METHODS: Seventy-eight subjects including 40 PD patients and 38 NC had completed optical coherence tomography angiography (OCTA) and neurological examinations for three rating scales (UPDRS-III, MMSE and MoCA). The IA was calculated by the absolute value of difference in right and left eyes. The IA of thickness in macular ganglion cell inner-plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and vessel density of superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) were obtained from OCTA.
RESULTS: The motor-symptom-onset side of eyes showed lower vessel density in parafovea of SCP (51.09 ± 3.46 vs 49.81 ± 4.16, P = 0.03) and superior hemi of perifovea DCP (49.55 ± 5.81 vs 47.33 ± 5.71, = 0.04). The PD patients showed larger IA in thickness of superior half of pRNFL (5.27 [2.67, 10.87] vs 3.08 [1.62, 5.61], P = 0.02) and parafovea GCIPL (2.40[1.25, 6.35] vs 1.40[0.50, 2.45], P = 0.02). No significant interocular asymmetry was found in vessel density between PD and NC. A higher UPDRS-III scale was associated with larger IA in GCIPL (β = 0.093, P = 0.001) and smaller IA in DCP (β = -0.065, P = 0.037).
CONCLUSIONS: The motor-symptom-onset side of eyes showed more severe loss of macular vessel density than the other side of eyes. The PD patients showed asymmetrical structural change in GCIPL and pRNFL, which showed the potential as the diagnostic biomarker for PD.
方法:78名受试者,包括40名PD患者和38名NC,完成了光学相干断层扫描血管造影(OCTA)和神经系统检查的三个等级量表(UPDRS-III,MMSE和MoCA)。IA是通过右眼和左眼差异的绝对值计算的。黄斑神经节细胞内丛状层(GCIPL)的厚度IA,乳头周围视网膜神经纤维层(pRNFL),和浅表毛细血管丛(SCP)的血管密度,深毛细血管丛(DCP),从OCTA获得放射状乳头周围毛细血管(RPC)。
结果:眼睛的运动症状发作侧显示SCP的旁瓣内血管密度较低(51.09±3.46vs49.81±4.16,P=0.03),而DCP的中央凹上半部分(49.55±5.81vs47.33±5.71,=0.04)。PD患者表现出上半pRNFL厚度较大的IA(5.27[2.67,10.87]vs3.08[1.62,5.61],P=0.02)和侧腹GCIPL(2.40[1.25,6.35]vs1.40[0.50,2.45],P=0.02)。PD和NC之间的血管密度未发现明显的眼间不对称性。较高的UPDRS-III量表与GCIPL中IA较大(β=0.093,P=0.001)和DCP中IA较小(β=-0.065,P=0.037)相关。
结论:眼睛的运动症状发作侧显示比眼睛另一侧更严重的黄斑血管密度损失。PD患者GCIPL和pRNFL结构不对称改变,显示了作为PD诊断生物标志物的潜力。