Abstract

The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology. The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson's Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p=0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

Highlights

  • The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology

  • Average and superior quadrant retinal nerve fiber layer (RNFL) thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p = 0.025, p=0.034, p> 0.05, respectively)

  • We aimed to evaluate the correlation between IPD progression and changes in RNFL thicknesses and central macular thickness (CMT) values and whether progressive neurodegeneration continues by examining changes in the RNFL and CMT during two-year follow-up of patients diagnosed with IPD

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Summary

Introduction

The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology. Non- motor symptoms are very frequent in all stages of Parkinson’s disease (rigidity, bradykinesia, tremor) [1, 2]. Parkinson’s disease is recognized as a multisystem, multi-neurotransmitter (dopaminergic, cholinergic, serotoninergic, noradrenergic) dysfunction-related heterogeneous disorder, which we know since the Braak staging[3]. Amacrine and interplexiform cells in the retina are rich in dopamine neurotransmitter [4]. It has been reported that visual pathologies in IPD patients may be due to dopamine reduction in amacrine cells in the retina[5, 6]. In post-mortem studies, dopamine levels in the retina were found to be decreased in IPD patients [7]

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