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The specific pattern of retinal nerve fiber layer thinning in Parkinson’s disease: a systematic review and meta-analysis

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Abstract

Background and purpose

The peripapillar nerve fiber layer (pRNFL) thinning in different retinal quadrants or sectors remains controversy. We conducted a systematic review and meta-analysis on the pattern of pRNFL thinning in Parkinson’s disease (PD) patients to provide a biomarker for PD differential diagnosis.

Methods

We systematically searched PubMed and EMBASE to identify studies comparing pRNFL thickness in PD patients and health controls using spectral domain-optical coherence tomography from inception to April 25, 2020. Random effects mode was used to pool mean difference (μm) of the average thickness of pRNFL and the thickness of pRNFL in four quadrants (superior, inferior, nasal and temporal) and in the subdivisions of superior (superonasal and superotemporal sectors) and inferior quadrants (inferonasal and inferotemporal sectors) between PD patients and health controls.

Results

We included 32 studies (33 sets of data) enrolling 2126 PD eyes and 2318 health control eyes. Between the eyes of PD patients and that of health controls, the pooled mean difference (μm) of average pRNFL was − 4.85 (95% CI [− 6.12, − 3.58]); the pooled mean difference (μm) of four quadrants were − 2.30 (95% CI [− 3.32, − 1.28], nasal), − 2.74 (95% CI [− 4.34, − 1.14], temporal), − 5.24 (95% CI [− 7.04, − 3.43], superior) and − 7.29 (95% CI [− 9.23, − 5.34], inferior); those of four sectors were − 5.16 (95% CI [− 7.70, − 2.62], superotemporal), − 3.55 (95% CI [− 5.87, − 1.23], superonasal), − 9.19 (95% [− 13.27, − 5.12], inferotemporal) and − 7.62 (95% CI [− 11.84, − 3.40], inferonasal).

Conclusion

In PD patients, pRNFL thinning followed a specific pattern with inferotemporal thinning most and nasal quadrant thinning least.

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Authors and Affiliations

  1. Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjingbei Street, Heping District, Shenyang, 110001, People’s Republic of China

    Lele Huang & Ruijun Zhang

  2. Department of Neurology, People’s Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People’s Republic of China

    Chen Wang, Wanting Wang & Yujie Wang

  3. Dalian Medical University, 9 Western Sections, Lvshun South Street, Lvshunkou District, Dalian, 116044, People’s Republic of China

    Chen Wang & Wanting Wang

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  1. Lele Huang
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  2. Chen Wang
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  4. Yujie Wang
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  5. Ruijun Zhang
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Contributions

RJZ and YJW contributed to the study conception and design. RJZ and YJW did the systematic literature search, selected studies for inclusion, extracted data, and statistical analyses, made the figures. RJZ, LLH and YJW interpreted data, wrote the first draft of the manuscript. All authors revised the manuscript for important intellectual content, approved the final draft.

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Correspondence to Ruijun Zhang.

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Huang, L., Wang, C., Wang, W. et al. The specific pattern of retinal nerve fiber layer thinning in Parkinson’s disease: a systematic review and meta-analysis. J Neurol 268, 4023–4032 (2021). https://doi.org/10.1007/s00415-020-10094-0

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