Visual field analysis in patients with Parkinson's disease

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Abstract

Background

To evaluate visual field changes in patients with Parkinson's disease.

Methods

Standard automated perimetry of 14 patients (28 eyes) with Parkinson's disease (PD) were compared with controls. PD patients with Unified Parkinson's Disease Rating Scale (UPDRS) score below 25 were included in the study.

Results

Visual field indices including mean deviation (−4.69±2.72 vs. −1.71±1.30, p=0.0008), pattern standard deviation (3.94±1.94 vs. 2.30±0.41, p=0.001), and corrected pattern standard deviation (3.23±2.18 vs. 1.20±0.91, p=0.003), were significantly worse in patients with PD when compared with the control group.

Bilateral glaucoma-like visual field defects were evident in six patients.

Conclusion

Parkinson's patients had worse visual field indices suggesting a common insult in the etiopathogenesis of nerve fiber layer damages observed in glaucoma and PD.

Introduction

It has recently been shown that apoptosis of retinal ganglion cells occurs both in experimental glaucomatous models and human glaucomatous eyes [1], [2]. Apparently, the death of retinal ganglion cells in glaucomatous optic neuropathy is similar to the programmed cell death observed in Parkinson's disease (PD), Alzheimer's disease (AD), and other neurodegenerative diseases [3].

The purpose of this study is to evaluate the visual fields of PD patients.

Section snippets

Methods

Patients with the diagnosis of PD [4] and Unified Parkinson's Disease Rating Scale (UPDRS) score [5] below 25 who were expected to perform automated perimetry were referred to the Ophthalmology Department.

Patients included in the study had no visual field testing before, and none had any known risk factors (history of glaucoma in the first degree relative, history of smoking, systemic hypertension or hypotension, diabetes and increased sensitivity of fingertips and limps in cold) for glaucoma.

Results

PD and control group consisted of 10 males and 4 female subjects. All patients including the PD and the control group had intraocular pressures within normal range. Comparison of intraocular pressures between groups was not significant (p>0.05). The sex distribution and mean age and mean intraocular pressure values of PD and control subjects are given in Table 1.

Visual field indices of both Parkinson's and control group are given in Table 2. All visual field indices including MD (−4.69±2.72 vs.

Discussion

Apoptosis is often defined as a genetically coded suicide program activated when cells are no longer needed or have been seriously damaged, and it is characterized by phagocytosis without inflammation. According to the recent studies, ganglion cells die by apoptosis in conditions like glaucoma [3]. A pathological process similar to apoptosis is also observed in other neurodegenerative conditions: PD, AD, amyotrophic lateral sclerosis, Huntington disease, etc. [6].

PD is a neurodegenerative

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