Longitudinal Analysis of Retinal Microvascular and Choroidal Imaging Parameters in Parkinson's Disease Compared with Controls

Abstract

To quantify rate of change of retinal microvascular and choroidal structural parameters in subjects with Parkinson's disease (PD) compared with controls using OCT and OCT angiography (OCTA). Prospective longitudinal study. Seventy-four eyes of 40 participants with PD and 149 eyes of 78 control individuals from the Eye Multimodal Imaging in Neurodegenerative Disease database. Subjects underwent OCT and OCTA imaging at 2 time points approximately 12 months apart. Imaging parameters included central subfield thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, peripapillary retinal nerve fiber layer thickness, choroidal vascularity index, superficial capillary plexus perfusion density (PFD), vessel density (VD), and foveal avascular zone area. Participants with PD had greater rate of yearly decrease in GC-IPL (PD=-0.403μm, control=+ 0.128 μm; P= 0.01), greater yearly decline in PFD in the 3× 3 mm ETDRS circle (PD=-0.016, control=+ 0.002; P<0.001) and ring (PD=-0.016, control=+ 0.002; P < 0.001); 6× 6 mm ETDRS circle (PD=-0.021, control= 0.00; P= 0.001), and outer ring (PD=-0.022, control= 0.00; P= 0.001). Participants with PD had greater rate of yearly decline in VD in 3× 3 mm circle (PD=-0.939/mm, control=+ 0.006/mm; P < 0.001) and ring (PD=-0.942/mm, control=+ 0.013/mm; P < 0.001); 6× 6 mm circle (PD=-0.72/mm, control=-0.054/mm; P= 0.006), and outer ring (PD=-0.746/mm, control=-0.054/mm; P= 0.005). When stratified by PD severity based on Hoehn and Yahr stage, faster rates of decline were seen in Hoehn and Yahr stages 3 to 4 in the 3× 3 mm circle PFD and VD as well as 3× 3 mm ring VD. Individuals with PD experience more rapid loss of retinal microvasculature quantified on OCTA and more rapid thinning of the GC-IPL than controls. There may be more rapid loss in patients with greater disease severity. The author(s) have no proprietary or commercial interest in any materials discussed in this article.