Prevalence of Age Related Macular Degeneration (ARMD) in Parkinson's Patients and Assesment of the Role of L-DOPA

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, has shown that Parkinson patients treated with L-DOPA, developed only later an ARMD when compared to the untreated patients. The L-Dopa is an endogenous ligand of the GPR43 receptor (G protein-coupled receptors), 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 estimate the prevalence of ARMD in a sample of Parkinson's Patients followed at Fondation Ophtalmologique Adolphe de Rothschild and to compared it to the prevalence of ARMD of the general population. Furthermore the study aims to explore a possible causal link between L-DOPA treatment and ARMD.

Official Title
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Evaluation of the Prevalence of Age Related Macular Degeneration (ARMD) in Parkinson's Patients and Assesment of the Role of L-DOPA (AMD-PARK)

Conditions
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Parkinson Disease, Age Related Macular Degeneration

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


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged of 50 years old and more Parkinson's disease Exclusion Criteria: Patient under a measure of legal protection

Ages Eligible for Study
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Minimum Age: 50 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 with Parkinson's disease treated with L-DOPA | Diagnostic Test: Color retinography<br>* Color retinography<br>Diagnostic Test: Optical coherence tomography<br>* Optical coherence tomography<br>Diagnostic Test: Fundus autofluorescence imaging<br>* Fundus autofluorescence imaging<br>|
| Non exposed patients<br>Patients with Parkinson's disease not treated with L-DOPA | Diagnostic Test: Color retinography<br>* Color retinography<br>Diagnostic Test: Optical coherence tomography<br>* Optical coherence tomography<br>Diagnostic Test: Fundus autofluorescence imaging<br>* Fundus autofluorescence imaging<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of ARMD | Comparison of the percentage of patients with ARMD in both groups (Parkinson's Patients treated or not treated with L-DOPA) : Diagnosis of ARMD by the ophthalmologist is based on 3 exams (Color retinography, Optical coherence tomography and Fundus autofluorescence imaging). In case of any discrepancy between the results of the 3 exams, the final diagnosis of ARMD is based on the Optical coherence tomography. | baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Parkinson Disease, Age Related Macular Degeneration, L-DOPA