Retinal Optical Coherence Tomography Features Associated With Incident and Prevalent Parkinson Disease

Disease areas:

• brain

Last updated:

2 July 2025

Author(s):

Siegfried Karl Wagner, David Romero-Bascones, Mario Cortina-Borja, Dominic J. Williamson, Robbert R. Struyven, Yukun Zhou, Salil Patel, Rimona S. Weil, Chrystalina A. Antoniades, Eric J. Topol, Edward Korot, Paul J. Foster, Konstantinos Balaskas, Unai Ayala, Maitane Barrenechea, Iñigo Gabilondo, Anthony H.V. Schapira, Anthony P. Khawaja, Praveen J. Patel, Jugnoo S. Rahi, Alastair K. Denniston, Axel Petzold, Pearse Andrew Keane, Naomi Allen, Tariq Aslam, Denize Atan, Sarah Barman, Jenny H Barrett, Paul Bishop, Graeme Black, Tasanee Braithwaite, Roxana O Carare, Usha Chakravarthy, Michelle Chan, Sharon YL Chua, Alexander Day, Parul Desai, Bal Dhillon, Andrew D Dick, Alexander Doney, Cathy Egan, Sarah Ennis, Marcus Fruttiger, John EJ Gallacher, David F Garway-Heath, Jane Gibson, Jeremy A Guggeinheim, Chris J Hammond, Alison Hardcastle, Simon P Harding, Ruth E Hogg, Pirro Hysi, Sir Peng T Khaw, Gerassimos Lascaratos, Thomas Littlejohns, Andrew J Lotery, Robert Luben, Phil Luthert, Tom Macgillivray, Sarah Mackie, Bernadette McGuiness, Gareth J McKay, Marin McKibbin, Tony Moore, James E Morgan, Eoin O'Sullivan, Richard Oram, Chris G Owen, Euan Paterson, Tunde Peto, Alicja R Rudnicka, Naveed Sattar, Jay Self, Panagiotis Sergouniotis, Sobha Sivaprasad, David Steel, Irene Stratton, Nicholas Strouthidis, Cathie Sudlow, Zihan Sun, Robyn Tapp, Dhanes Thomas, Emanuele Trucco, Adnan Tufail, Veronique Vitart, Ananth C Viswanathan, Mike Weedon, Cathy Williams, Katie Williams, Jayne V Woodside, MaxM Yates, Jennifer Yip, Yalin Zheng

Publish date:

21 August 2023

Journal:

Neurology

PubMed ID:

37604659

DOI:

10.1212/wnl.0000000000207727

Abstract

BACKGROUND AND OBJECTIVES: Cadaveric studies have shown disease-related neurodegeneration and other morphological abnormalities in the retina of individuals with Parkinson disease (PD); however, it remains unclear whether this can be reliably detected with in vivo imaging. We investigated inner retinal anatomy, measured using optical coherence tomography (OCT), in prevalent PD and subsequently assessed the association of these markers with the development of PD using a prospective research cohort.

METHODS: This cross-sectional analysis used data from 2 studies. For the detection of retinal markers in prevalent PD, we used data from AlzEye, a retrospective cohort of 154,830 patients aged 40 years and older attending secondary care ophthalmic hospitals in London, United Kingdom, between 2008 and 2018. For the evaluation of retinal markers in incident PD, we used data from UK Biobank, a prospective population-based cohort where 67,311 volunteers aged 40-69 years were recruited between 2006 and 2010 and underwent retinal imaging. Macular retinal nerve fiber layer (mRNFL), ganglion cell-inner plexiform layer (GCIPL), and inner nuclear layer (INL) thicknesses were extracted from fovea-centered OCT. Linear mixed-effects models were fitted to examine the association between prevalent PD and retinal thicknesses. Hazard ratios for the association between time to PD diagnosis and retinal thicknesses were estimated using frailty models.

RESULTS: Within the AlzEye cohort, there were 700 individuals with prevalent PD and 105,770 controls (mean age 65.5 ± 13.5 years, 51.7% female). Individuals with prevalent PD had thinner GCIPL (-2.12 μm, 95% CI -3.17 to -1.07, p = 8.2 × 10^-5) and INL (-0.99 μm, 95% CI -1.52 to -0.47, p = 2.1 × 10^-4). The UK Biobank included 50,405 participants (mean age 56.1 ± 8.2 years, 54.7% female), of whom 53 developed PD at a mean of 2,653 ± 851 days. Thinner GCIPL (hazard ratio [HR] 0.62 per SD increase, 95% CI 0.46-0.84, p = 0.002) and thinner INL (HR 0.70, 95% CI 0.51-0.96, p = 0.026) were also associated with incident PD.

DISCUSSION: Individuals with PD have reduced thickness of the INL and GCIPL of the retina. Involvement of these layers several years before clinical presentation highlight a potential role for retinal imaging for at-risk stratification of PD.