Journal of Neural Transmission

, Volume 125, Issue 6, pp 931–936 | Cite as

In vivo exploration of retinal nerve fiber layer morphology in Parkinson’s disease patients

  • Femke VisserEmail author
  • Koenraad A. Vermeer
  • Babak Ghafaryasl
  • Annemarie M. M. Vlaar
  • Valentin Apostolov
  • Jan van Hellenberg Hubar
  • Henry C. Weinstein
  • Johannes F. de Boer
  • Henk W. Berendse
Neurology and Preclinical Neurological Studies - Original Article


Thinning of the retinal nerve fiber layer (RNFL) is a recently discovered feature of Parkinson’s disease (PD). Its exact pathological mechanism is yet unknown. We aimed to determine whether morphological changes of the RNFL are limited to RNFL thinning or also comprise an altered internal structure of this layer. Therefore, we investigated RNFL thickness and applied the RNFL attenuation coefficient (RNFL-AC), a novel method derived from optical coherence tomography, in PD patients and healthy controls (HCs). In this pilot study, we included 20 PD patients and 20 HCs matched for age, sex, and ethnicity. An ophthalmologist investigated all participants thoroughly, and we acquired retinal images from both eyes of each participant with a Spectralis optical coherence tomography system. We obtained both the RNFL-AC and RNFL thickness from peripapillary RNFL scans for the entire RNFL, as well as for each quadrant separately. We found no significant differences in the average RNFL-AC or the RNFL-AC of the separate retinal quadrants between PD patients and the HC group. However, compared to the HC group, PD patients had a significantly thinner RNFL in the temporal retinal quadrant. RNFL thinning was found in the temporal quadrant in PD patients without a corresponding change in the RNFL-AC. These findings suggest a reduction in the number of RNFL axons (atrophy) without other major changes in the structural integrity of the remaining RNFL.


Parkinson’s disease Optical coherence tomography Retinal nerve fiber layer Attenuation coefficient 



This study would not have been possible without the financial support of the ‘Stichting ParkinsonFonds’. We would also like to thank Ms. Lisette van Hulst (teacher of Academic English) for her revision of the English language. In addition, we would like to thank all the participants who made this study possible.


This study was (partially) funded by the ‘Stichting ParkinsonFonds’.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Femke Visser
    • 1
    Email author
  • Koenraad A. Vermeer
    • 2
  • Babak Ghafaryasl
    • 2
    • 6
  • Annemarie M. M. Vlaar
    • 1
  • Valentin Apostolov
    • 3
  • Jan van Hellenberg Hubar
    • 1
  • Henry C. Weinstein
    • 1
    • 4
  • Johannes F. de Boer
    • 5
  • Henk W. Berendse
    • 4
  1. 1.Department of NeurologyOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
  2. 2.Rotterdam Ophthalmic InstituteRotterdamThe Netherlands
  3. 3.Department of OphthalmologyOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
  4. 4.Department of NeurologyVU University Medical CentreAmsterdamThe Netherlands
  5. 5.Faculty of Exact SciencesVU UniversityAmsterdamThe Netherlands
  6. 6.Faculty of Applied SciencesDelft University of TechnologyDelftThe Netherlands

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