J Korean Med Sci.  2023 Mar;38(11):e86. 10.3346/jkms.2023.38.e86.

Retinal Thickness and Its Interocular Asymmetry Between Parkinson’s Disease and Drug-Induced Parkinsonism

• Suh W
• Baek SU
• Oh JS
• Seo SY
• Kim JS
• Han YM
• Kim MS
• Kang SY

• KMID: 2540652
• DOI: http://doi.org/10.3346/jkms.2023.38.e86

Abstract

Background
Drug-induced parkinsonism (DIP) is common, but diagnosis is challenging. Although dopamine transporter imaging is useful, the cost and inconvenience are problematic, and an easily accessible screening technique is needed. We aimed to determine whether optical coherence tomography (OCT) findings could differentiate DIP from Parkinson’s disease (PD).
Methods
We investigated 97 de novo PD patients and 27 DIP patients using OCT and [ 18 F] N-(3-fluoropropyl)-2b-carbon ethoxy-3b-(4-iodophenyl) nortropane (FP-CIT) positron emission tomography. We compared peripapillary retinal nerve fiber layer thickness (pRNFLT) and macular retinal thickness (mRT) between PD and DIP patients as well as interocular differences in the pRNFLT and the mRT. Asymmetric index (%) for retinal thickness (AIRT) was calculated to measure the interocular differences between pRNFLT and mRT. The correlation between AIRT and total striatal specific/non-specific binding ratio asymmetry index (SNBRAI) was investigated in PD and DIP patients.
Results
No significant differences in pRNFLT and mRT values were observed between PD and DIP patients (all Pvalues > 0.090). The mean SNBRAI was significantly higher in PD than in DIP (P = 0.008) patients; however, AIRT did not differ between PD and DIP patients in pRNFLT and mRT (all P values > 0.100). SNBRAI did not correlate with AIRT of pRNFL or mRT in PD and DIP patients (all P values > 0.060).
Conclusion
Our study showed no benefit of retinal thickness and interocular asymmetry measurements using OCT for distinguishing PD from DIP in the early stages. Additional investigations are needed for confirmation.

Keyword

Drug-Induced Parkinsonism; Parkinson’s Disease; Retina; Optical Coherence Tomography; Asymmetry; Dopamine Transporter Imaging

Reference

1. Shin HW, Chung SJ. Drug-induced parkinsonism. J Clin Neurol. 2012; 8(1):15–21. PMID: 22523509.

2. Yoo HS, Bak Y, Chung SJ, Lee Y, Ye BS, Sohn YH, et al. Impaired functional connectivity of sensorimotor network predicts recovery in drug-induced parkinsonism. Parkinsonism Relat Disord. 2020; 74:16–21. PMID: 32283491.

3. Byun JH, Cho H, Kim YJ, Kim JS, Baik JS, Jang S, et al. Trends in the prevalence of drug-induced parkinsonism in Korea. Yonsei Med J. 2019; 60(8):760–767. PMID: 31347331.

4. Sung YH, Noh Y, Lee J, Kim EY. Drug-induced parkinsonism versus idiopathic Parkinson disease: utility of nigrosome 1 with 3-T imaging. Radiology. 2016; 279(3):849–858. PMID: 26690908.

5. Kim JS, Ryu DW, Oh JH, Lee YH, Park SJ, Jeon K, et al. Cardiovascular autonomic dysfunction in patients with drug-induced parkinsonism. J Clin Neurol. 2017; 13(1):15–20. PMID: 27730767.

6. Koh SB, Jo YH, Kim BJ, Park MK, Park KW, Lee DH. Clinical characteristics of drug-induced parkinsonism. J Korean Geriatr Soc. 2001; 5(1):43–49.

7. Lee SH, Kim HK, Lee YG, Lyoo CH, Ahn SJ, Lee MS. Clinical features indicating nigrostriatal dopaminergic degeneration in drug-induced parkinsonism. J Mov Disord. 2017; 10(1):35–39. PMID: 28122428.

8. Kim JM, Kim YK, Kim SE, Jeon BS. Clinical usefulness of dopamine transporter imaging. Nucl Med Mol Imaging. 2007; 41(2):152–157.

9. Baek SU, Kang SY, Kwon S, Park IW, Suh W. Motor asymmetry and interocular retinal thickness in Parkinson’s disease. J Korean Med Sci. 2021; 36(6):e50. PMID: 33559408.

10. Lee JY, Martin-Bastida A, Murueta-Goyena A, Gabilondo I, Cuenca N, Piccini P, et al. Multimodal brain and retinal imaging of dopaminergic degeneration in Parkinson disease. Nat Rev Neurol. 2022; 18(4):203–220. PMID: 35177849.

11. Kaur M, Saxena R, Singh D, Behari M, Sharma P, Menon V. Correlation between structural and functional retinal changes in Parkinson disease. J Neuroophthalmol. 2015; 35(3):254–258. PMID: 25807477.

12. Lee JY, Kim JM, Ahn J, Kim HJ, Jeon BS, Kim TW. Retinal nerve fiber layer thickness and visual hallucinations in Parkinson’s disease. Mov Disord. 2014; 29(1):61–67. PMID: 23775932.

13. Aaker GD, Myung JS, Ehrlich JR, Mohammed M, Henchcliffe C, Kiss S. Detection of retinal changes in Parkinson’s disease with spectral-domain optical coherence tomography. Clin Ophthalmol. 2010; 4:1427–1432. PMID: 21188154.

14. Altintaş O, Işeri P, Ozkan B, Cağlar Y. Correlation between retinal morphological and functional findings and clinical severity in Parkinson’s disease. Doc Ophthalmol. 2008; 116(2):137–146. PMID: 17962989.

15. Jiménez B, Ascaso FJ, Cristóbal JA, López del Val J. Development of a prediction formula of Parkinson disease severity by optical coherence tomography. Mov Disord. 2014; 29(1):68–74. PMID: 24458320.

16. Pieters LE, Bakker PR, van Harten PN. Asymmetric drug-induced parkinsonism and psychopathology: a prospective naturalistic study in long-stay psychiatric patients. Front Psychiatry. 2018; 9:18. PMID: 29459835.

17. Hughes AJ, Ben-Shlomo Y, Daniel SE, Lees AJ. What features improve the accuracy of clinical diagnosis in Parkinson’s disease: a clinicopathologic study. Neurology. 1992; 42(6):1142–1146. PMID: 1603339.

18. Jiménez-Jiménez FJ, Ortí-Pareja M, Ayuso-Peralta L, Gasalla T, Cabrera-Valdivia F, Vaquero A, et al. Drug-induced parkinsonism in a movement disorders unit: a four-year survey. Parkinsonism Relat Disord. 1996; 2(3):145–149. PMID: 18591033.

19. Lee E, Lee JE, Yoo K, Hong JY, Oh J, Sunwoo MK, et al. Neural correlates of progressive reduction of bradykinesia in de novo Parkinson’s disease. Parkinsonism Relat Disord. 2014; 20(12):1376–1381. PMID: 25304859.

20. Oh M, Kim JS, Kim JY, Shin KH, Park SH, Kim HO, et al. Subregional patterns of preferential striatal dopamine transporter loss differ in Parkinson disease, progressive supranuclear palsy, and multiple-system atrophy. J Nucl Med. 2012; 53(3):399–406. PMID: 22323779.

21. Mawlawi O, Martinez D, Slifstein M, Broft A, Chatterjee R, Hwang DR, et al. Imaging human mesolimbic dopamine transmission with positron emission tomography: I. Accuracy and precision of D₂ receptor parameter measurements in ventral striatum. J Cereb Blood Flow Metab. 2001; 21(9):1034–1057. PMID: 11524609.

22. Oh JS, Oh M, Chung SJ, Kim JS. Cerebellum-specific 18F-FDG PET analysis for the detection of subregional glucose metabolism changes in spinocerebellar ataxia. Neuroreport. 2014; 25(15):1198–1202. PMID: 25144395.

23. Innis RB, Cunningham VJ, Delforge J, Fujita M, Gjedde A, Gunn RN, et al. Consensus nomenclature for in vivo imaging of reversibly binding radioligands. J Cereb Blood Flow Metab. 2007; 27(9):1533–1539. PMID: 17519979.

24. Zijlmans J, Evans A, Fontes F, Katzenschlager R, Gacinovic S, Lees AJ, et al. [¹²³I] FP-CIT SPECT study in vascular parkinsonism and Parkinson’s disease. Mov Disord. 2007; 22(9):1278–1285. PMID: 17486613.

25. Mello LG, Bissoli LB, Saraiva FP, Maia RP, Monteiro ML. retinal layers and choroid measurements in Parkinson’s disease with or without pramipexole treatment. Mov Disord. 2020; 35(12):2357–2359. PMID: 32901990.

26. Kline RB. Principles and Practice of Structural Equation Modeling. 3rd ed. New York, NY, USA: Guilford Press;2011.

27. Zhou WC, Tao JX, Li J. Optical coherence tomography measurements as potential imaging biomarkers for Parkinson’s disease: a systematic review and meta-analysis. Eur J Neurol. 2021; 28(3):763–774. PMID: 33107159.

28. Alkabie S, Lange A, Manogaran P, Stoessl AJ, Costello F, Barton JJ. Optical coherence tomography of patients with Parkinson’s disease and progressive supranuclear palsy. Clin Neurol Neurosurg. 2020; 189:105635. PMID: 31855622.

29. Tsironi EE, Dastiridou A, Katsanos A, Dardiotis E, Veliki S, Patramani G, et al. Perimetric and retinal nerve fiber layer findings in patients with Parkinson’s disease. BMC Ophthalmol. 2012; 12(1):54. PMID: 23031247.

30. Pillai JA, Bermel R, Bonner-Jackson A, Rae-Grant A, Fernandez H, Bena J, et al. Retinal nerve fiber layer thinning in Alzheimer’s disease: a case-control study in comparison to normal aging, Parkinson’s disease, and non-Alzheimer’s dementia. Am J Alzheimers Dis Other Demen. 2016; 31(5):430–436. PMID: 26888864.

31. Clémence-Fau M, Schwan R, Angioi-Duprez K, Laprévote V, Schwitzer T. Retinal structural changes in mood disorders: the optical coherence tomography to better understand physiopathology? Prog Neuropsychopharmacol Biol Psychiatry. 2021; 108:110080. PMID: 32827610.

32. Jerotic S, Ignjatovic Z, Silverstein SM, Maric NP. Structural imaging of the retina in psychosis spectrum disorders: current status and perspectives. Curr Opin Psychiatry. 2020; 33(5):476–483. PMID: 32639357.

33. Faure C, Audo I, Zeitz C, Letessier JB, Robert MP. Aripiprazole-induced chorioretinopathy: multimodal imaging and electrophysiological features. Doc Ophthalmol. 2015; 131(1):35–41. PMID: 25791769.

34. Fornaro P, Calabria G, Corallo G, Picotti GB. Pathogenesis of degenerative retinopathies induced by thioridazine and other antipsychotics: a dopamine hypothesis. Doc Ophthalmol. 2002; 105(1):41–49. PMID: 12152801.

35. Zhuo C, Ji F, Xiao B, Lin X, Chen C, Jiang D, et al. Antipsychotic agent-induced deterioration of the visual system in first-episode untreated patients with schizophrenia maybe self-limited: findings from a secondary small sample follow-up study based on a pilot follow-up study. Psychiatry Res. 2020; 286:112906. PMID: 32151847.

36. Shrier EM, Adam CR, Spund B, Glazman S, Bodis-Wollner I. Interocular asymmetry of foveal thickness in Parkinson disease. J Ophthalmol. 2012; 2012:728457. PMID: 22900149.

37. Chua J, Tham YC, Tan B, Devarajan K, Schwarzhans F, Gan A, et al. Age-related changes of individual macular retinal layers among Asians. Sci Rep. 2019; 9(1):20352. PMID: 31889143.