Open Access Research article

Perimetric and retinal nerve fiber layer findings in patients with Parkinson’s disease

Evangelia E Tsironi1*, Anna Dastiridou1, Andreas Katsanos1, Efthymios Dardiotis2, Stella Veliki1, Gianna Patramani2, Fani Zacharaki1, Stella Ralli2 and Georgios M Hadjigeorgiou2

Author Affiliations

1 Department of Ophthalmology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo 41222 Larissa, Greece

2 Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Larissa, Greece

For all author emails, please log on.

BMC Ophthalmology 2012, 12:54  doi:10.1186/1471-2415-12-54

Published: 2 October 2012

Abstract

Background

Visual dysfunction is common in Parkinson’s disease (PD). It remains, however, unknown whether it is related to structural alterations of the retina. The aim of this study is to compare visual field (VF) findings and circumpapillary retinal nerve fiber layer (RNFL) thickness in a series of PD patients and normal controls, in order to assess possible retinal anatomical changes and/or functional damage associated with PD.

Methods

PD patients and controls were recruited and underwent VF testing with static automated perimetry and RNFL examination with optical coherence tomography (OCT). Cognitive performance using Mini Mental State Examination (MMSE), PD staging using modified Hoehn and Yahr (H-Y) scale and duration of the disease was recorded in PD patients.

Results

One randomly selected eye from each of 24 patients and 24 age-matched controls was included. OCT RNFL thickness analysis revealed no difference in the inferior, superior, nasal or temporal sectors between the groups. The average peripapillary RNFL was also similar in the two groups. However, perimetric indices of generalized sensitivity loss (mean deviation) and localized scotomas (pattern standard deviation) were worse in patients with PD compared to controls (p < 0.01). 73% of eyes of PD patients had glaucomatous-like asymmetrical hemifield defects with abnormal Glaucoma Hemifield Test and various combinations of arcuate defects (n = 12), nasal steps (n = 11) and paracentral scotomas (n = 16). Bilateral defects were found in 14 patients (58%). No correlation was found between VF indices and MMSE or H-Y scores.

Conclusion

PD patients may demonstrate glaucomatous-like perimetric defects even in the absence of decreased RNFL thickness.

Keywords:
Visual loss; Visual fields; Parkinson's disease; Retina; Visual processing