Preliminary Observation And Analysis Of Changes Of Retinal Thickness And Volume In Macular Area Of Patients With Parkinson’s Disease

Objective:To observe the macular thickness(MRT)and macular volume(MV)in the center of the macula and its surrounding quadrants in patients with Parkinson’s disease(PD).To explore the characteristics of MRT and MV in PD patients,analyze the correlation between their changes and the disease course,age,medication type and Hoehn-Yahr(H-Y)grading of PD,explore and evaluate the use of Optical coherence tomography,The intuitiveness and ease of coordination of OCT can assist the diagnosis and monitoring of PD,and further help clinicians understand the influence of PD on the function and structure of ocular tissues.Methods: In this cross-sectional study,PD patients diagnosed in the Department of Neurology of Yunnan First Hospital from March 1,2022 to December 1,2022 were collected as the PD group,and healthy people matching the gender composition and age of PD group were randomly selected as the control group.All the included subjects underwent visual acuity,intraocular pressure,indirect fundus ophthalmoscopy with slit lamp microscope and OCT examination.The scope of OCT scanning was a ring fast scan with a diameter of 6.0mm and the center of the macular fovea.The retina within the scanning area was divided into three concentric circles with the center of the macular fovea by OCT analysis program(retinal map),and the concentric circles of 3mm and 6mm were divided into nine regions by two rays.The difference of MRT and MV between PD group and control group was compared and analyzed.The relationship between these measures and the disease time,H-Y grade and the type of drugs taken was analyzed.Statistical methods: SPSS26.0 statistical software was used to analyze the data,P<0.05 indicated that the results were statistically significant,and the receiver operating characteristic(ROC)curve was used to determine the optimal diagnostic cut-off value.Results: In this study,117 patients with PD meeting the criteria,234 eyes,were included as the PD group,and 112 patients with 224 eyes matching the gender and age of the PD group were randomly selected as the control group.t test was used to compare the results of MRT and MV between the control group and the PD group.The results showed that the MRT and MV in all areas of both eyes in the PD group were lower than those in the normal group(P < 0.05).One-way analysis of variance was used to compare the three groups of patients with different degrees(mild,moderate and severe)in PD group.The results showed that the duration of disease(F= 3.39270,P=0.037)and the duration of medication(F = 4.18258,P=0.018)in the moderate and severe groups were significantly longer than those in the mild group.Right eye nasal outer ring MRT(F= 7.24431,P=0.001),nasal inner ring MRT(F =30.3547,P=0.000),nasal outer ring MV(F=15.1013,P=0.000),upper outer ring MV(F=4.09486,P=0.019)Light and moderate groups were significantly higher than severe groups(P < 0.05);Multiple linear regression analysis was conducted to determine the effects of various drugs on the retina of PD patients.It was found that dopamine receptor agonists(DAs)medications might have a protective effect on the retina of patients with PD,and dopamine dopamine(β=14.72,95%CI,4.376-24.501),MRT of temporal inner ring(β=8.9,95%CI,1.009-16.999),MV of temporal outer ring(β =0.04,95%CI,0.003-0.075),MV of nasal inner ring(β =0.02,95%CI,0.005-0.037),the internal temporal ring MV(β=0.01,95%CI),0.001-0.027),P <0.05.ROC curve prediction threshold(sensitivity,specificity,AUC): MV=1.545um3(79.5%,89.2%,0.922),MRT=292.5um(79.5%,83.8%,0.893),MV=0.515um3(72.6%,82.9%,0.855).Conclusions: 1.The MRT and MV of the PD patients were lower than those of the normal control group,which proved that PD might have damage on the retinal structure of the patients,and the damage of the retinal structure was aggravated with the progress of PD.2.As indicators for the diagnosis of PD patients,MRT and MV have good sensitivity and specificity,which are worthy of further study.The examination and analysis of the retinal structure of patients with OCT with its advantages of non-invasive,easy coordination and low cost are helpful for the diagnosis,disease assessment,grading,monitoring and observation of the damage of PD to other tissues of the body.3.DAs may have a protective effect on retinal structure in PD patients,which is worthy of further study and exploration.