Journal of Neural Transmission

, Volume 120, Issue 5, pp 745–753 | Cite as

Remodeling of the fovea in Parkinson disease

  • B. Spund
  • Y. Ding
  • T. Liu
  • I. Selesnick
  • S. Glazman
  • E. M. Shrier
  • I. Bodis-Wollner
Neurology and Preclinical Neurological Studies - Original Article


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.


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

Supplementary material

702_2012_909_MOESM1_ESM.doc (465 kb)
Supplementary material 1 The standard output of the OCT equipment with the grid centered on the foveola. This illustration represents the recording of a 74-year-old HC. The subject fixates on a central fixation target and the equipment allows the operator to center the measuring grid (see the illustration). Post-recording, some corrections are possible but it is preferable to center the grid close to the central pixel, certainly not more distant than one pixel. Underneath each 0.25 by 0.25 square the volume is measured for thickness at that point. Figure represents the actual output of the OCT equipment, for a 74-year-old healthy Caucasian male. Upper left hand corner: color-coded thickness map of the foveal region, centered on the foveola. Below: a table of full thickness values in each labeled segment of the foveal image. Numbers represent mean thickness values in each perifoveolar ring, as defined by the ETDRS (Early Treatment Diabetic Retinopathy Study) protocol (see text). Top right: color-coded average volumes plotted in each region. Bottom right; the foveolar centered measuring grid with color-coded thickness values. Next to the grid left: an image of the vertical cross section of the fovea through the foveola. Bottom of the grid: the horizontal (temporo-nasal) cross section of the fovea. Many studies calculate macular volumes in the three zones of the EDTRS protocol (top right, above) and measure thickness of the full retina, or measure thickness at selected points of the image, using manual cursors (see text). Our measures reflect volumes in each pixel depicted in the grid. (DOC 465 kb)
702_2012_909_MOESM2_ESM.doc (50 kb)
Supplementary material 2 (DOC 50 kb)


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Copyright information

© Springer-Verlag Wien 2012

Authors and Affiliations

  • B. Spund
    • 3
  • Y. Ding
    • 4
  • T. Liu
    • 4
  • I. Selesnick
    • 4
  • S. Glazman
    • 3
  • E. M. Shrier
    • 1
    • 2
  • I. Bodis-Wollner
    • 1
    • 2
    • 3
  1. 1.Department of OphthalmologyState University of New York (SUNY), Downstate Medical Center (DMC)BrooklynUSA
  2. 2.SUNY Eye InstituteBrooklynUSA
  3. 3.Department of NeurologySUNY, DMCBrooklynUSA
  4. 4.Department of Electrical and Computer EngineeringPolytechnic Institute of New York UniversityBrooklynUSA

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