Retinal capillary plexus in Parkinson’s disease using optical coherence tomography angiography
Authors:   First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece, Giachos Ioannis , Tsiogka Anastasia ,   First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece, Manoli Konstantina ,   First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece, Tagaris George ,   Department of Neurology, General Hospital of Athens, &#x201C;Georgios Gennimatas&#x201D;, Athens 11527, Greece, Rotsos Tryfon ,   First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece, Kozobolis Vassilios ,   Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras 26504, Greece, Iliopoulos Ioannis ,   Neurology Department, Democritus University of Thrace, Alexandroupolis 68100, Greece, Moschos Marilita ,   First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens 11527, Greece
Published: December 2023

AIM: To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson's disease (PD) using optical coherence tomography angiography (OCT-A).
METHODS: A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens, “Georgios Gennimatas” from March 2021 to March 2022 was conducted. Totally 44 patients with PD were included and 18 healthy controls were examined, hence a total of 124 eyes were enrolled in the study. The foveal and parafoveal superficial and deep capillary plexus vascular density (fSCP-VD, fDCP-VD, pSCP-VD, pDCP-CD) and foveal avascular zone (FAZ) were quantified with OCTA. Optical coherence tomography (OCT) was used to measure macular thickness. Our statistical analysis was conducted by using a mixed effect linear regression model.
RESULTS: After adjustment for age and gender, the mean parafoveal superficial capillary plexus vascular density (pSCP-VD) and mean parafoveal deep capillary plexus vascular density (pDCP-VD) were significantly decreased in individuals with PD (P&#x0026;#x003C;0.001 in both) by -2.35 (95%CI -3.3, -1.45) and -7.5 (95%CI -10.4, -4.6) respectively. fSCP-VD and fDCP-VD didn't approach statistical significance. The FAZ area and perimeter were significantly decreased (P&#x0026;#x003C;0.001 in both) by -0.1 mm2 (95%CI -0.13, -0.07) and -0.49 mm2 (95%CI -0.66, -0.32) respectively. Circularity didn't approach statistical significance. Central retinal thickness (CRT) was significantly decreased in individuals with PD (P&#x0026;#x003C;0.001) by -23.1 μm (95%CI -30.2, -16) and temporal retinal thickness (TRT) was decreased (P=0.025) by -11 μm (95%CI -22, -1.5) while nasal retinal thickness (NRT) only approached statistical significance (P=0.066).
CONCLUSION: The mean pSCP-VD, pDCP-VD, CRT and TRT are significantly decreased and FAZ is altered in individuals with PD. These findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.