Remodeling of the Fovea in Parkinson Disease

Abstract

 

Purpose:

 

To quantify foveal thickness in Parkinson Disease (PD).

 

Methods:

 

Fourier-domain Optical Coherence Tomography (RTVue Model RT 100; Optovue, Inc.) scanner with the MM5 or EMM5 scan was performed in a foveola-centered grid in 54 eyes (29 subjects) of patients suffering from early to midstage PD and in 51 eyes (31 subjects) of age-matched controls. Participants were free of retinal pathology and other neurological disease other than PD. Retinal thickness measures were sampled in 0.25 mm increments from the foveal center. Mean thickness values of all control eyes were established as a template of the normal fovea. PD and control subject thickness values were compared to this normal template to quantify the ability to discriminate between pathological and non-pathological retinae. Sensitivity and specificity were analyzed using receiver operating characteristic (ROC) models and their corresponding area under the curve (AUC) graphs. Three-dimensional reconstructions of the mean control fovea and mean PD fovea shape were then created using MATLAB environment.

 

Results:

 

Optimal discrimination (AUC of 0.75-0.8) between the two groups defined the edge of the foveal pit to be between 1.5 and 2.0 mm radially from the foveal center, where the inner plexiform and nuclear layers emerge below the ganglion cell layer. The accompanying images reveal the change of the foveal pit in PD and in individual PD patients.

 

Conclusions:

 

PD causes a remodeling of the foveal pit in the human retina.  

 

Keywords: retina: proximal (bipolar, amacrine, and ganglion cells) • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • macula/fovea