Abstract:

Objective: To investigate the changes of retinal nerve fiber layer (RNFL) thickness and superficial vascular density in patients with Parkinson's disease (PD), and analyze the correlation between the changes and disease severity. Methods: Total 43 patients (76 eyes) with PD admitted to the Affiliated Hospital of North Sichuan Medical College from June 2021 to March 2022, and 45 patients (90 eyes) with normal neurological and visual functions from their family members were recruited as the control group. Optical coherence tomography angiography (OCTA) was used to measure RNFL thickness, retinal blood vessel length density and perfusion density, and the area and circumference of foveal avascular zone (FAZ). Disease severity was evaluated by modified Hoehn-Yahr staging, and motor function was evaluated by Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) in PD group. Pearson and partial correlation analyses were used to investigate the correlation between retinal parameters and PD severity. Results: Comparison of OCTA related parameters between the 2 groups: RNFL thickness (t =-6.424, P = 0.000), central length density (t =-3.629, P = 0.000), inner ring length density (Z =-2.846, P = 0.004) and central perfusion density (Z =-2.703, P = 0.007) in the PD group were lower than those in the control group. Correlation analysis showed that RNFL thickness was negatively correlated with UPDRSⅢ score (r =-0.625, P = 0.000). Conclusions: RNFL thickness may be a potential indicator for early diagnosis and evaluation of the severity of PD.

Key words: Parkinson disease, Retina, Tomography, optical coherence

摘要：

目的: 探讨帕金森病患者视网膜神经纤维层（RNFL）厚度与黄斑部浅层血管密度改变特点并分析其与疾病严重程度的相关性。方法: 选择2021年6月至2022年3月川北医学院附属医院收治的43例原发性帕金森病患者（76只眼）以及同期招募的45例神经功能和视觉功能正常者（90只眼）作为对照，采用光学相干断层扫描血管成像（OCTA）测量视网膜神经纤维层厚度、视网膜血管长度密度和血流灌注密度、中央凹无血管区面积和周长；改良Hoehn-Yahr分期评价帕金森病严重程度；统一帕金森病评价量表第三部分（UPDRSⅢ）评价帕金森病患者运动功能。Pearson相关分析和偏相关分析探讨OCTA参数与帕金森病严重程度的相关性。结果: 帕金森病组视网膜神经纤维层厚度（t=-6.424，P=0.000）、中心血管长度密度（t=-3.629，P=0.000）、内环血管长度密度（Z=-2.846，P=0.004）和中心血流灌注密度（Z=-2.703，P=0.007）均低于对照组。相关分析显示，仅视网膜神经纤维层厚度与UPDRSⅢ评分呈负相关关系（r=-0.625，P=0.000）。结论: 帕金森病患者存在视网膜结构损害，视网膜神经纤维层厚度可能是早期诊断和评价帕金森病严重程度的极具潜力的指标。

关键词: 帕金森病, 视网膜, 体层摄影术，光学相干