title: Perimetric and retinal nerve fiber layer findings in patients with Parkinson's disease.
abstract: BACKGROUND
  Visual dysfunction is common in Parkinson's disease (PD). It remains, however, unknown whether it is related to structural alterations of the retina. The aim of this study is to compare visual field (VF) findings and circumpapillary retinal nerve fiber layer (RNFL) thickness in a series of PD patients and normal controls, in order to assess possible retinal anatomical changes and/or functional damage associated with PD.
  
  
  METHODS
  PD patients and controls were recruited and underwent VF testing with static automated perimetry and RNFL examination with optical coherence tomography (OCT). Cognitive performance using Mini Mental State Examination (MMSE), PD staging using modified Hoehn and Yahr (H-Y) scale and duration of the disease was recorded in PD patients.
  
  
  RESULTS
  One randomly selected eye from each of 24 patients and 24 age-matched controls was included. OCT RNFL thickness analysis revealed no difference in the inferior, superior, nasal or temporal sectors between the groups. The average peripapillary RNFL was also similar in the two groups. However, perimetric indices of generalized sensitivity loss (mean deviation) and localized scotomas (pattern standard deviation) were worse in patients with PD compared to controls (p < 0.01). 73% of eyes of PD patients had glaucomatous-like asymmetrical hemifield defects with abnormal Glaucoma Hemifield Test and various combinations of arcuate defects (n = 12), nasal steps (n = 11) and paracentral scotomas (n = 16). Bilateral defects were found in 14 patients (58%). No correlation was found between VF indices and MMSE or H-Y scores.
  
  
  CONCLUSIONS
  PD patients may demonstrate glaucomatous-like perimetric defects even in the absence of decreased RNFL thickness.
authors.affiliation: Department of Ophthalmology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo 41222 Larissa, Greece. e_tsironi@hotmail.com
authors.forename: Evangelia E
authors.initials: EE
authors.lastname: Tsironi
authors.forename: Anna
authors.initials: A
authors.lastname: Dastiridou
authors.forename: Andreas
authors.initials: A
authors.lastname: Katsanos
authors.forename: Efthymios
authors.initials: E
authors.lastname: Dardiotis
authors.forename: Stella
authors.initials: S
authors.lastname: Veliki
authors.forename: Gianna
authors.initials: G
authors.lastname: Patramani
authors.forename: Fani
authors.initials: F
authors.lastname: Zacharaki
authors.forename: Stella
authors.initials: S
authors.lastname: Ralli
authors.forename: Georgios M
authors.initials: GM
authors.lastname: Hadjigeorgiou
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D015354:Vision, Low / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields