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Sekimitsu S, Shweikh Y, Shareef S, Zhao Y, Elze T, Segrè A, Wiggs J, Zebardast N. Association of retinal optical coherence tomography metrics and polygenic risk scores with cognitive function and future cognitive decline. Br J Ophthalmol 2024; 108:599-606. [PMID: 36990674 DOI: 10.1136/bjo-2022-322762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE To evaluate the potential of retinal optical coherence tomography (OCT) measurements and polygenic risk scores (PRS) to identify people at risk of cognitive impairment. METHODS Using OCT images from 50 342 UK Biobank participants, we examined associations between retinal layer thickness and genetic risk for neurodegenerative disease and combined these metrics with PRS to predict baseline cognitive function and future cognitive deterioration. Multivariate Cox proportional hazard models were used to predict cognitive performance. P values for retinal thickness analyses are false-discovery-rate-adjusted. RESULTS Higher Alzheimer's disease PRS was associated with a thicker inner nuclear layer (INL), chorio-scleral interface (CSI) and inner plexiform layer (IPL) (all p<0.05). Higher Parkinson's disease PRS was associated with thinner outer plexiform layer (p<0.001). Worse baseline cognitive performance was associated with thinner retinal nerve fibre layer (RNFL) (aOR=1.038, 95% CI (1.029 to 1.047), p<0.001) and photoreceptor (PR) segment (aOR=1.035, 95% CI (1.019 to 1.051), p<0.001), ganglion cell complex (aOR=1.007, 95% CI (1.002 to 1.013), p=0.004) and thicker ganglion cell layer (aOR=0.981, 95% CI (0.967 to 0.995), p=0.009), IPL (aOR=0.976, 95% CI (0.961 to 0.992), p=0.003), INL (aOR=0.923, 95% CI (0.905 to 0.941), p<0.001) and CSI (aOR=0.998, 95% CI (0.997 to 0.999), p<0.001). Worse future cognitive performance was associated with thicker IPL (aOR=0.945, 95% CI (0.915 to 0.999), p=0.045) and CSI (aOR=0.996, 95% CI (0.993 to 0.999) 95% CI, p=0.014). Prediction of cognitive decline was significantly improved with the addition of PRS and retinal measurements. CONCLUSIONS AND RELEVANCE Retinal OCT measurements are significantly associated with genetic risk of neurodegenerative disease and may serve as biomarkers predictive of future cognitive impairment.
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Affiliation(s)
| | - Yusrah Shweikh
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Sussex, UK
| | - Sarah Shareef
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Yan Zhao
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Tobias Elze
- Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Ayellet Segrè
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Janey Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Rezende Filho FM, Jurkute N, de Andrade JBC, Marianelli BF, de Lima FD, França MC, Sallum JMF, Yu-Wai-Man P, Barsottini OGP, Pedroso JL. Optic Disc and Retinal Architecture Changes in Patients with Spinocerebellar Ataxia Type 2. Mov Disord 2024; 39:203-209. [PMID: 38037516 DOI: 10.1002/mds.29675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND ATXN2 is the causative gene of spinocerebellar ataxia type 2 (SCA2) and has been implicated in glaucoma pathogenesis. Therefore, studying ocular changes in SCA2 could uncover clinically relevant changes. OBJECTIVE The aim was to investigate optic disc and retinal architecture in SCA2. METHODS We evaluated 14 patients with SCA2 and 26 controls who underwent intraocular pressure measurement, fundoscopy, and macular and peripapillary spectral domain optical coherence tomography (SD-OCT). We compared SD-OCT measurements in SCA2 and controls, and the frequency of glaucomatous changes among SCA2, controls, and 76 patients with other SCAs (types 1, 3, 6, and 7). RESULTS The macula, peripapillary retinal nerve fiber and inner plexiform layers were thinner in SCA2 than in controls. Increased cup-to-disc ratio was more frequent in SCA2 than in controls and other SCAs. CONCLUSIONS Ocular changes are part of SCA2 phenotype. Future studies should further investigate retinal and optic nerve architecture in this disorder.
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Affiliation(s)
- Flávio Moura Rezende Filho
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Neringa Jurkute
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
- The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - João Brainer Clares de Andrade
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | | | - Fabrício Diniz de Lima
- Department of Neurology, School of Medical Sciences-University of Campinas (UNICAMP), São Paulo, Brazil
| | | | | | - Patrick Yu-Wai-Man
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
- Department of Clinical Neurosciences, Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, United Kingdom
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Orlando G P Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
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Lee YW, Lim MN, Lee JY, Yoo YJ. Central retina thickness measured with spectral-domain optical coherence tomography in Parkinson disease: A meta-analysis. Medicine (Baltimore) 2023; 102:e35354. [PMID: 37800768 PMCID: PMC10553016 DOI: 10.1097/md.0000000000035354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/01/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Optical coherence tomography (OCT) can detect visual alterations associated with Parkinson disease, such as damage to the retinal nerve fiber layer or changes in retinal vasculature. Macula thinning in association with Parkinson disease (PD) remains controversial. Therefore, we conducted a meta-analysis to investigate the central retina thickness in PD measured using spectral-domain OCT (SD-OCT). METHODS We searched PubMed and the Excerpta Medica database to identify studies that compared macular thickness between patients with PD and healthy controls published before July 31, 2021. A random-effects model was used to examine PD-associated changes in macular thickness. Meta-regression analysis was performed by assessing heterogeneity, publication bias, and study quality. RESULTS Thirty-two studies with a cross-sectional design were selected, including 2118 patients with PD and 2338 controls. We identified significant differences in the thickness of the ganglion cell-inner plexiform layer (standardized mean difference [SMD], -0.41; 95% confidence interval [CI], -0.66 to -0.16; I2 = 80%), ganglion cell complex (SMD, -0.33; 95% CI, -0.50 to -0.17; I2 = 0%), and of all inner and outer sectors of the macula (SMD range, -0.21 to -0.56; all P < .05) between patients with PD and controls. DISCUSSION These results corroborate the increased prevalence of changes in OCT measures in individuals with PD, highlighting the efficacy of SD-OCT-determined macular thickness as a biomarker for PD. Our findings may provide helpful guidelines for clinicians in rapidly evolving areas of PD diagnosis.
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Affiliation(s)
- Yong Woo Lee
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, Korea
| | - Myung-Nam Lim
- Biomedical Research Institute, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae Yeon Lee
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Yung-Ju Yoo
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, Korea
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Elanwar R, Al Masry H, Ibrahim A, Hussein M, Ibrahim S, Masoud MM. Retinal functional and structural changes in patients with Parkinson's disease. BMC Neurol 2023; 23:330. [PMID: 37723424 PMCID: PMC10506234 DOI: 10.1186/s12883-023-03373-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Visual dysfunction have been well reported as one of the non-motor symptoms in Parkinson's disease (PD). The aim of this study was to evaluate the functional and structural changes in the retina in patients with PD, and to correlate these changes with disease duration and motor dysfunction. METHODS For this case-control study, we recruited patients fulfilling the diagnostic criteria for idiopathic PD according to British Brain Bank criteria, aged between 50 and 80 years. Age- and sex-matched healthy controls aged between 50 and 80 years were also recruited. Motor function for PD patients was assessed using Modified Hoehn and Yahr staging scale (H & Y staging) and Unified Parkinson's Disease Rating Scale (UPDRS). Optical Coherence Tomography (OCT) and full field electroretinogram (ff-ERG) were done to all participants. RESULTS Data from 50 patients and 50 healthy controls were included in the analysis. Patients with idiopathic Parkinson's had significantly reduced peripapillary retinal nerve fiber layer (RNFL) thickness and macular ganglion cell complex (GCC) thickness compared to healthy controls (P-value < 0.05 in all parameters). They also had significantly delayed latency and reduced amplitude in both dark-adapted rods and the light-adapted cone for both a & b waves compared to healthy controls (P-value < 0.001 in all parameters). There were statistically significant negative correlations between disease duration, and left superior, right inferior and right & left average RNFL thickness [(r) coef. = -0.327, -0.301, -0.275, and -0.285 respectively]. UPDRS total score was negatively correlated with the amplitude of light-adapted of both RT and LT a & b wave and with dark-adapted RT b-wave latency [(r) coef. = -0.311, -0.395, -0.362, -0.419, and -0.342]. CONCLUSION The retinal structure and function were significantly affected in patients with PD in comparison to healthy controls. There was a significant impact of disease duration on retinal thickness, and there was a significant negative correlation between the degree of motor dysfunction in patients with PD and retinal function.
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Affiliation(s)
- Rehab Elanwar
- Neuro Diagnostic Research Center, Beni-Suef University, Beni-Suef, Egypt
| | - Hatem Al Masry
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt
| | - Amna Ibrahim
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt
| | - Mona Hussein
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt.
| | - Sahar Ibrahim
- Department of Ophthalmology, Beni-Suef University, Beni-Suef, 62511, Egypt
| | - Mohammed M Masoud
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt
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Kalahasty K, Lee Y, Locatelli E, Djulbegovic M, Cabrera K, Pakravan P, Goodman C, Jensen A, Aenlle K, Klimas N, Goldhardt R, Galor A. Ocular and inflammatory markers associated with Gulf War illness symptoms. Sci Rep 2023; 13:3512. [PMID: 36864130 DOI: 10.1038/s41598-023-30544-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
To examine the utility of ocular coherence tomography (OCT) metrics, in conjunction with systemic markers of inflammation, in identifying individuals with Gulf War Illness (GWI) symptoms. Prospective case-control study of 108 Gulf War Era veterans, split into 2 groups based on the presence of GWI symptoms, defined by the Kansas criteria. Information on demographics, deployment history, and co-morbidities were captured. 101 individuals underwent OCT imaging and 105 individuals provided a blood sample which was analyzed for inflammatory cytokines using an enzyme-linked immunosorbent assay-based chemiluminescent assay. The main outcome measure was predictors of GWI symptoms, examined with multivariable forward stepwise logistic regression analysis followed by receiver operating characteristic (ROC) analysis. The mean age of the population was 55 ± 4, 90.7% self-identified as male, 53.3% as White, and 54.3% as Hispanic. A multivariable model that considered demographics and co-morbidities found that a lower inferior temporal ganglion cell layer-inner plexiform layer (GCL‒IPL) thickness, higher temporal nerve fiber layer (NFL) thickness, lower interleukin (IL)-1β levels, higher IL-1α levels, and lower tumor necrosis factor-receptor I levels correlated with GWI symptoms. ROC analysis demonstrated an area under the curve of 0.78 with the best cut-off value for the prediction model having a sensitivity of 83% and specificity of 58%. RNFL and GCL‒IPL measures, namely increased temporal thickness and decreased inferior temporal thickness, respectively, in conjunction with a number of inflammatory cytokines, had a reasonable sensitivity for the diagnosis of GWI symptoms in our population.
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Vujosevic S, Parra MM, Hartnett ME, O'Toole L, Nuzzi A, Limoli C, Villani E, Nucci P. Optical coherence tomography as retinal imaging biomarker of neuroinflammation/neurodegeneration in systemic disorders in adults and children. Eye (Lond) 2023; 37:203-219. [PMID: 35428871 PMCID: PMC9012155 DOI: 10.1038/s41433-022-02056-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/10/2022] [Accepted: 03/31/2022] [Indexed: 01/28/2023] Open
Abstract
The retina and the optic nerve are considered extensions of the central nervous system (CNS) and thus can serve as the window for evaluation of CNS disorders. Spectral domain optical coherence tomography (OCT) allows for detailed evaluation of the retina and the optic nerve. OCT can non-invasively document changes in single retina layer thickness and structure due to neuronal and retinal glial cells (RGC) modifications in systemic and local inflammatory and neurodegenerative diseases. These can include evaluation of retinal nerve fibre layer and ganglion cell complex, hyper-reflective retinal spots (HRS, sign of activated microglial cells in the retina), subfoveal neuroretinal detachment, disorganization of the inner retinal layers (DRIL), thickness and integrity of the outer retinal layers and choroidal thickness. This review paper will report the most recent data on the use of OCT as a non invasive imaging biomarker for evaluation of the most common systemic neuroinflammatory and neurodegenerative/neurocognitive disorders in the adults and in paediatric population. In the adult population the main focus will be on diabetes mellitus, multiple sclerosis, optic neuromyelitis, neuromyelitis optica spectrum disorders, longitudinal extensive transverse myelitis, Alzheimer and Parkinson diseases, Amyotrophic lateral sclerosis, Huntington's disease and schizophrenia. In the paediatric population, demyelinating diseases, lysosomal storage diseases, Nieman Pick type C disease, hypoxic ischaemic encephalopathy, human immunodeficiency virus, leukodystrophies spinocerebellar ataxia will be addressed.
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Affiliation(s)
- Stela Vujosevic
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
- Eye Clinic, IRCCS MultiMedica, Milan, Italy.
| | - M Margarita Parra
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - M Elizabeth Hartnett
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Louise O'Toole
- Department of Ophthalmology Mater Private Network, Dublin, Ireland
| | - Alessia Nuzzi
- Eye Clinic, IRCCS MultiMedica, Milan, Italy
- University of Milan, Milan, Italy
| | - Celeste Limoli
- Eye Clinic, IRCCS MultiMedica, Milan, Italy
- University of Milan, Milan, Italy
| | - Edoardo Villani
- Eye Clinic, IRCCS MultiMedica, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo Nucci
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Stuparu AZ, Jurja S, Stuparu AF, Axelerad A. Narrative Review Concerning the Clinical Spectrum of Ophthalmological Impairments in Parkinson's Disease. Neurol Int 2023; 15:140-61. [PMID: 36810467 DOI: 10.3390/neurolint15010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/30/2023] Open
Abstract
Ophthalmic non-motor impairments are common in Parkinson's disease patients, from the onset of the neurodegenerative disease and even prior to the development of motor symptoms. This is a very crucial component of the potential for early detection of this disease, even in its earliest stages. Since the ophthalmological disease is extensive and impacts all extraocular and intraocular components of the optical analyzer, a competent assessment of it would be beneficial for the patients. Because the retina is an extension of the nervous system and has the same embryonic genesis as the central nervous system, it is helpful to investigate the retinal changes in Parkinson's disease in order to hypothesize insights that may also be applicable to the brain. As a consequence, the detection of these symptoms and signs may improve the medical evaluation of PD and predict the illness' prognosis. Another valuable aspect of this pathology is the fact that the ophthalmological damage contributes significantly to the decrease in the quality of life of patients with Parkinson's disease. We provide an overview of the most significant ophthalmologic impairments associated with Parkinson's disease. These results certainly constitute a large number of the prevalent visual impairments experienced by PD patients.
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Wang X, Jiao B, Jia X, Wang Y, Liu H, Zhu X, Hao X, Zhu Y, Xu B, Zhang S, Xu Q, Wang J, Guo J, Yan X, Tang B, Zhao R, Shen L. The macular inner plexiform layer thickness as an early diagnostic indicator for Parkinson's disease. NPJ Parkinsons Dis 2022; 8:63. [PMID: 35614125 DOI: 10.1038/s41531-022-00325-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 05/05/2022] [Indexed: 11/25/2022] Open
Abstract
Whether structural alterations of intraretinal layers are indicators for the early diagnosis of Parkinson’s disease (PD) remains unclear. We assessed the retinal layer thickness in different stages of PD and explored whether it can be an early diagnostic indicator for PD. In total, 397 [131, 146, and 120 with Hoehn-Yahr I (H-Y I), H-Y II, and H-Y III stages, respectively] patients with PD and 427 healthy controls (HCs) were enrolled. The peripapillary retinal nerve fiber layer (pRNFL), total macular retinal thickness (MRT), and macular volume (TMV) were measured by high-definition optical coherence tomography, and the macular intraretinal thickness was analyzed by the Iowa Reference Algorithms. As a result, the PD group had a significantly lower average, temporal quadrant pRNFL, MRT, and TMV than the HCs group (all p < 0.001). Moreover, the ganglion cell layer (GCL), inner plexiform layer (IPL), and outer nuclear layer were thinner in patients with PD with H-Y I, and significantly decreased as the H-Y stage increased. In addition, we observed that GCL and IPL thicknesses were both correlated with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS III) scores and non-motor symptoms assessment scores. Furthermore, macular IPL thickness in the superior inner (SI) quadrant (IPL-SI) had the best diagnostic performance in patients with PD with H-Y I versus HCs, with a sensitivity and specificity of 75.06% and 81.67%, respectively. In conclusion, we confirmed the retinal structure was significantly altered in patients with PD in different clinical stages, and that GCL and IPL changes occurred during early PD disease and were correlated with MDS-UPDRS III scores and non-motor symptoms assessment scores. Furthermore, macular IPL-SI thickness might be performed as an early diagnostic indicator for PD.
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Christinaki E, Kulenovic H, Hadoux X, Baldassini N, Van Eijgen J, De Groef L, Stalmans I, van Wijngaarden P. Retinal imaging biomarkers of neurodegenerative diseases. Clin Exp Optom 2022; 105:194-204. [PMID: 34751086 DOI: 10.1080/08164622.2021.1984179] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The timely detection of neurodegenerative diseases is central to improving clinical care as well as enabling the development and deployment of disease-modifying therapies. Retinal imaging is emerging as a method to detect features of a number of neurodegenerative diseases, given the anatomical and functional similarities between the retina and the brain. This review provides an overview of the current status of retinal imaging biomarkers of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, Lewy body dementia, frontotemporal dementia, Huntington's disease and multiple sclerosis. Whilst research findings are promising, efforts to harmonise study designs and imaging methods will be important in translating these findings into clinical care. Doing so may mean that eye care providers will play important roles in the detection of a variety of neurodegenerative diseases in future.
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Affiliation(s)
- Eirini Christinaki
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Hana Kulenovic
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Xavier Hadoux
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Nicole Baldassini
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Jan Van Eijgen
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | - Lies De Groef
- Neural Circuit Development and Regeneration Research Group, Department of Biology, University of Leuven (KU Leuven), Leuven, Belgium.,Leuven Brain Institute, Leuven, Belgium
| | - Ingeborg Stalmans
- Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.,Neural Circuit Development and Regeneration Research Group, Department of Biology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Peter van Wijngaarden
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Parkville, Australia
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Lee JY, Martin-Bastida A, Murueta-Goyena A, Gabilondo I, Cuenca N, Piccini P, Jeon B. Multimodal brain and retinal imaging of dopaminergic degeneration in Parkinson disease. Nat Rev Neurol 2022. [PMID: 35177849 DOI: 10.1038/s41582-022-00618-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 12/12/2022]
Abstract
Parkinson disease (PD) is a progressive disorder characterized by dopaminergic neurodegeneration in the brain. The development of parkinsonism is preceded by a long prodromal phase, and >50% of dopaminergic neurons can be lost from the substantia nigra by the time of the initial diagnosis. Therefore, validation of in vivo imaging biomarkers for early diagnosis and monitoring of disease progression is essential for future therapeutic developments. PET and single-photon emission CT targeting the presynaptic terminals of dopaminergic neurons can be used for early diagnosis by detecting axonal degeneration in the striatum. However, these techniques poorly differentiate atypical parkinsonian syndromes from PD, and their availability is limited in clinical settings. Advanced MRI in which pathological changes in the substantia nigra are visualized with diffusion, iron-sensitive susceptibility and neuromelanin-sensitive sequences potentially represents a more accessible imaging tool. Although these techniques can visualize the classic degenerative changes in PD, they might be insufficient for phenotyping or prognostication of heterogeneous aspects of PD resulting from extranigral pathologies. The retina is an emerging imaging target owing to its pathological involvement early in PD, which correlates with brain pathology. Retinal optical coherence tomography (OCT) is a non-invasive technique to visualize structural changes in the retina. Progressive parafoveal thinning and fovea avascular zone remodelling, as revealed by OCT, provide potential biomarkers for early diagnosis and prognostication in PD. As we discuss in this Review, multimodal imaging of the substantia nigra and retina is a promising tool to aid diagnosis and management of PD.
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Zhang Y, Zhang X, Yue Y, Tian T. Retinal Degeneration: A Window to Understand the Origin and Progression of Parkinson’s Disease? Front Neurosci 2022; 15:799526. [PMID: 35185448 PMCID: PMC8854654 DOI: 10.3389/fnins.2021.799526] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Parkinson’s disease (PD), the second most prevalent neurodegenerative disorder, manifests with motor and non-motor symptoms associated with two main pathological hallmarks, including the deterioration of dopaminergic cells and aggregation of alpha-synuclein. Yet, PD is a neurodegenerative process whose origin is uncertain and progression difficult to monitor and predict. Currently, a possibility is that PD may be secondary to long lasting peripheral affectations. In this regard, it has been shown that retinal degeneration is present in PD patients. Although it is unknown if retinal degeneration precedes PD motor symptoms, the possibility exists since degeneration of peripheral organs (e.g., olfaction, gut) have already been proven to antedate PD motor symptoms. In this paper, we explore this possibility by introducing the anatomical and functional relationship of retina and brain and providing an overview of the physiopathological changes of retinal structure and visual function in PD. On the basis of the current status of visual deficits in individuals with PD, we discuss the modalities and pathological mechanism of visual function or morphological changes in the retina and focus on the correlation between visual impairment and some representative structural features with clinical significance. To consider retinal degeneration as a contributor to PD origin and progress is important because PD evolution may be monitored and predicted by retinal studies through state-of-the-art techniques of the retina. It is significant to integrally understand the role of retinal morphological and functional changes in the neurodegenerative process for the diagnosis and therapeutic strategies of PD.
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Affiliation(s)
- Yanyan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoguang Zhang
- Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yunhua Yue
- Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Yunhua Yue,
| | - Tian Tian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Tian Tian,
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Suciu VI, Suciu CI, Nicoară SD, Perju-Dumbravă L. Circumpapillary Retinal Nerve Fiber Layer OCT Imaging in a Parkinson’s Disease Cohort—A Multidisciplinary Approach in a Clinical Research Hospital. J Pers Med 2022; 12:jpm12010080. [PMID: 35055395 PMCID: PMC8780025 DOI: 10.3390/jpm12010080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 11/21/2022] Open
Abstract
(1) Background: The purpose of this paper is to report the data of the first study in a Clinical Research Hospital, in the Transylvania region, focusing on the Spectral Domain Optical Coherence Tomography (SD-OCT) measurements in the early stages of Parkinson’s disease (PD), and to compare the results with age-matched healthy controls. (2) Methods: This study assessed the circumpapillary retinal nerve fiber layer (cpRNFL) SD-OCT measurements (Heidelberg Spectralis, Heidelberg Engineering, Germany) of two study groups: patients suffering from PD (Hoehn−Yahr stages 1–3) and healthy controls. Secondary objectives were to investigate the reported visual symptoms by evaluating the color vision, contrast sensitivity, and the central visual defects for macular disease using standardized charts. Subjects with prior history of ophthalmologic diseases, advanced stages of PD (Hoehn−Yahr stages 4–5), or with psychiatric conditions were not included in this study. The same team of neurologists and ophthalmologists evaluated all individuals in order to have comparable data and to eliminate inter-examiner differences. All subjects were recruited from the same Clinical Research Hospital in the Transylvania region, Romania. (3) Results: 72% of the PD patients (n = 17) in this study reported visual symptoms. In respect to the ophthalmologic chart evaluation for PD patients, the most frequent disturbances were identified in the Ishihara color perception testing (33%). The regression analysis showed significant results for the Ishihara testing in relation to the cpRNFL thinning in the temporal retinal sectors for both eyes. cpRNFL thinning was predominantly contralateral to the parkinsonism (p = 0.001). The temporal and global values of the cpRNFL were significantly lower in all PD patients < 70 years old, compared to the age-matched healthy controls. (4) Conclusions: Specific patterns of cpRNFL thinning were found in the PD subjects younger than 70 years. A multidisciplinary approach is essential for a complete evaluation of PD patients.
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Affiliation(s)
- Vlad-Ioan Suciu
- Department of Neuroscience, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
- Correspondence:
| | - Corina-Iuliana Suciu
- Department of Ophthalmology, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.-I.S.); (S.-D.N.)
| | - Simona-Delia Nicoară
- Department of Ophthalmology, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.-I.S.); (S.-D.N.)
| | - Lăcrămioara Perju-Dumbravă
- Department of Neuroscience, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
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13
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Wilson D, Hallett M, Anderson T. An Eye on Movement Disorders. Mov Disord Clin Pract 2021; 8:1168-1180. [PMID: 34765682 DOI: 10.1002/mdc3.13317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/28/2021] [Accepted: 07/20/2021] [Indexed: 02/06/2023] Open
Abstract
Eye disorders spanning a range of ocular tissue are common in patients with movement disorders. Highlighting these ocular manifestations will benefit patients and may even aid in diagnosis. In this educational review we outline the anatomy and function of the ocular tissues with a focus on the tissues most affected in movement disorders. We review the movement disorders associated with ocular pathology and where possible explore the underlying cellular basis thought to be driving the pathology and provide a brief overview of ophthalmic investigations available to the neurologist. This review does not cover intracranial primary visual pathways, higher visual function, or the ocular motor system.
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Affiliation(s)
- Duncan Wilson
- Department of Neurology Christchurch Hospital Christchurch New Zealand.,New Zealand Brain Research Institute Christchurch New Zealand
| | - Mark Hallett
- Human Motor Control Section, NINDS, NIH Bethesda Maryland USA
| | - Tim Anderson
- Department of Neurology Christchurch Hospital Christchurch New Zealand.,New Zealand Brain Research Institute Christchurch New Zealand.,Department of Medicine Otago University Dunedin New Zealand
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14
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Hanna-Pladdy B, Pahwa R, Lyons KE. Dopaminergic Basis of Spatial Deficits in Early Parkinson's Disease. Cereb Cortex Commun 2021; 2:tgab042. [PMID: 34738086 DOI: 10.1093/texcom/tgab042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 11/14/2022] Open
Abstract
Dopaminergic mechanisms regulating cognitive and motor control were evaluated comparing visuoperceptual and perceptuomotor functions in Parkinson's disease (PD). The performance of PD patients (n = 40) was contrasted with healthy controls (n = 42) across two separate visits (on and off dopaminergic medications) on computerized tasks of perception and aiming to a target at variable stimulus lengths (4, 8, 12 cm). Novel visuoperceptual tasks of length equivalence and width interval estimations without motor demands were compared with tasks estimating spatial deviation in movement termination. The findings support the presence of spatial deficits in early PD, more pronounced with increased discrimination difficulty, and with shorter stimulus lengths of 4 cm for both visuoperceptual and perceptumotor functions. Dopaminergic medication had an adverse impact on visuoperceptual accuracy in particular for length equivalence estimations, in contrast with dopaminergic modulation of perceptuomotor functions that reduced angular displacements toward the target. The differential outcomes for spatial accuracy in perception versus movement termination in PD are consistent with involvement of the direct pathway and models of progressive loss of dopamine through corticostriatal loops. Future research should develop validated and sensitive standardized tests of perception and explore dopaminergic selective deficits in PD to optimize medication titration for motor and cognitive symptoms of the disease.
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Affiliation(s)
- B Hanna-Pladdy
- Center for Advanced Imaging Research (CAIR), Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - R Pahwa
- Parkinson's Disease and Movement Disorder Center, Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - K E Lyons
- Parkinson's Disease and Movement Disorder Center, Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA
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15
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Moons L, De Groef L. Multimodal retinal imaging to detect and understand Alzheimer's and Parkinson's disease. Curr Opin Neurobiol 2021; 72:1-7. [PMID: 34399146 DOI: 10.1016/j.conb.2021.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/01/2021] [Accepted: 07/14/2021] [Indexed: 12/28/2022]
Abstract
Retinal neurodegeneration and visual dysfunctions have been reported in a majority of Alzheimer's and Parkinson's patients, and, in light of the quest for novel biomarkers for these neurodegenerative proteinopathies, the retina has been receiving increasing attention as an organ for diagnosing, monitoring, and understanding disease. Thinning of retinal layers, abnormalities in vasculature, and protein deposition can be imaged at unprecedented resolution, which offers a unique systems biology view on the cellular and molecular changes underlying these pathologies. It makes the retina not only a promising target for biomarker development, but it also suggests that novel fundamental insights into the pathophysiology of Alzheimer's and Parkinson's disease can be obtained by studying the retina-brain axis.
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Affiliation(s)
- Lieve Moons
- Neural Circuit Development and Regeneration Research Group, Biology Department, University of Leuven, Naamsestraat 61 Box 2464, Leuven, 3000, Belgium; Leuven Brain Institute, Leuven, 3000, Belgium.
| | - Lies De Groef
- Neural Circuit Development and Regeneration Research Group, Biology Department, University of Leuven, Naamsestraat 61 Box 2464, Leuven, 3000, Belgium; Leuven Brain Institute, Leuven, 3000, Belgium
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16
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Kashani AH, Asanad S, Chan JW, Singer MB, Zhang J, Sharifi M, Khansari MM, Abdolahi F, Shi Y, Biffi A, Chui H, Ringman JM. Past, present and future role of retinal imaging in neurodegenerative disease. Prog Retin Eye Res 2021; 83:100938. [PMID: 33460813 DOI: 10.1016/j.preteyeres.2020.100938] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 02/08/2023]
Abstract
Retinal imaging technology is rapidly advancing and can provide ever-increasing amounts of information about the structure, function and molecular composition of retinal tissue in humans in vivo. Most importantly, this information can be obtained rapidly, non-invasively and in many cases using Food and Drug Administration-approved devices that are commercially available. Technologies such as optical coherence tomography have dramatically changed our understanding of retinal disease and in many cases have significantly improved their clinical management. Since the retina is an extension of the brain and shares a common embryological origin with the central nervous system, there has also been intense interest in leveraging the expanding armamentarium of retinal imaging technology to understand, diagnose and monitor neurological diseases. This is particularly appealing because of the high spatial resolution, relatively low-cost and wide availability of retinal imaging modalities such as fundus photography or OCT compared to brain imaging modalities such as magnetic resonance imaging or positron emission tomography. The purpose of this article is to review and synthesize current research about retinal imaging in neurodegenerative disease by providing examples from the literature and elaborating on limitations, challenges and future directions. We begin by providing a general background of the most relevant retinal imaging modalities to ensure that the reader has a foundation on which to understand the clinical studies that are subsequently discussed. We then review the application and results of retinal imaging methodologies to several prevalent neurodegenerative diseases where extensive work has been done including sporadic late onset Alzheimer's Disease, Parkinson's Disease and Huntington's Disease. We also discuss Autosomal Dominant Alzheimer's Disease and cerebrovascular small vessel disease, where the application of retinal imaging holds promise but data is currently scarce. Although cerebrovascular disease is not generally considered a neurodegenerative process, it is both a confounder and contributor to neurodegenerative disease processes that requires more attention. Finally, we discuss ongoing efforts to overcome the limitations in the field and unmet clinical and scientific needs.
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17
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Asanad S, O'Neill H, Addis H, Chen S, Wang J, Goldwaser E, Kochunov P, Hong LE, Saeedi OJ. Neuroretinal Biomarkers for Schizophrenia Spectrum Disorders. Transl Vis Sci Technol 2021; 10:29. [PMID: 34004009 PMCID: PMC8083086 DOI: 10.1167/tvst.10.4.29] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We evaluated the patient-control differences and predictive value of the retina as potential biomarkers for schizophrenia. Methods The institutional study included both eyes of 58 schizophrenia spectrum disorder (SSD) patients (age 37.2 ± 12.3 years) and 35 controls (age 41.1 ± 15.2 years). Retinal nerve fiber layer (RNFL), ganglion cell–inner plexiform layer, outer retinal photoreceptor complex, and total macula thicknesses were measured by optical coherence tomography (OCT). Anterior segment parameters including central corneal thickness, anterior chamber depth, and axial length were measured to rule out confounds on the retinal measures. Results The peripapillary RNFL was overall significantly thinner in SSD relative to controls (F = 3.97, P = 0.049), most pronounced in the temporal (5.2 µm difference, F = 6.95, P = 0.010) and inferior quadrants (12.1 µm difference, F = 7.32, P = 0.009). There were no significant group differences in thickness for the macular RNFL, ganglion, or photoreceptor cell related measures (P > 0.05). Peripapillary RNFL, central macula, and outer photoreceptor complex thicknesses were together able to classify SSD patients with 80% sensitivity and 71% specificity; area under the curve = 0.82 (95% confidence interval, 0.75–0.88). Conclusions SSD patients exhibited significant RNFL thinning relative to controls. Notably, retinal thickness measures including both peripapillary and macular data exhibited improved diagnostic accuracy for SSD as compared to these regions alone. Translational Relevance This is the first study to evaluate the predictive value of both the inner and outer retina in SSD. OCT retinal thickness measures including peripapillary data in conjunction with macular data may provide an informative, noninvasive in vivo ocular biomarker for schizophrenia.
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Affiliation(s)
- Samuel Asanad
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hugh O'Neill
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hampton Addis
- Children's National Health System, Washington, DC, USA
| | - Shuo Chen
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, and Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jingtao Wang
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, and Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Eric Goldwaser
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Osamah J Saeedi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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18
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Rascunà C, Cicero CE, Chisari CG, Russo A, Giuliano L, Castellino N, Terravecchia C, Grillo M, Longo A, Avitabile T, Zappia M, Reibaldi M, Nicoletti A. Retinal thickness and microvascular pathway in Idiopathic Rapid eye movement sleep behaviour disorder and Parkinson's disease. Parkinsonism Relat Disord 2021; 88:40-45. [PMID: 34118642 DOI: 10.1016/j.parkreldis.2021.05.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Retinal impairment has previously been described in Parkinson's Disease (PD), also in early stage of disease. Idiopathic Rapid-eye-movement sleep Behavior Disorder (iRBD) is considered the strongest marker in the diagnosis of "Prodromal PD". Thus, we evaluated the thickness of retinal layers and the microvascular retinal pattern in a group of iRBD patients compared to PD and healthy subjects (HCs). METHODS retinal layer's thickness and microvascular pattern among PD, iRBD and HCs were assessed using Spectral-Density Optical Coherence Tomography (SD-OCT) and OCT-Angiography (OCT-A), respectively. RESULTS Forty-one eyes from 21 PD, 37 eyes from 19 iRBD and 33 eyes from 17 HCs were analysed. Peripapillary Retinal Nerve Fiber Layer (RNFL) was thinner in PD and RBD compared to HCs. All macular retinal layers, except for retinal pigment epithelium, resulted to be significantly thinner in iRBD and in PD compared to HCs, also adjusting by age, sex and hypertension. Macular RNFL and ganglionic cell layer were thinner in PD compared to iRBD. Moreover, in iRBD, a peculiar microvascular pattern was found, characterized by a higher vascularization of the deep capillary plexus with respect both PD patients and HCs. CONCLUSION in PD and iRBD patients retina was thinner than HCs, and values of iRBD were between PD and HCs. Moreover, in iRBD, a peculiar microvascular pattern has been found, characterized by a higher vascularization of the deep capillary plexus. Our findings suggest that retina might be considered a biomarker of neurodegeneration in iRBD, easily estimable using non-invasive tool such as OCT and OCT-A.
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Affiliation(s)
- Cristina Rascunà
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Clara Grazia Chisari
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Loretta Giuliano
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | | | - Claudio Terravecchia
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Marco Grillo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Teresio Avitabile
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, CT, Italy.
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, Section of Neurosciences, University of Catania, Catania, CT, Italy.
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19
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Xiong W, Lu L, Chen Q, Xiao Y, An D, Sander JW, Zhang M, Zhou D. Reduction of Retinal Thickness Ipsilateral to Hippocampal Sclerosis in Epilepsy. Front Neurol 2021; 12:663559. [PMID: 34046004 PMCID: PMC8144461 DOI: 10.3389/fneur.2021.663559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/06/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: Reductions in the peripapillary retinal nerve fiber layer (pRNFL) have been reported in epilepsy, namely in drug-resistant people. Hippocampal sclerosis (HS) is the most frequent cause of drug-resistant epilepsy in tertiary care centers. We aimed to evaluate the likelihood and characteristic of RNFL loss in individuals with epilepsy having HS. Methods: Fifty-five adults diagnosed with unilateral HS (mean age of 25 years; 42 female) by magnetic resonance imaging were included in this observational cross-sectional study, 58 age-matched individuals with epilepsy with no detectable structural brain abnormality were included as non-HS, and 55 people without neurological diseases were included as healthy controls. pRNFL of both eyes was measured by optical coherence tomography (OCT). In each individual disease related information was recorded. Results: Among the 55 individuals with unilateral HS, one (1.82%) and ten (18.18%) had significant or borderline abnormal thinning of the pRNFL of the ipsilateral eye to the HS. The average pRNFL ipsilateral to the side of HS was significantly thinner than people with epilepsy non-HS (p = 0.013) and healthy controls (p = 0.000), especially in the inferior quadrants. Only age was significantly correlated with the average and inferior quadrant pRNFL thickness of the ipsilateral eye to the HS (R = −0.286, p = 0.035; R = −0.353, p = 0.008 respectively). Conclusion: These preliminary findings suggest that retinal abnormalities associated with HS may have a specific pattern. Further studies need to confirm this finding and to unravel the underlying mechanism.
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Affiliation(s)
- Weixi Xiong
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China.,Institute of Brain Science and Brain-inspired technology of West China Hospital, Sichuan University, Chengdu, China
| | - Lu Lu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China.,Institute of Brain Science and Brain-inspired technology of West China Hospital, Sichuan University, Chengdu, China
| | - Qin Chen
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China
| | - Yingfeng Xiao
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China
| | - Dongmei An
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China.,Institute of Brain Science and Brain-inspired technology of West China Hospital, Sichuan University, Chengdu, China
| | - Josemir W Sander
- The National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London Institute of Neurology, London, United Kingdom.,Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom.,Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, China.,Institute of Brain Science and Brain-inspired technology of West China Hospital, Sichuan University, Chengdu, China
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20
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Sharma G, Pfeffer G, Shutt TE. Genetic Neuropathy Due to Impairments in Mitochondrial Dynamics. Biology (Basel) 2021; 10:268. [PMID: 33810506 PMCID: PMC8066130 DOI: 10.3390/biology10040268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 12/12/2022]
Abstract
Mitochondria are dynamic organelles capable of fusing, dividing, and moving about the cell. These properties are especially important in neurons, which in addition to high energy demand, have unique morphological properties with long axons. Notably, mitochondrial dysfunction causes a variety of neurological disorders including peripheral neuropathy, which is linked to impaired mitochondrial dynamics. Nonetheless, exactly why peripheral neurons are especially sensitive to impaired mitochondrial dynamics remains somewhat enigmatic. Although the prevailing view is that longer peripheral nerves are more sensitive to the loss of mitochondrial motility, this explanation is insufficient. Here, we review pathogenic variants in proteins mediating mitochondrial fusion, fission and transport that cause peripheral neuropathy. In addition to highlighting other dynamic processes that are impacted in peripheral neuropathies, we focus on impaired mitochondrial quality control as a potential unifying theme for why mitochondrial dysfunction and impairments in mitochondrial dynamics in particular cause peripheral neuropathy.
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Affiliation(s)
- Govinda Sharma
- Departments of Medical Genetics and Biochemistry & Molecular Biology, Cumming School of Medicine, Alberta Children’s Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Gerald Pfeffer
- Departments of Clinical Neurosciences and Medical Genetics, Cumming School of Medicine, Hotchkiss Brain Institute, Alberta Child Health Research Institute, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Timothy E. Shutt
- Departments of Medical Genetics and Biochemistry & Molecular Biology, Cumming School of Medicine, Alberta Children’s Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada;
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21
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Robbins CB, Grewal DS, Thompson AC, Soundararajan S, Yoon SP, Polascik BW, Scott BL, Fekrat S. Identifying Peripapillary Radial Capillary Plexus Alterations in Parkinson's Disease Using OCT Angiography. Ophthalmol Retina 2021; 6:29-36. [PMID: 33713852 DOI: 10.1016/j.oret.2021.03.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare radial peripapillary capillary (RPC) plexus vascular parameters and retinal nerve fiber layer (RNFL) thickness between those with Parkinson's disease (PD) and controls. DESIGN Prospective, cross-sectional study. PARTICIPANTS A total of 151 eyes of 81 PD participants and 514 eyes of 266 controls. METHODS Participants underwent OCT angiography (OCTA) imaging using the Zeiss Cirrus HD-5000 AngioPlex (Carl Zeiss AG). Capillary perfusion density (CPD) and capillary flux index (CFI) were assessed using a 4.5 × 4.5-mm peripapillary scan, and RNFL thickness was assessed using a 200 × 200-μm optic nerve cube OCT scan. Hoehn and Yahr clinical staging for PD was determined by an experienced movement disorders specialist. Generalized estimating equations adjusted for age and sex were used for analysis. MAIN OUTCOME MEASURES Differences in RNFL thickness, CPD, and CFI as assessed using multivariable generalized estimating equations between individuals with PD and controls. RESULTS After adjustment for age and sex, average CPD (0.446% ± 0.018% vs. 0.439% ± 0.017%, P < 0.001) and CFI (0.434 ± 0.031 vs. 0.426 ± 0.036, P = 0.008) were significantly higher in PD eyes. Average RNFL thickness was similar between groups (PD 89.71 ± 10.45 μm vs. control 88.20 ± 10.33 μm, P = 0.19). Significant correlations between Hoehn and Yahr stage and OCTA parameters were not observed. The OCTA parameters were not significantly different between eyes of the same patient. CONCLUSIONS Increased peripapillary microvascular density and flux were detected in a large cohort of individuals with PD compared with controls after adjusting for age and sex; however, RNFL thickness was similar between groups. Peripapillary OCTA parameters may not correlate with the severity of PD. OCTA may serve as a noninvasive method to identify novel biomarkers for the early diagnosis of PD; as such, this methodology deserves further investigation.
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Affiliation(s)
- Cason B Robbins
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Dilraj S Grewal
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Atalie C Thompson
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Srinath Soundararajan
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Stephen P Yoon
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Bryce W Polascik
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Burton L Scott
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Sharon Fekrat
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
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22
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Abstract
Melanopsin retinal ganglion cells (mRGCs) are the third class of retinal photoreceptors with unique anatomical, electrophysiological, and biological features. There are different mRGC subtypes with differential projections to the brain. These cells contribute to many nonimage-forming functions of the eye, the most relevant being the photoentrainment of circadian rhythms through the projections to the suprachiasmatic nucleus of the hypothalamus. Other relevant biological functions include the regulation of the pupillary light reflex, mood, alertness, and sleep, as well as a possible role in formed vision. The relevance of the mRGC-related pathways in the brain is highlighted by the role that the dysfunction and/or loss of these cells may play in affecting circadian rhythms and sleep in many neurodegenerative disorders including Alzheimer's, Parkinson's and Huntington's disease and in aging. Moreover, the occurrence of circadian dysfunction is a known risk factor for dementia. In this chapter, the anatomy, physiology, and functions of these cells as well as their resistance to neurodegeneration in mitochondrial optic neuropathies or their predilection to be lost in other neurodegenerative disorders will be discussed.
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23
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Visser F, Apostolov VI, Vlaar AMM, Twisk JWR, Weinstein HC, Berendse HW. Visual hallucinations in Parkinson's disease are associated with thinning of the inner retina. Sci Rep 2020; 10:21110. [PMID: 33273513 PMCID: PMC7712774 DOI: 10.1038/s41598-020-77833-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/10/2020] [Indexed: 11/09/2022] Open
Abstract
Visual hallucinations (VH) are common in patients with Parkinson's disease (PD), yet the underlying pathophysiological mechanisms are still unclear. We aimed to explore the association of the presence of VH with inner retinal thinning and, secondarily, with visual acuity. To this end, we included 40 PD patients in this exploratory study, of whom 14 had VH, and 22 age- and sex-matched healthy controls. All participants were interviewed for the presence of VH by a neurologist specialized in movement disorders and underwent a thorough ophthalmologic examination, including measurement of the best-corrected visual acuity (BCVA) and optical coherence tomography to obtain macular scans of the combined ganglion cell layer and inner plexiform layer (GCL-IPL). Patients with VH had a thinner GCL-IPL than patients without VH, which persisted after correction for age, disease stage, levodopa equivalent daily dose (LED) and cognitive function. Furthermore, BCVA was lower in the PD group with VH than in the PD group without VH, although only a trend remained after correction for age, disease stage, LED and cognitive function. Taken together, in patients with PD, visual hallucinations appear to be associated with a thinning of the inner retinal layers and, possibly, with reduced visual acuity. Further research using a longitudinal design is necessary to confirm these findings and to establish the causality of these relationships.
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Affiliation(s)
- F Visser
- Department of Neurology, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
| | - V I Apostolov
- Department of Ophthalmology, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands
| | - A M M Vlaar
- Department of Neurology, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands
| | - J W R Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
| | - H C Weinstein
- Department of Neurology, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.,Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - H W Berendse
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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24
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Gokcinar NB, Buturak SV, Ozkal F, Ozcicek G, Yumusak ME, Turgal E. Optical coherence tomography neurodegenerative findings in patients with bipolar disorder. Asia Pac Psychiatry 2020; 12:e12394. [PMID: 32452640 DOI: 10.1111/appy.12394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/31/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Neuroimaging studies of patients with bipolar disorder (BD) have recently revealed neurodegenerative changes in the central nervous system. Optical coherence tomography (OCT) imaging of the retina, as an extension of brain, may be a biomarker in understanding the neurobiology of the disease. To assess OCT as a tool to detect neurodegeneration in BD we compared the retinal changes between patients with BD and healthy individuals. METHODS We performed complete ophthalmological examinations and took OCT images for 70 eyes of 70 patients with BD, and for age and sex-matched individual controls. We compared retinal nerve fiber layers (RNFLs) and total retinal (TR) thickness in the peripapillary areas; and ganglion cell complexes (GCCs) and TR thickness in the maculas between the groups. RESULTS The mean age of the patients was 40.41 ± 13.22 years and that of the controls 40.20 ± 13.03 years. The men/women ratios were 37/33 in both groups. BD was significantly associated with a decrease in the average peripapillary RNFL, with the average peripapillary TR, and with the average GCC thickness (P = .033, P = .008, and P = .009, respectively). The peripapillary RNFL and TR thinnings were prominent in the superior (P = .039, P = .033, respectively) and inferior quadrants (P = .031, P = .018, respectively). The BD effects on GCC thinning was prominent in the superior half (P = .001) and in the nasal sectors (except in the inner superonasal sector; all P < .05). BD was associated with a decrease in macular TR thickness only at the inner superior sector (P = .014). Disease duration was inversely correlated with the peripapillary RNFL, TR, and macular GCC thicknesses (P < .05). DISCUSSION Our findings support the neurodegeneration hypothesis in the etiopathogenesis of BD. OCT, a non-invasive neuro-imaging method, may be useful for BD diagnosis and follow-ups.
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Affiliation(s)
| | - Sadiye Visal Buturak
- Department of Psychiatry, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Fatma Ozkal
- Department of Ophthalmology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Gamze Ozcicek
- Department of Psychiatry, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Mehmet Erhan Yumusak
- Department of Ophthalmology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Ebru Turgal
- Department of Biostatistics, Faculty of Medicine, Hitit University, Çorum, Turkey
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25
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Indrieri A, Pizzarelli R, Franco B, De Leonibus E. Dopamine, Alpha-Synuclein, and Mitochondrial Dysfunctions in Parkinsonian Eyes. Front Neurosci 2020; 14:567129. [PMID: 33192254 PMCID: PMC7604532 DOI: 10.3389/fnins.2020.567129] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/22/2020] [Indexed: 12/21/2022] Open
Abstract
Parkinson’s disease (PD) is characterized by motor dysfunctions including bradykinesia, tremor at rest and motor instability. These symptoms are associated with the progressive degeneration of dopaminergic neurons originating in the substantia nigra pars compacta and projecting to the corpus striatum, and by accumulation of cytoplasmic inclusions mainly consisting of aggregated alpha-synuclein, called Lewy bodies. PD is a complex, multifactorial disorder and its pathogenesis involves multiple pathways and mechanisms such as α-synuclein proteostasis, mitochondrial function, oxidative stress, calcium homeostasis, axonal transport, and neuroinflammation. Motor symptoms manifest when there is already an extensive dopamine denervation. There is therefore an urgent need for early biomarkers to apply disease-modifying therapeutic strategies. Visual defects and retinal abnormalities, including decreased visual acuity, abnormal spatial contrast sensitivity, color vision defects, or deficits in more complex visual tasks are present in the majority of PD patients. They are being considered for early diagnosis together with retinal imaging techniques are being considered as non-invasive biomarkers for PD. Dopaminergic cells can be found in the retina in a subpopulation of amacrine cells; however, the molecular mechanisms leading to visual deficits observed in PD patients are still largely unknown. This review provides a comprehensive analysis of the retinal abnormalities observed in PD patients and animal models and of the molecular mechanisms underlying neurodegeneration in parkinsonian eyes. We will review the role of α-synuclein aggregates in the retina pathology and/or in the onset of visual symptoms in PD suggesting that α-synuclein aggregates are harmful for the retina as well as for the brain. Moreover, we will summarize experimental evidence suggesting that the optic nerve pathology observed in PD resembles that seen in mitochondrial optic neuropathies highlighting the possible involvement of mitochondrial abnormalities in the development of PD visual defects. We finally propose that the eye may be considered as a complementary experimental model to identify possible novel disease’ pathways or to test novel therapeutic approaches for PD.
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Affiliation(s)
- Alessia Indrieri
- Telethon Institute of Genetics and Medicine, Pozzuoli, Italy.,Institute for Genetic and Biomedical Research, National Research Council, Milan, Italy
| | - Rocco Pizzarelli
- Center for Life Nanoscience, Istituto Italiano di Tecnologia, Rome, Italy
| | - Brunella Franco
- Telethon Institute of Genetics and Medicine, Pozzuoli, Italy.,Medical Genetics, Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Elvira De Leonibus
- Telethon Institute of Genetics and Medicine, Pozzuoli, Italy.,Institute of Biochemistry and Cellular Biology, National Research Council, Rome, Italy
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26
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Rascunà C, Russo A, Terravecchia C, Castellino N, Avitabile T, Bonfiglio V, Fallico M, Chisari CG, Cicero CE, Grillo M, Longo A, Luca A, Mostile G, Zappia M, Reibaldi M, Nicoletti A. Retinal Thickness and Microvascular Pattern in Early Parkinson's Disease. Front Neurol 2020; 11:533375. [PMID: 33117254 PMCID: PMC7575742 DOI: 10.3389/fneur.2020.533375] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 08/24/2020] [Indexed: 01/09/2023] Open
Abstract
A thinning of intraretinal layers has been previously described in Parkinson's disease (PD) patients compared to healthy controls (HCs). Few studies evaluated the possible correlation between retinal thickness and retinal microvascularization. Thus, here we assessed the thickness of retinal layers and microvascular pattern in early PD patients and HCs, using, respectively, spectral-domain optical coherence tomography (SD-OCT) and SD-OCT-angiography (SD-OCT-A), and more interestingly, we evaluated a possible correlation between retinal thickness and microvascular pattern. Patients fulfilling criteria for clinically established/clinically probable PD and HCs were enrolled. Exclusion criteria were any ocular, retinal, and systemic disease impairing the visual system. Retinal vascularization was analyzed using SD-OCT-A, and retinal layer thickness was assessed using SD-OCT. Forty-one eyes from 21 PD patients and 33 eyes from 17 HCs were evaluated. Peripapillary retinal nerve fiber layer (RNFL) and macular RNFL, ganglionic cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL), resulted to be thinner in PD compared to HCs. Among PD patients, a positive correlation between RNFL, GCL, and IPL thickness and microvascular density was found in the foveal region, also adjusting by age, sex, and, especially, hypertension. Such findings were already present in the early stage of disease and were irrespective of dopaminergic treatment. Thus, the retina might be considered a biomarker of PD and could be a useful instrument for onset and disease progression.
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Affiliation(s)
- Cristina Rascunà
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Claudio Terravecchia
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | | | | | | | - Matteo Fallico
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Clara Grazia Chisari
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Marco Grillo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Antonio Longo
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Antonina Luca
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Giovanni Mostile
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Mario Zappia
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
| | - Michele Reibaldi
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Section of Neurosciences, Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Catania, Italy
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27
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Guo B, Huang Y, Gao Q, Zhou Q. Stabilization of microtubules improves cognitive functions and axonal transport of mitochondria in Alzheimer's disease model mice. Neurobiol Aging 2020; 96:223-232. [PMID: 33039900 DOI: 10.1016/j.neurobiolaging.2020.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/08/2020] [Accepted: 09/05/2020] [Indexed: 01/08/2023]
Abstract
One major pathological process in Alzheimer's disease is mediated by hyperphosphorylated tau, which includes altered microtubules (MTs) and functions associated with tau. A potential way to compensate for altered MT function is to use an MT stabilizer, such as epothilone D (EpoD). Previous studies have demonstrated improved cognitive functions and axonal transport by EpoD in tau-mutation mice. Here, we demonstrated that extended EpoD treatment also has beneficial effects on APP/PS1 double-transgenic mice, improving their motor and spatial memory, increasing key synaptic protein levels, while not affecting amyloid plaque density or level of tau phosphorylation. Interestingly, EpoD appears to improve the retrieval of formed memories. We also observed improved axonal transport of mitochondria in cultured neurons from APP/PS1 mice. In addition, higher level of perineuronal nets are found in APP/PS1 mice injected with EpoD, suggesting potential contributions of increased inhibition. Our results suggest potential therapeutic value of EpoD in treating Alzheimer's disease.
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Affiliation(s)
- Baihong Guo
- Peking University, Shenzhen Graduate School, School of Chemical Biology and Biotechnology, State Key Laboratory of Chemical Oncogenomics, Key Laboratory of Chemical Genomics, Shenzhen, China
| | - Yangmei Huang
- Peking University, Shenzhen Graduate School, School of Chemical Biology and Biotechnology, State Key Laboratory of Chemical Oncogenomics, Key Laboratory of Chemical Genomics, Shenzhen, China
| | - Qingtao Gao
- Peking University, Shenzhen Graduate School, School of Chemical Biology and Biotechnology, State Key Laboratory of Chemical Oncogenomics, Key Laboratory of Chemical Genomics, Shenzhen, China
| | - Qiang Zhou
- Peking University, Shenzhen Graduate School, School of Chemical Biology and Biotechnology, State Key Laboratory of Chemical Oncogenomics, Key Laboratory of Chemical Genomics, Shenzhen, China.
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28
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Jafari Z, Kolb BE, Mohajerani MH. Reply to a Letter by Dr. Stefani and Colleagues on: "Auditory Dysfunction in Parkinson's Disease". Mov Disord 2020; 35:1284-1285. [PMID: 32691907 DOI: 10.1002/mds.28133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Zahra Jafari
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Alberta, Canada.,Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | - Bryan E Kolb
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Majid H Mohajerani
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Alberta, Canada
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29
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Tsokolas G, Tsaousis KT, Diakonis VF, Matsou A, Tyradellis S. Optical Coherence Tomography Angiography in Neurodegenerative Diseases: A Review. Eye Brain 2020; 12:73-87. [PMID: 32765149 PMCID: PMC7368556 DOI: 10.2147/eb.s193026] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background Optical coherence tomography angiography (OCT-A) has emerged as a novel, fast, safe and non-invasive imaging technique of analyzing the retinal and choroidal microvasculature in vivo. OCT-A captures multiple sequential B-scans performed repeatedly over a specific retinal area at high speed, thus enabling the composition of a vascular map with areas of contrast change (high flow zones) and areas of steady contrast (slow or no flow zones). It therefore provides unique insight into the exact retinal or choroidal layer and location at which abnormal blood flow develops. OCTA has evolved into a useful tool for understanding a number of retinal pathologies such as diabetic retinopathy, age-related macular degeneration, central serous chorioretinopathy, vascular occlusions, macular telangiectasia and choroidal neovascular membranes of other causes. OCT-A technology is also increasingly being used in the evaluation of optic disc perfusion and has been suggested as a valuable tool in the early detection of glaucomatous damage and monitoring progression. Objective To review the existing literature on the applications of optical coherence tomography angiography in neurodegenerative diseases. Summary A meticulous literature was performed until the present day. Google Scholar, PubMed, Mendeley search engines were used for this purpose. We used 123 published manuscripts as our references. OCT-A has been utilized so far to describe abnormalities in multiple sclerosis (MS), Alzheimer’s disease, arteritic and non-arteritic optic neuropathy (AION and NAION), Leber’s hereditary optic neuropathy (LHON) papilloedema, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis (ALS), Wolfram syndrome, migraines, lesions of the visual pathway and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). It appears that OCT-A findings correlate quite well with the severity of the aforementioned diseases. However, OCT-A has its own limitations, namely its lack of wide-field view of the peripheral retina and the inaccurate interpretation due to motion artifacts in uncooperative groups of patients (e.g. children). Larger prospective longitudinal studies will need to be conducted in order to eliminate the aforementioned limitations.
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Affiliation(s)
- Georgios Tsokolas
- Ophthalmology Department, Leicester Royal Infirmary, University Hospitals of Leicester, Leicester, UK
| | - Konstantinos T Tsaousis
- Ophthalmology Department, Leicester Royal Infirmary, University Hospitals of Leicester, Leicester, UK
| | | | - Artemis Matsou
- Ophthalmology Department, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Straton Tyradellis
- Ophthalmology Department, Leicester Royal Infirmary, University Hospitals of Leicester, Leicester, UK
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30
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Pellegrini M, Vagge A, Ferro Desideri L, Bernabei F, Triolo G, Mastropasqua R, Del Noce C, Borrelli E, Sacconi R, Iovino C, Di Zazzo A, Forlini M, Giannaccare G. Optical Coherence Tomography Angiography in Neurodegenerative Disorders. J Clin Med 2020; 9:E1706. [PMID: 32498362 PMCID: PMC7356677 DOI: 10.3390/jcm9061706] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022] Open
Abstract
Retinal microcirculation shares similar features with cerebral small blood vessels. Thus, the retina may be considered an accessible 'window' to detect the microvascular damage occurring in the setting of neurodegenerative disorders. Optical coherence tomography angiography (OCT-A) is a non-invasive imaging modality providing depth resolved images of blood flow in the retina, choroid, and optic nerve. In this review, we summarize the current literature on the application of OCT-A in glaucoma and central nervous system conditions such as Alzheimer's disease, Parkinson's disease, and multiple sclerosis. Future directions aiming at evaluating whether OCT-A can be an additional biomarker for the early diagnosis and monitoring of neurodegenerative disorders are also discussed.
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Affiliation(s)
- Marco Pellegrini
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Aldo Vagge
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy; (L.F.D.); (C.D.N.)
| | - Lorenzo Ferro Desideri
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy; (L.F.D.); (C.D.N.)
| | - Federico Bernabei
- Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (F.B.)
| | - Giacinto Triolo
- Ophthalmology Department, Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, 63631 Milan, Italy;
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Chiara Del Noce
- University Eye Clinic, DINOGMI, Polyclinic Hospital San Martino IRCCS, 16132 Genoa, Italy; (L.F.D.); (C.D.N.)
| | - Enrico Borrelli
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Riccardo Sacconi
- Department of Ophthalmology, Hospital San Raffaele, University Vita Salute San Raffaele, 20132 Milan, Italy; (E.B.); (R.S.)
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy;
| | - Antonio Di Zazzo
- Department of Ophthalmology, University Campus Bio-Medico of Rome, 00128 Rome, Italy;
| | - Matteo Forlini
- Domus Nova Hospital, 48121 Ravenna, Italy;
- Department of Ophthalmology, Ospedale dello Stato della Repubblica di San Marino, 47893 Città di San Marino, San Marino
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University “Magna Graecia”, 88100 Catanzaro, Italy;
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31
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Mohana Devi S, Mahalaxmi I, Aswathy NP, Dhivya V, Balachandar V. Does retina play a role in Parkinson's Disease? Acta Neurol Belg 2020; 120:257-65. [PMID: 31965540 DOI: 10.1007/s13760-020-01274-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/06/2020] [Indexed: 12/19/2022]
Abstract
Visual disorder is one of the non-motor symptoms found in Parkinson's disease (PD). It can be easily identified in the early stages even before the spread of pathological conditions to the brain parts. Studies have revealed that loss of dopamine (DA) cells in retinal layers is a prime cause for both retinal disturbance and pathological conditions of PD. This reduction of DA in retina is due to the aggregation of phosphorylated α-synuclein (aSyn) in the intra-retinal region, which eventually results in visual impairment in PD. Until now, very limited studies have been focused on the mechanism of aSyn influence and DA depletion as a cause for both retinal layer dysfunction and PD. Thus, more research is warranted to provide the missing connection between the exact role of DA and aSyn as a risk factor for visual problems in PD. Hence, the current review's focus is on the function and effects of DA degeneration in retinal cells of PD. Further, we suggest that iron plays a major role in regulating the aggregation of aSyn in the DA cells of retina and brain in PD. The study finds that the unidentified pathophysiological role of retinal degeneration in PD is an essential biomarker that needs further investigation to use it as a novel therapy in treating retinal dysfunctions in PD.
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32
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Tugcu B, Melikov A, Yildiz GB, Gökcal E, Ercan R, Uysal O, Ozdemir H. Evaluation of retinal alterations in Parkinson disease and tremor diseases. Acta Neurol Belg 2020; 120:107-113. [PMID: 31679150 DOI: 10.1007/s13760-019-01228-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 10/17/2019] [Indexed: 11/29/2022]
Abstract
Optical coherence tomography (OCT) has been suggested as a method for detection of retinal alterations in neurodegenerative diseases. The usefulness of OCT as a diagnostic tool to differentiate Parkinson's disease (PD) from other tremor diseases, remains unknown. We aimed to evaluate morphological changes of the retina in patients with PD, essential tremor (ET), essential tremor-Parkinson's disease (ET-PD) using OCT. Forty-two eyes of 21 patients with PD, 24 eyes of 12 patients with ET, 24 eyes of 12 patients with ET-PD and 44 eyes of 22 age-matched healthy controls were included in the study. All participants underwent detailed neurological and ophthalmological examination. Measurements in all quadrants of macula and retinal nerve fiber layer (RNFL) thickness using OCT were recorded. There was no significant difference among the groups regarding age, sex. The average RNFL thickness was thinner in PD patients than that of ET (p = 0.032). The RNFL thickness in superior quadrant was lower in PD group compared with the ET and control group (p = 0.001, p = 0.016). Significant differences were observed in most of the macular thickness parameters excluding foveolar and foveal thickness (p = 0.865, 0.394). Correlations were found among several OCT parameters and disease duration or severity in all patient groups (p > 0.05). Retinal alterations were found in PD patients compared to ET. However, no significant retinal changes were detected by OCT in patients with ET and ET-PD compared to controls. According to our data, retinal assessments by OCT do not seem to be satisfactory for differentiation of these disorders.
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Affiliation(s)
- Betul Tugcu
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakıf Üniversitesi Tıp Fakültesi, Bezmialem Vakif University, Göz Hastalıkları A.D. Adnan Menderes Bulvarı, 34093, Istanbul, Turkey.
| | - Arif Melikov
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakıf Üniversitesi Tıp Fakültesi, Bezmialem Vakif University, Göz Hastalıkları A.D. Adnan Menderes Bulvarı, 34093, Istanbul, Turkey
| | - Gulsen Babacan Yildiz
- Department of Neurology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Elif Gökcal
- Department of Neurology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Rukiye Ercan
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Omer Uysal
- Department of Medical Statistics and Informatics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Hakan Ozdemir
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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33
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Alkabie S, Lange A, Manogaran P, Stoessl AJ, Costello F, Barton JJS. Optical coherence tomography of patients with Parkinson's disease and progressive supranuclear palsy. Clin Neurol Neurosurg 2019; 189:105635. [PMID: 31855622 DOI: 10.1016/j.clineuro.2019.105635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/23/2019] [Accepted: 12/07/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To determine if Parkinson's disease (PD) and progressive supranuclear palsy (PSP) differed on retinal measurements using optical coherence tomography (OCT). PATIENTS AND METHODS In a prospective, controlled, cross-sectional cohort study, we recruited patients with PD or PSP for more than three years, as well as control subjects. We measured peripapillary retinal nerve fiber layer (RNFL) thickness and macular volume using spectral-domain OCT. The association between these OCT measures and the disease characteristics of duration and disability were examined using a linear mixed effect model. RESULTS We analyzed eyes from n = 12 PD patients, n = 11 PSP patients, and n = 12 control subjects. RNFL thickness was reduced in eyes from patients with PSP, but there were no differences in macular volume between groups. RNFL thickness and macular volume were not significantly different between eyes from patients with PD and controls. Worse disability was associated with reduced macular volumes. CONCLUSION PSP but not PD is associated with thinning of the peripapillary RNFL when symptoms have been present for more than three years.
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Affiliation(s)
- Samir Alkabie
- Division of Neurology, University of British Columbia, Vancouver, BC, Canada; Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, NY, USA; Department of Neurology, Kings County Hospital, Brooklyn, NY, USA.
| | - Alex Lange
- Neuro-ophthalmology, Department of Ophthalmology, University of British Columbia, Vancouver, BC, Canada; Vista Klinik, Vista Diagnostics and Laser Vista, Binningen, Switzerland
| | - Praveena Manogaran
- Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Department of Information Technology and Electrical Engineering, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - A Jon Stoessl
- Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Fiona Costello
- Neuro-ophthalmology, Department of Clinical Neurosciences and Surgery, University of Calgary, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Jason J S Barton
- Neuro-ophthalmology, Department of Ophthalmology, University of British Columbia, Vancouver, BC, Canada
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Yap TE, Balendra SI, Almonte MT, Cordeiro MF. Retinal correlates of neurological disorders. Ther Adv Chronic Dis 2019; 10:2040622319882205. [PMID: 31832125 PMCID: PMC6887800 DOI: 10.1177/2040622319882205] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
Considering the retina as an extension of the brain provides a platform from which to study diseases of the nervous system. Taking advantage of the clear optical media of the eye and ever-increasing resolution of modern imaging techniques, retinal morphology can now be visualized at a cellular level in vivo. This has provided a multitude of possible biomarkers and investigative surrogates that may be used to identify, monitor and study diseases until now limited to the brain. In many neurodegenerative conditions, early diagnosis is often very challenging due to the lack of tests with high sensitivity and specificity, but, once made, opens the door to patients accessing the correct treatment that can potentially improve functional outcomes. Using retinal biomarkers in vivo as an additional diagnostic tool may help overcome the need for invasive tests and histological specimens, and offers the opportunity to longitudinally monitor individuals over time. This review aims to summarise retinal biomarkers associated with a range of neurological conditions including Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and prion diseases from a clinical perspective. By comparing their similarities and differences according to primary pathological processes, we hope to show how retinal correlates can aid clinical decisions, and accelerate the study of this rapidly developing area of research.
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Affiliation(s)
- Timothy E Yap
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
| | - Shiama I Balendra
- Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
| | - Melanie T Almonte
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | - M Francesca Cordeiro
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, NW1 5QH, UK
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Rojas P, de Hoz R, Ramírez AI, Ferreras A, Salobrar-Garcia E, Muñoz-Blanco JL, Urcelay-Segura JL, Salazar JJ, Ramírez JM. Changes in Retinal OCT and Their Correlations with Neurological Disability in Early ALS Patients, a Follow-Up Study. Brain Sci 2019; 9:brainsci9120337. [PMID: 31771268 PMCID: PMC6955774 DOI: 10.3390/brainsci9120337] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/12/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To compare early visual changes in amyotrophic lateral sclerosis (ALS) patients with healthy controls in a baseline exploration, to follow-up the patients after 6 months, and to correlate these visual changes with neurological disability. METHODS All patients underwent a comprehensive neurological and ophthalmological examination. A linear mixed analysis and Bonferroni p-value correction were performed, testing four comparisons as follows: Control baseline vs. control follow-up, control baseline vs. ALS baseline, control follow-up vs. ALS follow-up, and ALS baseline vs. ALS follow-up. RESULTS The mean time from the diagnosis was 10.80 ± 5.5 months. The analysis of the optical coherence tomography (OCT) showed: (1) In ALS baseline vs. control baseline, a macular significantly increased thickness of the inner macular ring temporal and inferior areas; (2) in ALS follow-up vs. ALS baseline, a significant macular thinning in the inner and outer macular ring inferior areas; (3) in ALS follow-up vs. ALS baseline, a significant peripapillary retinal nerve fiber layer (pRNFL) thinning in the superior and inferior quadrants; and (4) ALS patients showed a moderate correlation between some OCT pRNFL parameters and Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score. CONCLUSION The OCT showed retinal changes in patients with motoneuron disease and could serve as a complementary tool for studying ALS.
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Affiliation(s)
- Pilar Rojas
- General University Hospital Gregorio Marañón, Ophthalmic Institute of Madrid, 28007 Madrid, Spain; (P.R.); (J.L.U.-S.)
- Ramón Castroviejo Ophthalmological Research Institute, Complutense University of Madrid, 28040 Madrid, Spain; (R.d.H.); (A.I.R.); (E.S.-G.)
| | - Rosa de Hoz
- Ramón Castroviejo Ophthalmological Research Institute, Complutense University of Madrid, 28040 Madrid, Spain; (R.d.H.); (A.I.R.); (E.S.-G.)
- Department of Immunology, Ophthalmology and Otorhinolaryngology, School of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Ana I. Ramírez
- Ramón Castroviejo Ophthalmological Research Institute, Complutense University of Madrid, 28040 Madrid, Spain; (R.d.H.); (A.I.R.); (E.S.-G.)
- Department of Immunology, Ophthalmology and Otorhinolaryngology, School of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Antonio Ferreras
- Miguel Servet University Hospital, Aragonese Institute of Health Sciences, 50009 Zaragoza, Spain;
| | - Elena Salobrar-Garcia
- Ramón Castroviejo Ophthalmological Research Institute, Complutense University of Madrid, 28040 Madrid, Spain; (R.d.H.); (A.I.R.); (E.S.-G.)
- Department of Immunology, Ophthalmology and Otorhinolaryngology, School of Medicine, Complutense University, 28040 Madrid, Spain
| | - José L. Muñoz-Blanco
- Department of Neurology, ALS-Neuromuscular Unit, Gregorio Marañón Health Research Institute, 28007 Madrid, Spain;
| | - José L. Urcelay-Segura
- General University Hospital Gregorio Marañón, Ophthalmic Institute of Madrid, 28007 Madrid, Spain; (P.R.); (J.L.U.-S.)
- Department of Immunology, Ophthalmology and Otorhinolaryngology, School of Medicine, Complutense University, 28040 Madrid, Spain
| | - Juan J. Salazar
- Ramón Castroviejo Ophthalmological Research Institute, Complutense University of Madrid, 28040 Madrid, Spain; (R.d.H.); (A.I.R.); (E.S.-G.)
- Department of Immunology, Ophthalmology and Otorhinolaryngology, School of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
- Correspondence: (J.J.S.); (J.M.R.)
| | - José M. Ramírez
- Ramón Castroviejo Ophthalmological Research Institute, Complutense University of Madrid, 28040 Madrid, Spain; (R.d.H.); (A.I.R.); (E.S.-G.)
- Department of Immunology, Ophthalmology and Otorhinolaryngology, School of Medicine, Complutense University, 28040 Madrid, Spain
- Correspondence: (J.J.S.); (J.M.R.)
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Lee J, Ahn J, Oh S, Shin JY, Kim YK, Nam H, Jeon B. Retina Thickness as a Marker of Neurodegeneration in Prodromal Lewy Body Disease. Mov Disord 2019; 35:349-354. [DOI: 10.1002/mds.27914] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/02/2019] [Accepted: 10/06/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jee‐Young Lee
- Department of Neurology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Jeeyun Ahn
- Department of Ophthalmology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Sohee Oh
- Department of Biomedical Statistics Seoul Metropolitan Government‐Seoul National University Boramae Medical Center Seoul Republic of Korea
| | - Joo Young Shin
- Department of Ophthalmology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Hyunwoo Nam
- Department of Neurology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Beomseok Jeon
- Department of Neurology Seoul National University Hospital and Seoul National University College of Medicine Seoul Republic of Korea
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Ma LJ, Xu LL, Mao CJ, Fu YT, Ji XY, Shen Y, Chen J, Yang YP, Liu CF. Progressive Changes in the Retinal Structure of Patients with Parkinson's Disease. J Parkinsons Dis 2019; 8:85-92. [PMID: 29480221 DOI: 10.3233/jpd-171184] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many optical coherence tomography (OCT) studies have reported alterations in the retinal nerve fiber layer (RNFL) in Parkinson's disease (PD) and other neurodegenerative diseases. However, whether retinal alterations are a biomarker for PD is still controversial. OBJECTIVE To investigate potential correlations between PD and morphological changes in retina using OCT and to determine its usefulness as a biomarker of disease progression in PD. METHODS We performed a cross-sectional study on patients with PD (N = 37) and age-matched controls (N = 42), followed by a longitudinal study of the PD patients (N = 22) over approximately 2.5 years. RESULTS The average retinal nerve fiber layer (RNFL) thickness (p < 0.001), total macular thickness (p = 0.001), and macular volume (p = 0.001) were decreased in PD patients compared to controls and had further decreased at the follow-up visit (p < 0.05 for all). The average RNFL thickness and the total thickness of macular were negatively correlated with age in PD patients at baseline. Linear regression analysis revealed that age (p = 0.002, p = 0.003, respectively) and LEDD (p = 0.011, p = 0.013, respectively) were correlated to total thickness and volume of macular in 22 PD patients in the follow-up study. However, no correlation was found between RNFL and other parameters. CONCLUSIONS PD progression is associated with pronounced retinal structure changes, which can be quantified by OCT. Patterns of RNFL and macular damage detected by the noninvasive technology of OCT can be a useful biomarker for evaluating the progression of PD.
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Affiliation(s)
- Li-Jing Ma
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ling-Li Xu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun-Ting Fu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiao-Yan Ji
- Department of Ophthalmology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun Shen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ya-Ping Yang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China.,Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
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Sung MS, Choi SM, Kim J, Ha JY, Kim BC, Heo H, Park SW. Inner retinal thinning as a biomarker for cognitive impairment in de novo Parkinson's disease. Sci Rep 2019; 9:11832. [PMID: 31413302 PMCID: PMC6694167 DOI: 10.1038/s41598-019-48388-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/02/2019] [Indexed: 12/13/2022] Open
Abstract
We investigated the association between retinal changes measured using optical coherence tomography (OCT) and diverse clinical grading scales in patients with Parkinson’s disease (PD). Seventy-four eyes of 74 patients with de novo PD and 53 eyes of age-matched control subjects were included. The thickness of the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) were measured. We analyzed the correlations between the clinical PD grading scales and OCT parameters, and between the OCT parameters and volumetric data in the cerebral cortical and subcortical structures. The area under the receiver operating characteristic curve (AUC) was calculated for diagnosing cognitive impairment in patients with PD. Statistically significant reductions in the thickness of average, temporal, and inferior pRNFL and overall mGCIPL were observed in patients with PD. The Montreal Cognitive Assessment score was significantly associated with mGCIPL thinning. The AUC of the mGCIPL parameters for diagnosing cognitive impairment in patients with PD ranged from 0.651 to 0.760. Moreover, thinning of the mGCIPL was significantly associated with the volumetric parameters of associated brain structures. Our findings highlight the clinical implications of OCT measurements as a potential biomarker for early detection of cognitive impairment in patients with PD.
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Affiliation(s)
- Mi Sun Sung
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Jonghwa Kim
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Jun Young Ha
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Byeong-Chae Kim
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Hwan Heo
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea.
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Mailankody P, Lenka A, Pal PK. The role of Optical Coherence Tomography in Parkinsonism: A critical review. J Neurol Sci 2019; 403:67-74. [PMID: 31228766 DOI: 10.1016/j.jns.2019.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 05/11/2019] [Accepted: 06/09/2019] [Indexed: 12/21/2022]
Abstract
Optical coherence tomography (OCT) has been evaluated as a tool to assess retinal changes in various neurodegenerative disorders. Parkinson's disease (PD), is a neurodegenerative disorder wherein dopaminergic deficiency results in some of the symptoms. As retina also has high concentration of dopamine, it would be of interest for both the clinician as well as the basic scientist to know if there is a correlation between the clinical features and the retinal changes. The objective of this review is to critically evaluate the literature and study the utility of OCT as a tool to evaluate retinal changes in PD.
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Affiliation(s)
- Pooja Mailankody
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India
| | - Abhishek Lenka
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India.
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Abstract
BACKGROUND Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial encephalomyopathy caused by multiple mtDNA abnormalities. There is little information about the changes of ocular fundus with CPEO. The aim of this work was to measure and evaluate changes in the macular retinal thickness and optic nerve head in patients with CPEO using spectral-domain optical coherence tomography and to compare the findings with those of healthy individuals. METHODS Totally, 18 CPEO patients were enrolled in this study. Healthy volunteers matched for gender, age, and diopter settings were included as a control group. The retinal thickness of macular central fovea, inner and outer retinal layer thickness of perifoveal macular, optic nerve head parameters, and peripapillay retinal nerve fiber layer thickness (pRNFLT) for all included cases were measured using spectral-domain optical coherence tomography. A paired t test was used to compare the differences in the studied parameters between the two groups. The correlations between macular retinal thickness, pRNFLT, disease duration, and age of onset were also analyzed. RESULTS Among the macular parameters, retinal thickness of macular central fovea (t = -2.135, P < 0.05) and outer retinal layer thickness (t = -1.994, P < 0.05) of patients in the CPEO group were statistically significant lower than those of patients in the normal control group. For the optic nerve head parameters, the patients in the CPEO group showed a larger rim volume (t = -2.499, P < 0.05) and nerve head volume (t = -2.103, P < 0.05). The overall pRNFLT of patients in the CPEO group was statistically significant lower than that of patients in the control group (t = -4.125, P < 0.05). The comparison of pRNFLT in eight sectors showed that the pRNFLT of patients in the CPEO group was statistically significant lower than that of the control group mainly in the inferior and temporal sectors. The degree of pRNFL defect negatively correlated with the disease duration (r = -0.583, P < 0.05). CONCLUSIONS The retinal thickness of patients with CPEO was significantly thinner, which was mostly the outer retina. The patients' optic discs had a low volume and the loss of the retinal nerve fiber layer was obvious. With the extension of the disease duration, the retinal nerve fiber layer defect was even more significant.
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Chrysou A, Jansonius NM, van Laar T. Retinal layers in Parkinson's disease: A meta-analysis of spectral-domain optical coherence tomography studies. Parkinsonism Relat Disord 2019; 64:40-49. [PMID: 31054866 DOI: 10.1016/j.parkreldis.2019.04.023] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 03/15/2019] [Accepted: 04/29/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with Parkinson's disease experience visual symptoms, partially originating from retinal changes. Since 2011, multiple case-control studies using spectral-domain OCT, which allows for studying individual retinal layers, have been published. The aim of this study was to substantiate the occurrence, extent, and location of retinal degeneration in Parkinson's by meta-analysis. METHODS Spectral-domain OCT case-control data were collected by performing a search in PubMed and Embase with terms: "optical coherence tomography" and "parkinson", up to November 5th, 2018. Studies with fewer than 10 patients or controls were excluded. We performed a random effects meta-analysis. Heterogeneity was evaluated with I2 statistics; publication bias with Egger's and Begg's tests. RESULTS Out of 77 identified studies, 36 were included, totaling 1916 patients and 2006 controls. A significant thinning of the peripapillary retinal nerve fiber layer (d = -0.42; 95% confidence interval -0.54 to -0.29) and the combined ganglion cell and inner plexiform layers (d = -0.40; -0.72, to -0.07) was found. The inner nuclear layer and outer plexiform layer did not show significant changes. Heterogeneity ranged from 3 to 92%; no publication bias was found. CONCLUSIONS Parkinson's patients show significant thinning of the inner retinal layers, resembling changes found in glaucoma and other neurodegenerative diseases like Alzheimer's. Study of different cell layers in-vivo is possible by moving from time-to spectral domain OCT. Retinal degeneration may be affiliated with neurodegenerative pathology overall, and could serve as a biomarker in neurodegenerative disorders. Longitudinal research including clinical correlations is needed to determine usefulness in Parkinson's disease.
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Affiliation(s)
- Asterios Chrysou
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Teus van Laar
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
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Veys L, Vandenabeele M, Ortuño-Lizarán I, Baekelandt V, Cuenca N, Moons L, De Groef L. Retinal α-synuclein deposits in Parkinson's disease patients and animal models. Acta Neuropathol 2019; 137:379-395. [PMID: 30721408 DOI: 10.1007/s00401-018-01956-z] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 12/22/2018] [Accepted: 12/22/2018] [Indexed: 12/21/2022]
Abstract
Despite decades of research, accurate diagnosis of Parkinson's disease remains a challenge, and disease-modifying treatments are still lacking. Research into the early (presymptomatic) stages of Parkinson's disease and the discovery of novel biomarkers is of utmost importance to reduce this burden and to come to a more accurate diagnosis at the very onset of the disease. Many have speculated that non-motor symptoms could provide a breakthrough in the quest for early biomarkers of Parkinson's disease, including the visual disturbances and retinal abnormalities that are seen in the majority of Parkinson's disease patients. An expanding number of clinical studies have investigated the use of in vivo assessments of retinal structure, electrophysiological function, and vision-driven tasks as novel means for identifying patients at risk that need further neurological examination and for longitudinal follow-up of disease progression in Parkinson's disease patients. Often, the results of these studies have been interpreted in relation to α-synuclein deposits and dopamine deficiency in the retina, mirroring the defining pathological features of Parkinson's disease in the brain. To better understand the visual defects seen in Parkinson's disease patients and to propel the use of retinal changes as biomarkers for Parkinson's disease, however, more conclusive neuropathological evidence for the presence of retinal α-synuclein aggregates, and its relation to the cerebral α-synuclein burden, is urgently needed. This review provides a comprehensive and critical overview of the research conducted to unveil α-synuclein aggregates in the retina of Parkinson's disease patients and animal models, and thereby aims to aid the ongoing discussion about the potential use of the retinal changes and/or visual symptoms as biomarkers for Parkinson's disease.
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Litvinenko IV, Dynin PS, Trufanov AG, Gimadutdinov RF, Maltsev DS. [Eye as an object of investigation of cognitive impairment in Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:105-114. [PMID: 30346443 DOI: 10.17116/jnevro2018118062105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To study visual and spatial disorders in Parkinson's disease (PD). MATERIAL AND METHODS One hundred and eighteen patients with PD and 30 healthy people (the control group) were studied. All participants underwent neurological and ophthalmological examinations. PD progression was assessed using The Hoehn and Yahr scale. MMSE, FAB and other psychological tests were administered. Optical coherence tomography (OCT) and MRI of the brain were performed. RESULTS AND CONCLUSION The relationship of the variation in the thickness of various parts of the retina and brain cortex with cognitive deficit that manifests itself as visual-spatial disturbances is shown. The complex diagnostic technique, including neuropsychological and instrumental method (OCT of the retina, MRI of the brain with MRI-morphometry), should be used.
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Affiliation(s)
- I V Litvinenko
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - P S Dynin
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - A G Trufanov
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - R F Gimadutdinov
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - D S Maltsev
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
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Guo L, Normando EM, Shah PA, De Groef L, Cordeiro MF. Oculo-visual abnormalities in Parkinson's disease: Possible value as biomarkers. Mov Disord 2018; 33:1390-1406. [DOI: 10.1002/mds.27454] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/16/2018] [Accepted: 05/18/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Li Guo
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
| | - Eduardo M. Normando
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Western Eye Hospital, Imperial College Healthcare National Health Service Trust; London UK
- Imperial College Ophthalmology Research Group, Department of Surgery and Cancer, Imperial College London; London UK
| | - Parth Arvind Shah
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
| | - Lies De Groef
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Neural Circuit Development and Regeneration Research Group, Department of Biology; University of Leuven; Leuven Belgium
| | - M. Francesca Cordeiro
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Western Eye Hospital, Imperial College Healthcare National Health Service Trust; London UK
- Imperial College Ophthalmology Research Group, Department of Surgery and Cancer, Imperial College London; London UK
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Turcano P, Chen JJ, Bureau BL, Savica R. Early ophthalmologic features of Parkinson’s disease: a review of preceding clinical and diagnostic markers. J Neurol 2019; 266:2103-11. [DOI: 10.1007/s00415-018-9051-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
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Affiliation(s)
- Olga Waln
- Department of Neurology, Houston Methodist Neurological Institute, Houston, TX, USA
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorder Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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Visser F, Vermeer KA, Ghafaryasl B, Vlaar AMM, Apostolov V, van Hellenberg Hubar J, Weinstein HC, de Boer JF, Berendse HW. In vivo exploration of retinal nerve fiber layer morphology in Parkinson’s disease patients. J Neural Transm (Vienna) 2018; 125:931-6. [DOI: 10.1007/s00702-018-1872-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Carelli V, La Morgia C, Ross-Cisneros FN, Sadun AA. Optic neuropathies: the tip of the neurodegeneration iceberg. Hum Mol Genet 2018; 26:R139-R150. [PMID: 28977448 PMCID: PMC5886475 DOI: 10.1093/hmg/ddx273] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 07/10/2017] [Indexed: 01/06/2023] Open
Abstract
The optic nerve and the cells that give origin to its 1.2 million axons, the retinal ganglion cells (RGCs), are particularly vulnerable to neurodegeneration related to mitochondrial dysfunction. Optic neuropathies may range from non-syndromic genetic entities, to rare syndromic multisystem diseases with optic atrophy such as mitochondrial encephalomyopathies, to age-related neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease where optic nerve involvement has, until recently, been a relatively overlooked feature. New tools are available to thoroughly investigate optic nerve function, allowing unparalleled access to this part of the central nervous system. Understanding the molecular pathophysiology of RGC neurodegeneration and optic atrophy, is key to broadly understanding the pathogenesis of neurodegenerative disorders, for monitoring their progression in describing the natural history, and ultimately as outcome measures to evaluate therapies. In this review, the different layers, from molecular to anatomical, that may contribute to RGC neurodegeneration and optic atrophy are tackled in an integrated way, considering all relevant players. These include RGC dendrites, cell bodies and axons, the unmyelinated retinal nerve fiber layer and the myelinated post-laminar axons, as well as olygodendrocytes and astrocytes, looked for unconventional functions. Dysfunctional mitochondrial dynamics, transport, homeostatic control of mitobiogenesis and mitophagic removal, as well as specific propensity to apoptosis may target differently cell types and anatomical settings. Ultimately, we can envisage new investigative approaches and therapeutic options that will speed the early diagnosis of neurodegenerative diseases and their cure.
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Affiliation(s)
- Valerio Carelli
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Chiara La Morgia
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | | | - Alfredo A Sadun
- Doheny Eye Institute, Los Angeles, CA 90033, USA.,Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
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Unlu M, Gulmez Sevim D, Gultekin M, Karaca C. Correlations among multifocal electroretinography and optical coherence tomography findings in patients with Parkinson's disease. Neurol Sci 2018; 39:533-541. [PMID: 29349656 DOI: 10.1007/s10072-018-3244-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/02/2018] [Indexed: 11/26/2022]
Abstract
To assess the correlation between functional and anatomical evaluations with multifocal electroretinography (mfERG) and spectral-domain optical coherence tomography (SD-OCT) in patients with Parkinson's disease (PD). This cross-sectional study involved 116 eyes of 58 patients with PD and 30 age- and sex-matched control subjects. All study participants underwent a comprehensive neuro-ophthalmic examination, retinal single-layer thicknesses and volumes, and peripapillary retinal nerve fiber layer (pRNFL) measurements with SD-OCT, and the patients' mfERG recordings were evaluated. The macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), and photoreceptor layer (PR) thicknesses, and mRNFL, RPE, and PR volumes were found lower in PD compared to those of controls, while outer plexiform layer (OPL) volumes were increased (p < 0.05). We found delayed implicit times and decreased amplitudes in the mfERG of PD patients versus those in control subjects (p < 0.05). We found significant correlations between outer macular volumes, PR thicknesses, and N1 amplitudes of rings 2 and 3and P1 amplitudes of rings 3, 4, and 5. Our study revealed thinning of both inner and outer retinal single layers, increased OPL volume, and delayed implicit times and decreased amplitudes in the mfERG of PD patients versus control subjects and correlation between structural and functional parameters. Our findings point out that SD-OCT and mfERG could both serve as non-invasive tools for evaluating ophthalmic manifestations of Parkinson's disease.
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Affiliation(s)
- Metin Unlu
- School of Medicine, Ophthalmology Department, Erciyes University, 38039, Kayseri, Turkey.
| | - Duygu Gulmez Sevim
- School of Medicine, Ophthalmology Department, Erciyes University, 38039, Kayseri, Turkey
| | - Murat Gultekin
- School of Medicine, Neurology Department, Erciyes University, 38039, Kayseri, Turkey
| | - Cagatay Karaca
- School of Medicine, Ophthalmology Department, Erciyes University, 38039, Kayseri, Turkey
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