title: Correlation Between Structural and Functional Retinal Changes in Parkinson Disease.
abstract: BACKGROUND
  To evaluate structural changes in the retina and correlate those with visual function measurements in patients with Parkinson disease (PD).
  
  
  METHODS
  A cross-sectional comparative study of 20 patients with PD and 20 age-matched healthy controls was conducted. Visual acuity, color vision, contrast sensitivity, visual fields, pattern visual-evoked response (VER), and multifocal electroretinogram were recorded to determine functional change, whereas structural changes were evaluated with retinal nerve fiber layer (RNFL) thickness, macular thickness, macular volume, and ganglion cell-inner plexiform layer complex (GCL-IPL) thickness using spectral domain ocular coherence tomography (SD-OCT).
  
  
  RESULTS
  PD patients ranged from Stage 1-3, with median Stage 2 (Hoehn and Yahr Classification) with mean Unified Parkinson Disease Rating Scale III score of 19 ± 10.42, and average disease duration of 5.8 ± 2.78 years. Visual acuity, color vision, and visual fields were unaffected but contrast sensitivity was significantly worse than controls (P < 0.001). Multifocal electroretinogram values in the central 2° field revealed decreased foveal electrical activity, with increased pattern VER amplitude and latency. Significant RNFL thinning was observed in the average RNFL (P = 0.033), superior (P = 0.018), and temporal (P = 0.036) quadrants. Significant ganglion cell layer loss was captured on SD-OCT with average, minimum GCL-IPL, and all 6 sectors showing thinning (P ≤ 0.003). The functional changes correlated significantly with structural changes, disease duration, and severity. There was no correlation between structural changes in the retina and disease duration or severity.
  
  
  CONCLUSIONS
  Subclinical visual dysfunction was observed in patients with PD with good structural-functional correlation. GCL-IPL thinning may be a more reliable parameter than RNFL thickness for structural alterations of the retina in patients with PD.
authors: Squint and Neuro-Ophthalmology Section, Dr. Rajendra Prasad Centre for Ophthalmic Sciences (MK, RS, DS, PS, VM), All India Institute of Medical Sciences, New Delhi, India; and Department of Neurology (MB), Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
authors: Manpreet
authors: M
authors: Kaur
authors: Rohit
authors: R
authors: Saxena
authors: Digvijay
authors: D
authors: Singh
authors: Madhuri
authors: M
authors: Behari
authors: Pradeep
authors: P
authors: Sharma
authors: Vimla
authors: V
authors: Menon
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005074:Evoked Potentials, Visual / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D010300:Parkinson Disease / Q000150:complications* / Q000473:pathology*; D012160:Retina / Q000473:pathology* / Q000503:physiopathology*; D013223:Statistics as Topic; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000209:etiology*; D014794:Visual Fields / Q000502:physiology