Changes In The Retinal Nerve Fiber Layer In Patients With Parkinson's Disease, Progressive Supranuclear Palsy, And Multiple System Atrophy With And Without Dementia

帕金森病、进行性核上性麻痹和多系统萎缩(伴或不伴痴呆)患者的视网膜神经纤维层变化

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Abstract

BACKGROUND: Several studies have evaluated RNFL thickness in PD, with only a few on other Parkinsonian syndromes. There is insufficient information on the pattern of changes in these patients who have dementia. Therefore, the present study examined the RNFL thickness in Parkinsonism patients with and without dementia. METHODS: In this cross-sectional study, all patients diagnosed with PD, MSA, and PSP from March 2017 to February 2019 were evaluated. The severity of the disease and the presence of dementia were determined using the UPDRS and MMSE tests, respectively. The thickness of the RNFL was measured in the superior, inferior, nasal, and temporal quadrants using the 3D-OCT 1000 Mark II. Statistical methods, including the independent t-test, one-way analysis of variance (ANOVA), and the Pearson correlation coefficient, were used to analyze the data at a significance level of 0.05 using SPSS statistical software. RESULTS: Fifty-three patients were examined. The mean age and mean UPDRS showed a significant difference between the groups, while gender and disease duration did not show. The mean RNFL thickness in the nasal sector had a significant difference among the three groups, with a thinner thickness in patients with MSA (P<0.05). Patients with PD, PSP, and MSA with dementia showed a significantly greater reduction in RNFL thickness in the upper and temporal quadrants, nasal quadrant, and upper and temporal quadrants compared to PD, PSP, and MSA without dementia, respectively (P<0.05). CONCLUSION: Evaluating RNFL can be useful in predicting ocular involvement. Once validated in further studies, OCT may serve as a biomarker for predicting the presence or progression of movement disorders. OCT may also assist in predicting the presence of dementia in these patients by reflecting a more significant reduction in RNFL thickness compared to patients without dementia.

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