Parkinson Disease
Conditions
Keywords
Parkinson's disease, vision, quality of life
Brief summary
Non motor symptoms and signs in Parkinson's disease (PD) also include a series of visual deficits; deepening these aspects could be useful for a better management of symptoms, to standardize a specific protocol for the issues related to vision and also to understand how these aspects are important for the understanding of the mechanisms underlying the PD.
Detailed description
In Parkinson's disease (PD) several non-motor signs and symptoms already occur in the early stages of the disease; the symptoms are diverse and these also involve visual difficulties which commonly affect the majority of patients and which gradually worsen the quality of life. The most common malfunction produced by PD is the dysfunction of dopaminergic pathways that may be responsible for a series of visual deficits too: * decreased visual acuity and decreased sensibility to light and color, * strabismus and forms of sensory and eye movement dysfunctions, * eyelid dysfunctions and dry eye syndrome Moreover, in patients affected by PD, typical retinal features were discovered for the first time in 2004 by the use of OCT (Optical Coherence Tomography) such as: * the reduction of the retinal nerve fiber layer (RNFL) * a typical thinning of the macular thickness, even if with different results. In the follow-up of the PD, these retinal features, verifiable by the use of OCT, could be considered as a marker of the pathology. For these reasons it may be useful: * quantify in an objective manner how much the visual aspects affect the overall deterioration of the quality of life in patients with PD * demonstrate the validity of a specific and integrated outpatient diagnostic protocol for the study of visual and ophthalmological disorders in patients with PD * demonstrate the diagnostic role of early changes in macular thickness and of the optic disc in subjects suffering from PD using the OCT * establish orthoptic evidence in patients with PD
Interventions
DIAGNOSTIC_TESTClinical evaluation of vision and eye tests
* VFQ-25 Questionnaire * BCVA * Contrast sensitivity * Color sensitivity examination (Ishihara test 38 plates) * Complete evaluation of orthoptic features, eye movements, eyelid function, pupil function * Slit lamp examination * Shirmer test, Break up time test * Corneal pachymetry (optical pachymetry) * IOP * Quantitative and qualitative analysis of the macular area and of the optical disc by OCT: RPE, RNFL and Neuroretine Layer
Sponsors
Neuromed IRCCS
Study design
Observational model
CASE_CONTROL
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients aged ≥ 18 years * Patients affected by Parkinson's disease (PD) according to the diagnostic criteria of the United Kingdom Brain Bank, in the ON phase of their usual treatment * Hoehn-Yahr Stage from 1 to 3 * Signature of the Informed Consent and of the privacy form
Exclusion criteria
* Patients with symptoms and signs compatible with atypical parkinsonism * PD patients treated with antagonist drugs for central dopaminergic receptors (first and second generation antipsychotics) in the last 6 months before enrollment * Patients suffering from other neurological diseases * Patients with evident cognitive impairment (MMSE \<24/30) * Patients with manifest eye movement disorders prior to the diagnosis of PD. * Patients with daltonism * Patients with amblyopia * Patients suffering from high anisometropia * Patients suffering from advanced cataracts * Patients suffering from glaucoma * Patients suffering from maculopathy * Patients suffering from pathologies of the optic nerve * Patients with severe visual field deficits * Patients with refractive defects above 5 diopters
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Check the impact of visual condition on the quality of life in patients with PD through the use of questionnaires. | through study completion with an avarage of 6 months | Quantify the impact of visual condition using the VFQ-25 (Visual Functional Questionnaire) in patients with PD through the main method of this questionnaire: all items are scored, each item is then converted to a 0 to 100 scale so that the lowest and highest possible scores are set at 0 and 100 points, respectively so that scores represent the achieved percentage of the total possible score, e.g. a score of 50 represents 50% of the highest possible score. The lowest percentage is the better outcome for the visual condition. |
| Survey the validity of a specific diagnostic protocol for the evaluation of the visual condition in patients with PD. | through study completion with an avarage of 6 months | Review the validity of a specific and integrated ambulatory diagnostic protocol for the study of visual and ophthalmological disorders through a visit protocol and exams designed specifically for patients with PD based on the evidence of visual conditions in the disease currently present in the scientific literature trough the best corrected visual acuity expressed in twentieths and the use of the SLOAN chart. |
| Inspection of orthoptic condition in patients with PD | through study completion with an avarage of 6 months | Analysis of orthoptic features in patients with PD trough eye movements examination to determine hypofunctions/ hyperfunctions in ductions and versions. |
| Observation of retinal features in patients with PD through the use of OCT | through study completion with an avarage of 6 months | Registration of the retinal features in patients with PD using OCT trough a quantitative analysis of the macular area and of the optical disc by the registration of retinal tickness expressed in microns for RPE, RNFL and Neuroretine Layer. |
Countries
Italy
Contacts
Primary ContactNicola Modugno, MD, PhD
Backup ContactMichele Meglio, BSc, M.Sc
Outcome results
None listed