A combination of retinal morphology and visual electrophysiology testing increases diagnostic yield in Parkinson's disease

Parkinsonism Relat Disord. 2016 Jan:22 Suppl 1:S134-7. doi: 10.1016/j.parkreldis.2015.09.015. Epub 2015 Sep 5.

Abstract

Background: Impaired vision and remodeled foveal pit have been demonstrated in Parkinson's disease (PD) patients using different techniques.

Methods: Ten PD (20 eyes) and eight healthy controls (HC) subjects (16 eyes) were enrolled. Subjects were evaluated for N70 and P100 latencies using two-channel VEP with pattern reversal and on/off pattern; Contrast sensitivity (CS) using Pelli-Robson chart; macular thickness measured using Zeiss-HD optical coherence tomography (OCT).

Results: PD patients had a significantly delayed N70 (reversal pattern) and P100 (on/off pattern), lower CS score, and decreased retinal thickness at temporal 1.5-2.5 mm from the foveola. N70 latency was negatively correlated with CS (R = -0.419, P = 0.01) and average GCL-IPL thickness (R = -0.529, P = 0.001). CS was positively correlated with parafoveal thickness (R = 0.490, P = 0.002). A combination of parafoveal thickness and CS score yielded an AUC of 0.784 for PD discrimination which increased to 0.844 when combined with N70 and P100 measures.

Conclusion: A combination of pattern reversal VEP latency, CS score, and inner retinal foveal thickness measures has a high diagnostic yield for PD.

Keywords: Contrast sensitivity; OCT; PD diagnosis; VEP.

MeSH terms

  • Aged
  • Contrast Sensitivity / physiology
  • Cross-Sectional Studies
  • Electrodiagnosis / methods
  • Evoked Potentials, Visual / physiology*
  • Female
  • Fovea Centralis / pathology
  • Fovea Centralis / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / physiopathology
  • Photic Stimulation / methods*
  • Retina / pathology*
  • Retina / physiopathology
  • Tomography, Optical Coherence / methods*