Shulei Man
- Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Ming Zhang
- Department of Ophthalmology, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yanming Xu
- Department of Neurology, Sichuan University West China Hospital, Chengdu, Sichuan, China
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24
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Murueta-Goyena A, Barrenechea M, Erramuzpe A, Teijeira-Portas S, Pengo M, Ayala U, Romero-Bascones D, Acera M, Del Pino R, Gómez-Esteban JC, Gabilondo I. Foveal Remodeling of Retinal Microvasculature in Parkinson's Disease. Front Neurosci 2021; 15:708700. [PMID: 34321998 PMCID: PMC8311167 DOI: 10.3389/fnins.2021.708700] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background Retinal microvascular alterations have been previously described in Parkinson’s disease (PD) patients using optical coherence tomography angiography (OCT-A). However, an extensive description of retinal vascular morphological features, their association with PD-related clinical variables and their potential use as diagnostic biomarkers has not been explored. Methods We performed a cross-sectional study including 49 PD patients (87 eyes) and 40 controls (73 eyes). Retinal microvasculature was evaluated with Spectralis OCT-A and cognitive status with Montreal Cognitive Assessment. Unified PD Rating Scale and disease duration were recorded in patients. We extracted microvascular parameters from superficial and deep vascular plexuses of the macula, including the area and circularity of foveal avascular zone (FAZ), skeleton density, perfusion density, vessel perimeter index, vessel mean diameter, fractal dimension (FD) and lacunarity using Python and MATLAB. We compared the microvascular parameters between groups and explored their association with thickness of macular layers and clinical outcomes. Data were analyzed with General Estimating Equations (GEE) and adjusted for age, sex, and hypertension. Logistic regression GEE models were fitted to predict diagnosis of PD versus controls from microvascular, demographic, and clinical data. The discrimination ability of models was tested with receiver operating characteristic curves. Results FAZ area was significantly smaller in patients compared to controls in superficial and deep plexuses, whereas perfusion density, skeleton density, FD and lacunarity of capillaries were increased in the foveal zone of PD. In the parafovea, microvascular parameters of superficial plexus were associated with ganglion cell-inner plexiform layer thickness, but this was mainly driven by PD with mild cognitive impairment. No such associations were observed in controls. FAZ area was negatively associated with cognition in PD (non-adjusted models). Foveal lacunarity, combined with demographic and clinical confounding factors, yielded an outstanding diagnostic accuracy for discriminating PD patients from controls. Conclusion Parkinson’s disease patients displayed foveal microvascular alterations causing an enlargement of the vascular bed surrounding FAZ. Parafoveal microvascular alterations were less pronounced but were related to inner retinal layer thinning. Retinal microvascular abnormalities helped discriminating PD from controls. All this supports OCT-A as a potential non-invasive biomarker to reveal vascular pathophysiology and improve diagnostic accuracy in PD.
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Affiliation(s)
- Ane Murueta-Goyena
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Maitane Barrenechea
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - Asier Erramuzpe
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - Sara Teijeira-Portas
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Marta Pengo
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Unai Ayala
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - David Romero-Bascones
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - Marian Acera
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Rocío Del Pino
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neurology Department, Cruces University Hospital, Barakaldo, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Iñigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neurology Department, Cruces University Hospital, Barakaldo, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain
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25
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Rascunà C, Cicero CE, Chisari CG, Russo A, Giuliano L, Castellino N, Terravecchia C, Grillo M, Longo A, Avitabile T, Zappia M, Reibaldi M, Nicoletti A. Retinal thickness and microvascular pathway in Idiopathic Rapid eye movement sleep behaviour disorder and Parkinson's disease. Parkinsonism Relat Disord 2021; 88:40-45. [PMID: 34118642 DOI: 10.1016/j.parkreldis.2021.05.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Retinal impairment has previously been described in Parkinson's Disease (PD), also in early stage of disease. Idiopathic Rapid-eye-movement sleep Behavior Disorder (iRBD) is considered the strongest marker in the diagnosis of "Prodromal PD". Thus, we evaluated the thickness of retinal layers and the microvascular retinal pattern in a group of iRBD patients compared to PD and healthy subjects (HCs). METHODS retinal layer's thickness and microvascular pattern among PD, iRBD and HCs were assessed using Spectral-Density Optical Coherence Tomography (SD-OCT) and OCT-Angiography (OCT-A), respectively. RESULTS Forty-one eyes from 21 PD, 37 eyes from 19 iRBD and 33 eyes from 17 HCs were analysed. Peripapillary Retinal Nerve Fiber Layer (RNFL) was thinner in PD and RBD compared to HCs. All macular retinal layers, except for retinal pigment epithelium, resulted to be significantly thinner in iRBD and in PD compared to HCs, also adjusting by age, sex and hypertension. Macular RNFL and ganglionic cell layer were thinner in PD compared to iRBD. Moreover, in iRBD, a peculiar microvascular pattern was found, characterized by a higher vascularization of the deep capillary plexus with respect both PD patients and HCs. CONCLUSION in PD and iRBD patients retina was thinner than HCs, and values of iRBD were between PD and HCs. Moreover, in iRBD, a peculiar microvascular pattern has been found, characterized by a higher vascularization of the deep capillary plexus. Our findings suggest that retina might be considered a biomarker of neurodegeneration in iRBD, easily estimable using non-invasive tool such as OCT and OCT-A.
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Affiliation(s)
- Cristina Rascunà
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Clara Grazia Chisari
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Loretta Giuliano
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | | | - Claudio Terravecchia
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Marco Grillo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Teresio Avitabile
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
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26
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Castellino N, Longo A, Fallico M, Russo A, Bonfiglio V, Cennamo G, Fossataro F, Fabbrocini G, Balato A, Parisi G, D'urso RM, Lacarrubba F, Musumeci ML, Alosi P, Petrillo F, Micali G, Avitabile T, Reibaldi M. Retinal Vascular Assessment in Psoriasis: A Multicenter Study. Front Neurosci 2021; 15:629401. [PMID: 33568971 PMCID: PMC7868328 DOI: 10.3389/fnins.2021.629401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/06/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the vascular status of the macula in psoriasis patients without history of ocular inflammation by Optical Coherence Tomography Angiography (OCTA). Methods This prospective cross-sectional multicenter study included 55 psoriasis patients and 55 control healthy subjects. A complete eye examination and 6 mm × 6 mm OCTA imaging were performed. Retinal vascular status was evaluated by analyzing vascular density (VD) of superficial vascular plexus (superficial wVD) and deep vascular plexuses (deep wVD) in a 6 mm × 6 mm area and in foveal (superficial fVD and deep fVD) and parafoveal sectors (superficial pVD and deep pVD). In addition, foveal thickness (FT) and foveal avascular zone (FAZ) and clinical variables, including best corrected visual acuity (BCVA), intraocular pressure and refractive condition, were collected. Results BCVA, intraocular pressure and refractive condition were comparable between cases and controls. OCTA imaging showed that superficial wVD and superficial pVD were lower in the psoriasis group in comparison with controls (p = 0.009 and p = 0.01, respectively). Similarly, deep wVD and pVD were lower in the psoriasis group in comparison with control subjects (p = 0.03 and p = 0.01, respectively). In a sub-analysis of 47 patients affected by psoriasis without psoriatic arthritis, lower values of wVD and pVD in both superficial and deep capillary plexuses were registered. Conclusion OCTA is a useful tool which provides data on vascular status of the retina in psoriasis with no ocular involvement. VD data may suggest that vascular changes may occur earlier than clinical onset of posterior inflammation.
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Affiliation(s)
| | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Vincenza Bonfiglio
- Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Palermo, Italy
| | - Gilda Cennamo
- Public Health Department, University of Naples Federico II, Naples, Italy
| | - Federica Fossataro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Anna Balato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Guglielmo Parisi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Rosa Maria D'urso
- Department of Surgical Science, Dermatology Clinic, University of Catania, Catania, Italy
| | - Francesco Lacarrubba
- Department of Surgical Science, Dermatology Clinic, University of Catania, Catania, Italy
| | - Maria Letizia Musumeci
- Department of Surgical Science, Dermatology Clinic, University of Catania, Catania, Italy
| | - Pietro Alosi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | | | - Giuseppe Micali
- Department of Surgical Science, Dermatology Clinic, University of Catania, Catania, Italy
| | | | - Michele Reibaldi
- Department of Surgical Science, Eye Clinic, University of Turin, Turin, Italy
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