Funda DİKKAYA, Ahmet ÖZKÖK, Şakir DELİL

Parkinson Hastalığında Retina Sinir Lifi Tabakası ve Makula Kalınlığının Değerlendirilmesi

Amaç: Parkinson hastalarını retina sinir lifi tabakası (RSLT) ve makula kalınlıkları yönünden incelemek ve sağlıklı kontrol grubu ile karşılaştırmak Yöntem: Parkinson tanısı alan yaş ortalaması 69,2±8,2 yıl olan 25 hasta ve sistemik hastalık öyküsü bulunmayan yaş ortalaması 67,2±7,1 yıl olan 19 hasta göz bulguları açısından değerlendirildi. Hastalara Optik Koherens Tomografi (OKT) ile RSLT ve makula kalınlık ölçümleri yapıldı. Gruplar elde edilen veriler açısından Student t testi ile karşılaştırıldı. Bulgular: İnferior kadran RSLT Parkinson grubunda 133,1±19,3 μm, kontrol grubunda ise 145,1±19,6 μm olarak ölçüldü. İnferior kadran RSLT’deki bu incelme istatistiksel olarak anlamlı bulundu (p=0,049). Diğer kadran RSLT ve makula kalınlıklarında gruplar arası fark tespit edilmedi. Sonuç: Çalışmamızda Parkinson hastalarında inferior kadran RSLT kalınlığında azalma tespit ettik. Parkinson hastalarında retinadaki dopamin miktarında meydana gelen azalma ganglion hücre kaybına yol açarak RSLT kalınlığında incelmeye neden olabilmektedir.

Evaluation of the retinal nerve fiber layer and macular thickness in patients with Parkinson’s disease

Objective: To investigate the retinal nerve fiber layer (RNFL) and macular thickness in patients with Parkinson’s disease and to compare the results with healthy control group. Methods: 25 Parkinson’s patients with the mean age of 69.2±8.2 years and 19 healthy control subjects with the mean age of 67.2±7.1 years were included in the study. Patients received RNFL and macular thickness measurements with optical coherence tomography (OCT). Values were compared between groups with student’s t-test. Results: RNFL in inferior quadrant was 133.1±19.3 μm for Parkinson’s disease group, 145.1±19.6 μm for control group. The difference was statistically significant (p=0.049). There was no statistical significant difference between other quadrant RNFL and macular thickness. Conclusion: We found decrease in inferior quadrant RNFL in patients with Parkinson’s disease. Decreased dopamine content of the retina in Parkinson disease may cause RNFL thinning via ganglion cell loss

PDF

___

Bayer AU, Keller ON, Ferrari F, Maag KP. Association of glaucoma with neurodegenerative diseases with apoptotic cell death: Alzheimer’s disease and Parkinson’s disease. Am J Ophthalmol. 2002; 133: 135– 7.
Balci SY, Eraslan M, Temel A. Glokom, Parkinson hastalığı ve no rodejenerasyon. Marmara Medical Journal. 2015; 28: 8-12.
Garcia-Valenzuela E, Shareef S, Walsh J, Sharma SC. Programmed cell death of retinal ganglion cells during experimental glaucoma. Exp Eye Res. 1995; 61: 33 44.
Hajee ME, March WF, Lazzaro DR, et al. Inner retinal layer thinning in Parkinson disease. Arch Ophthalmol. 2009; 127: 737–41
Frederick JM, Rayborn ME, Laties AM, Lam DM,Hollyfield JG. Dopaminergic neurons in the human retina. J Comp Neurol. 1982; 210: 65-79.
Djamgoz MB, Hankins MW, Hirano J, Archer SN. Neurobiology of retinal dopamine in relation to degenerative states of the tissue. Vision Research. 1997; 37: 3509 29.
Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008 Apr; 79: 368-76).
Aaker GD, Myung JS, Ehrlich JR, et al. Detection of retinal changes in Parkinson’s disease with spectraldomain optical coherence tomography. Clin Ophthalmol. 2010; 4: 1427–32.
Tsironi EE, Dastiridou A, Katsanos A, et al. Perimetric and retinal nerve fiber layer findings in patients with Parkinson’s disease. BMC Ophthalmology. 2012; 12: 54.
Bittersohl D, Stemplewitz B, Keseru M, et al. Detection of retinal changes in idiopathic Parkinson’s disease using high-resolution optical coherence tomography and heidelberg retina tomography. Acta Ophthalmol. 2015: 93: e578–e584.
Archibald NK, Clarke MP, Mosimann UP, Burn DJ. Retinal thickness in Parkinson’s disease. Parkinsonism Relat Disord. 2011; 17: 431–6.
Moschos MM, Tagaris G, Markopoulos I, et al. Morphologic changes and functional retinal impairment in patients with Parkinson disease without visual loss. Eur J Ophthalmol. 2011; 21: 24–9.
Altintas O, Iseri P, Ozkan B, Caglar Y. Correlation between retinal morphological and functional findings and clinical severity in Parkinson’s disease. Doc Ophthalmol. 2008; 116: 137–46.
Bayhan HA, Bayhan SA, Tanık N, Gürdal C. The Association of Spectral-Domain Optical Coherence Tomography Determined Ganglion Cell Complex Parameters and Disease Severity in Parkinson’s Disease. Current Eye Research. 2014; 39: 1117–22.
Inzelberg R, Ramirez JA, Nisipeanu P, Ophir A. Retinal nerve fiber layer thinning in Parkinson disease. Vision Research. 2004; 44: 2793–7.
Parisi V, Manni G, Spadaro M, et al. Correlation between morphological and functional retinal impairment in multiple sclerosis patients. Invest Ophthalmol Vis Sci. 1999; 40: 2520–7.
Parisi V, Restuccia R, Fattapposta F, et al. Morphological and functional retinal impairment in Alzheimer’s disease patients. Clin Neurophysiol. 2001; 112: 1860–7.
Ekinci C, Tuğcu B, Şen A. Parkinson hastalığında göz bulguları. MN Oftalmoloji. 2017; 24: 235-8.
Armstrong RA. Visual signs and symptoms of Parkinson’s disease. Clin Exp Optom. 2008; 91: 129–38.
Harnois C, Di Paolo T. Decreased dopamine in the retinas of patients with Parkinson’s disease. Invest Ophthalmol Vis Sci. 1990; 31: 2473-5.
Aygül R, Demir R. Parkinson hastalığı tanı kriterleri. Turkiye Klinikleri J Neurol-Special Topics. 2012; 5: 53- 7.