Abstract
Purpose :
A key manifestation of Parkinson’s disease (PD) is visual impairment. Cognitive impairment has been found to commonly overlap with convergence insufficiency (CI) in PD and is associated with significantly greater near point convergence (NPC) distance. Difficulty reading and diplopia were the most often reported symptoms of CI in PD. The prevalence of CI is greater among patients with PD. No meta-analysis examined this subject; therefore, our aim was to assess the relationship between PD and CI.
Methods :
This meta-analysis study has followed the standards and guidelines of Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). PubMed search was used with the terms "Parkinson's Disease" AND "Convergence insufficiency ". The results showed 1,563 articles, 11 articles met the inclusion criteria, 8 articles were used for the CI screening survey as the primary outcome and 3 articles were used for the NPC distance (cm) as the secondary outcome. The random effects meta-analysis was used. Heterogeneity was evaluated with I2 statistics, publication bias with Funnel plot, Egger’s and Begg’s tests.
Results :
The database search resulted in 8 studies with a total of 1,520 PD patients and 905 control subjects for the primary outcome and a total of 103 PD patients and 52 control subjects for the secondary outcome. Relative to the control group, the PD group has high odds ratio (OR(s)) of CI clinical diagnosis (ORs = 3.67, 95%CI [2.71, 4.95]; P <0.00001). In addition, PD group showed a statistically significant increase in NPC distance using mean difference (MD) compared to the control group (MD = 4.97; 95%CI [1.33, 8.61]; P=0.007). No evidence of publication bias was detected.
Conclusions :
These data suggest that the PD group increased the likelihood of CI visual symptoms and increased NPC distance compared to control group. These findings indicate that regular eye exam is very important for patients with PD. In addition, patients with objective findings of CI, if symptomatic or not, may have a high risk of cognitive impairment. Eye clinicians should have a high assumption for cognitive impairment in CI patients.
This is a 2021 ARVO Annual Meeting abstract.