Analysis Of The Characteristic Changes Of Macular Thickness In Patients With Parkinson?s Disease

Objective: To analyze the characteristic changes of macular thickness in patients with Parkinson's disease by spectral-domain optical coherence tomography(SD-OCT).Find out the association between macular thickness and disease progression,cognitive dysfunction,visuospatial impairment and asymmetry of motor symptoms.Methods: Seventy-one PD patients and sixty-one healthy controls were enrolled and underwent SD-OCT examination.The macular thickness of all retinal quadrant segments,foveal thickness,and macular volume between two groups was comparatively analyzed.Associations between macular measurements and clinical parameters such as disease duration,UPDRS-III scores,MoCA total scores,and visuospatial subscores were analyzed using generalized estimated equation fitted with linear regression models.Results: Mean macular thickness in the PD group were significantly reduced than those in the control group((261.94±12.90)?m vs(270.96±10.71)?m,B=-8.135,P<0.01).All quadrants of macular thickness(except fovea and 1 mm central zone)in the PD group were reduced than those in the control group.Receiver operating characteristic(ROC)curve analysis revealed that inner superior thickness could predict the presence of PD with an area under ROC of 0.727(95%CI 0.662-0.792,P<0.01).UPDRS-?scores were negatively correlated with foveal thickness(B=-9.132,P=0.034),1 mm central zone thickness(B=-6.963,P=0.036)and all quadrants of the inner ring [superior(B=-7.727,P<0.01),inferior(B=-5.169,P=0.044),nasal(B=-5.960,P<0.01)and temporal(B=-5.905,P<0.01)] macular thickness.The disease duration had no relationship with any quadrant of macular measurements.No difference was found between the macula parameters of the hemiretinae corresponding to more and less severely affected cerebral hemisphere(P>0.05).MoCA total scores were positively correlated with all quadrants of the inner ring [superior(B=2.693,P=0.007),inferior(B=3.391,P=0.002),nasal(B=2.609,P=0.001)and temporal(B=2.115,P=0.013)] macular thickness.MoCA visuospatial subscores were positively associated with average macular thickness(B=4.368,P=0.042),macular volume(B=0.161,P=0.004),inferior(B=8.582 and 6.541),nasal(B=8.130 and 6.017)and temporal(B=5.938 and 5.316)quadrants of both outer and inner rings macular thickness(all P<0.05).Conclusions: In PD patients,the macular thickness and macular volume are decreased.We did not identify asymmetry between hemiretinae in PD.Some quadrants of macular thickness were associated with disease progression,cognitive dysfunction,and visuospatial impairment.