帕金森病患者视网膜外层厚度与视力的关系

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。

Correlation between Outer Retinal Thickness and Visual Acuity in Patients with Parkinson's Disease

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.