Parafoveal thinning of inner retina is associated with visual dysfunction in Lewy body diseases
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2019-09-01
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John Wiley and Sons Inc.
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Background: Retinal optical coherence tomography findings in Lewy body diseases and their implications for visual outcomes remain controversial. We investigated whether region-specific thickness analysis of retinal layers could improve the detection of macular atrophy and unravel its association with visual disability in Parkinson's disease. Methods: Patients with idiopathic Parkinson's disease (n = 63), dementia with Lewy bodies (n = 8), and E46K mutation carriers in the α-synuclein gene (E46K-SNCA) (n = 4) and 34 controls underwent Spectralis optical coherence tomography macular scans and a comprehensive battery of visual function and cognition tests. We computed mean retinal layer thicknesses of both eyes within 1-, 2-, 3-, and 6-mm diameter macular discs and in concentric parafoveal (1- to 2-mm, 2- to 3-mm, 1- to 3-mm) and perifoveal (3- to 6-mm) rings. Group differences in imaging parameters and their relationship with visual outcomes were analyzed. A multivariate logistic model was developed to predict visual impairment from optical coherence tomography measurements in Parkinson's disease, and cutoff values were determined with receiver operating characteristic analysis. Results: When compared with controls, patients with dementia with Lewy bodies had significant thinning of the ganglion cell–inner plexiform layer complex within the central 3-mm disc mainly because of differences in 1- to 3-mm parafoveal thickness. This parameter was strongly correlated in patients, but not in controls, with low contrast visual acuity and visual cognition outcomes (P <.05, False Discovery Rate), achieving 88% of accuracy in predicting visual impairment in Parkinson's disease. Conclusion: Our findings support that parafoveal thinning of ganglion cell–inner plexiform complex is a sensitive and clinically relevant imaging biomarker for Lewy body diseases, specifically for Parkinson's disease. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Murueta-Goyena, A., del Pino, R., Reyero, P., Galdós, M., Arana, B., Lucas-Jiménez, O., Acera, M., Tijero, B., Ibarretxe-Bilbao, N., Ojeda, N., Peña, J., Cortés, J., Gómez-Esteban, J. C., & Gabilondo, I. (2019). Parafoveal thinning of inner retina is associated with visual dysfunction in Lewy body diseases. Movement Disorders, 34(9), 1315-1324. https://doi.org/10.1002/MDS.27728