In vivo morphology of the optic nerve and retina in patients with Parkinson’s disease

PURPOSE: To investigate optic nerve (ON) and macular morphology in patients with Parkinson’s disease (PD) using spectral-domain optical coherence tomography (SD-OCT). SUBJECTS. Twenty-five participants with PD (19 males and 6 females; mean age 60.79; SD 6 9.24) and 25 sex-, age-, ethnicity-, and refraction-matched healthy controls. METHODS: A high-resolution SD-OCT device was used to acquire scans in 25 participants with PD (mean age 60.79; 6 SD 9.24) and 25 sex-, age-, ethnicity-, and refraction-matched healthy controls. Main outcome measures included optic nerve head parameters (disc/cup diameters/ areas, cup/rim volumes, cup depth, cup/disc ratio; peripapillary retinal nerve fiber layer [ppRNFL] thickness), retinal thickness (in inner and outer annuli around the foveal center) and thickness of individual retinal layers. RESULTS: Our study showed significant ppRNFL thinning in PD patients in all quadrants (P < 0.05) associated with a shallower optic cup (P = 0.03) as compared with controls. Foveal remodelling with retinal thinning (nasal and temporal segments in both annuli; and superior segment in outer annulus; P < 0.05), foveal pit widening (P = 0.05), central outer plexiform layer (OPL) thickening (P < 0.001), and nasal RPE thinning (P < 0.001) was also found in PD. The differences were more obvious in hemiretinae related to the predominantly affected cerebral hemisphere. Changes were more pronounced in advanced stages and longer PD duration. CONCLUSIONS: Optic nerve changes in PD are likely to be caused by primary neurodegeneration. Central retinal thinning, pit widening, central OPL thickening, and RPE thinning indicate foveal remodelling. Specific changes of the fovea and thinning of individual retinal layers, correlating with disease severity and duration, indicate that ON and retinal changes have potential to be used as biomarkers for PD.