Evaluation of the Protective Role of the L-DOPA Against Age Related Macular Degeneration in Parkinson's Patients

Study Overview
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Brief Summary
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Age related macular degeneration (ARMD) is a major and irreversible cause of blindness among the elderly. The sub-retinal space, located between the retinal pigmentary epithelium (RPE) and the external segments of the retinal photoreceptors, plays a crucial role in this pathology. A recent epidemiologic study in the US, unpublished yet, has shown that patients treated with the L-DOPA, developed only later an ARMD when compared to the untreated patients. The L-Dopa is an endogenous ligand of the GPR43 receptor, located on the RPE's cell's apical pole. This receptor, via several intracellular mechanisms, regulates the cell's exosomal and endosomal pathways: it would appear that the L-DOPA, by stimulating this receptor, decreases significantly the RPE's exosome release. The contents of the exosomes is still uncertain, however in addition to their signalization role, it seems they transport pro-inflammatory components, possibly helping the cellular recruitment due to the mononuclear phagocytic systems, particularly toxic for the photoreceptors. The aim of this study is to validate the hypothesis stating that he L-DOPA would play a protective role against age related macular degeneration.

Conditions
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Macular Degeneration, Senile

Intervention / Treatment
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* Device: Color retinography
* Device: Optical coherence tomography
* Device: Fundus autofluorescence imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged of 70 years old and more Parkinson's disease Exclusion Criteria: Opposition to participate in this trial Patient under a measure of legal protection Absence of affiliation to social security or universal health coverage (CMU)

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Exposed patients<br>Patients treated for Parkinson's disease with a cumulative dose of L-DOPA above the 59th percentile of the population | Device: Color retinography<br> <br> Device: Optical coherence tomography<br> <br> Device: Fundus autofluorescence imaging<br> <br> |
| Non exposed patients<br>Patients treated for Parkinson's disease with a cumulative dose of L-DOPA below the 41th percentile of the population | Device: Color retinography<br> <br> Device: Optical coherence tomography<br> <br> Device: Fundus autofluorescence imaging<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnosis of ARMD based on ophtalmological examination combining color retinography, optical coherence tomography and fundus autofluorescence Imaging | Risk of ARMD : Ratio between the ARMD prevalence rate in patients with an elevated cumulated dose of L-DOPA and the ARMD prevalence rate in patients with a low cumulated dose of L-DOPA Risk adjusted according to age and sexe | Diagnosis of ARMD made during a single consultation lasting about an hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Senile macular degeneration, Parkinson's disease