Neurology and Preclinical Neurological Studies - Original Article

Journal of Neural Transmission

, Volume 120, Issue 5, pp 745-753

Remodeling of the fovea in Parkinson disease

  • B. SpundAffiliated withDepartment of Neurology, SUNY, DMC
  • , Y. DingAffiliated withDepartment of Electrical and Computer Engineering, Polytechnic Institute of New York University
  • , T. LiuAffiliated withDepartment of Electrical and Computer Engineering, Polytechnic Institute of New York University
  • , I. SelesnickAffiliated withDepartment of Electrical and Computer Engineering, Polytechnic Institute of New York University
  • , S. GlazmanAffiliated withDepartment of Neurology, SUNY, DMC
  • , E. M. ShrierAffiliated withDepartment of Ophthalmology, State University of New York (SUNY), Downstate Medical Center (DMC)SUNY Eye Institute
  • , I. Bodis-WollnerAffiliated withDepartment of Ophthalmology, State University of New York (SUNY), Downstate Medical Center (DMC)SUNY Eye InstituteDepartment of Neurology, SUNY, DMC Email author 

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Abstract

To quantify the thickness of the inner retinal layers in the foveal pit where the nerve fiber layer (NFL) is absent, and quantify changes in the ganglion cells and inner plexiform layer. Pixel-by-pixel volumetric measurements were obtained via Spectral-Domain optical coherence tomography (SD-OCT) from 50 eyes of Parkinson disease (PD) (n = 30) and 50 eyes of healthy control subjects (n = 27). Receiver operating characteristics (ROC) were used to classify individual subjects with respect to sensitivity and specificity calculations at each perifoveolar distance. Three-dimensional topographic maps of the healthy and PD foveal pit were created. The foveal pit is thinner and broader in PD. The difference becomes evident in an annular zone between 0.5 and 2 mm from the foveola and the optimal (ROC-defined) zone is from 0.75 to 1.5 mm. This zone is nearly devoid of NFL and partially overlaps the foveal avascular zone. About 78 % of PD eyes can be discriminated from HC eyes based on this zone. ROC applied to OCT pixel-by-pixel analysis helps to discriminate PD from HC retinae. Remodeling of the foveal architecture is significant because it may provide a visible and quantifiable signature of PD. The specific location of remodeling in the fovea raises a novel concept for exploring the mechanism of oxidative stress on retinal neurons in PD. OCT is a promising quantitative tool in PD research. However, larger scale studies are needed before the method can be applied to clinical follow-ups.

Keywords

Parkinson disease (PD) Retinal foveal pit Optical coherence tomography (OCT) Receiver operating characteristics (ROC) Dopaminergic neurons Foveal avascular zone (FAZ)