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Optical coherence tomography angiography in Parkinson’s disease: a systematic review and meta-analysis

Eye volume 37, pages 2847–2854 (2023)Cite this article

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Abstract

Background

To examine the association between optical coherence tomography angiography (OCTA) retinal measurements and Parkinson’s disease (PD).

Methods

We searched MEDLINE and EMBASE from inception up to November 5th, 2021 for studies examining the differences between OCTA retinal measurements in PD patients and healthy controls. We used the Hartung–Knapp–Sidik–Jonkman random-effects method to combine study-specific standardized mean differences (SMD) in pooled effect estimates and a meta-analytic extension of the E-value metric to quantify the confounding bias capable of nullifying the pooled estimates.

Results

Nine eligible studies for our systematic review were identified through our search strategy. The pooled SMD between the retinal vessel density of PD patients and healthy participants in the whole superficial vascular plexus (SVP), foveal SVP, parafoveal SVP and foveal avascular zone (FAZ) was −0.68 (95% CI: −1.18 to −0.17, p value = 0.02, n = 7 studies), −0.14 (95% CI: −0.88 to 0.59, p value = 0.62, n = 5 studies), −0.59 (95% CI: −1.41 to 0.23, p value = 0.12, n = 5 studies) and −0.20 (95% CI: −0.79 to 0.38, p value = 0.39, n = 5 studies), respectively. An unmeasured confounder would need to be associated with a 3.01-fold, 1.54-fold, 2.81-fold and 1.70-fold increase in the risk of PD and OCTA retinal measurements, in order for the pooled SMD estimate of vessel density in whole SVP, parafoveal SVP and FAZ, respectively, to be nullified.

Conclusions

Our results provide evidence on an inverse association between whole SVP vessel density and PD.

摘要

背景: 探讨视网膜影像检查相干光断层扫描血流成像技术 (OCTA) 与帕金森病 (PD) 之间的相关性。

方法: 我们在MEDLINE和EMBASE上搜索了从开始时的相关文献到2021年11月5日之间的、研究PD患者和健康对照组的OCTA视网膜参数差异性的文献。我们使用Hartung-Knapp-Sidik-Jonkman随机效应法, 将研究特定的标准化平均差异 (SMD) 结合到集合效应估计中, 在合并效应估计和E值指标的元分析扩展中, 以量化能够合并估计无效的混杂偏差。

结果: 通过搜索, 我们确定了9项符合系统评价的研究。PD患者和健康参与者在整个浅层血管丛 (SVP) 、中心凹 (SVP) 、旁中心凹SVP和中心凹无血管区 (FAZ) 的视网膜血管密度集合的SMD为-0.68 (95% CI: −1.18 to −0.17, p = 0.02, n = 7)、−0.14 (95% CI: −0.88–0.59, p = 0.62, n = 5)、−0.59 (95% CI: −1.41–0.23, p = 0.12, n = 5) 和 -0.20 (95% CI: −0.79 至 0.38, p = 0.39, n = 5)。一个未测量的混杂因素需要与PD和OCTA视网膜测量的风险增加3.01倍、1.54倍、2.81倍和1.70倍相关, 以便使整个SVP、旁中心凹 SVP和FAZ的血管密度集合的SMD估计值失效。

结论: 我们的结果为整个SVP血管密度和PD之间呈负相关提供了证据。

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Fig. 1: Flowchart of the selection strategy of eligible studies.
Fig. 2: Forest plots of the pooled standardized mean differences (SMDs) on patients with Parkinson’s disease (PD) and healthy participants.

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Author notes

  1. These authors contributed equally: Andreas Katsimpris, Iason Papadopoulos.

Authors and Affiliations

  1. First Ophthalmology Department, “G.Gennimatas” Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Andreas Katsimpris, Iason Papadopoulos, Nafsika Voulgari, Stylianos Kandarakis, Petros Petrou, Anna Nina Dimitropoulou, Marios Katsimpras, Aristotelis Karamaounas, Anna Maria Sideri, Ilias Georgalas & George Kymionis

  2. Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece

    Theodoros Karampitsakos

  3. Department of Ophthalmology, General Hospital of Patras “Agios Andreas”, Patras, Greece

    John Katsimpris

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AK conceived and designed the presented study and performed the analysis. All authors wrote and critically reviewed the manuscript.

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Katsimpris, A., Papadopoulos, I., Voulgari, N. et al. Optical coherence tomography angiography in Parkinson’s disease: a systematic review and meta-analysis. Eye 37, 2847–2854 (2023). https://doi.org/10.1038/s41433-023-02438-7

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