Self-perception and determinants of color vision in Parkinson’s disease

Abstract

Visual dysfunction is common in patients with Parkinson’s disease (PD). The objective of this study was to investigate the perceived impact of visual dysfunction and especially color vision loss on PD patients, and to identify retinal and disease factors associated with color vision. Thirty PD patients and thirty-four healthy controls were included. Participants performed the Farnsworth–Munsell Hue-100 test (FMT). Patients answered the National Eye Institute Visual Function Questionnaire (NEI-VFQ), Unified Parkinson’s Disease Rating Scale (UPDRS) assessment, and underwent optical coherence tomography with measurement of retinal nerve fiber layer, ganglion cell layer + inner plexiform layer (GCIPL), and outer nuclear and photoreceptor layer. Dopaminergic treatment was assessed as levodopa equivalent dose (LED). Vision domains significantly worse in PD patients compared to normative data were General Vision, Near Activities, Distance Activities, Vision-Specific Dependency, Driving, and Peripheral Vision. Worse NEI-VFQ total scores were associated with worse UPDRS, higher LED, and higher age, but not with FMT, visual acuity, or OCT measures. Only two patients (7%) reported problems with color vision. In contrast, patients performed significantly worse in the FMT than healthy controls and 17 (56.7%) patients were outside the 95th percentile of normative data. In multiple regression analyses, lower LED and higher age were associated with worse color vision in the FMT. PD patients are not aware of color vision deficits. Given the impact of color vision loss on everyday tasks in other conditions, future research should investigate the impact of vision deficits on disease burden in PD.

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Acknowledgements

This study was funded by German Research Foundation (DFG) Grant Exc. 257.

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Correspondence to Alexander U. Brandt.

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Conflict of interest

Alexander U. Brandt served on the scientific advisory board of the Vision study for Biogen; received travel funding and/or speaker honoraria from Novartis and Biogen; has patents pending from method and system for fovea morphometry, perceptive visual computing based postural control analysis, multiple sclerosis biomarkers, and perceptive sleep motion analysis; has consulted for Motognosis; and received research support from Novartis Pharma, Biogen Idec, BMWi, BMBF, and Guthy Jackson Charitable Foundation. Hanna Zimmermann received honoraria fees from TEVA and Bayer Healthcare. Timm Oberwahrenbrock received honoraria fees from TEVA and Bayer Healthcare. Justine Isensee reports no conflict of interest. Thomas Müller received speaker honoraria from Zambon and Bial. Friedemann Paul serves on a scientific advisory board for Novartis; received speaker honoraria and travel funding from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Merck Serono, Alexion, Chugai, MedImmune, and Shire; is an academic editor for PLoS ONE; is an associate editor for Neurology® Neuroimmunology & Neuroinflammation; consulted for SanofiGenzyme, Biogen Idec, MedImmune, Shire, and Alexion; and received research support from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Alexion, Merck Serono, German Research Council, Werth Stiftung of the City of Cologne, German Ministry of Education and Research, Arthur Arnstein Stiftung Berlin, EU FP7 Framework Program, Arthur Arnstein Foundation Berlin, Guthy Jackson Charitable Foundation, and National Multiple Sclerosis of the USA.

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Brandt, A.U., Zimmermann, H.G., Oberwahrenbrock, T. et al. Self-perception and determinants of color vision in Parkinson’s disease. J Neural Transm 125, 145–152 (2018). https://doi.org/10.1007/s00702-017-1812-x

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Keywords

  • Levodopa
  • Color vision
  • Tomography, optical coherence
  • Parkinson disease
  • Visual acuity
  • Retina