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Abstract

O objetivo deste relato é correlacionar achados à tomografia de coerência óptica e prognóstico visual de pacientes com commotio retina e de gravidades diferentes. Dois pacientes do sexo masculino, de 20 e 23 anos com baixa visual unilateral após trauma ocular contuso atribuível a edema de Berlin foram avaliados pela retinografia e tomografia de coerência óptica. A acuidade visual no olho afetado era de 20/25 no primeiro paciente e conta dedos a 2 metros no segundo. O exame oftalmológico revelou uveíte traumática e, na fundoscopia, evidenciaram-se opacificação retiniana moderada no primeiro caso e grave no segundo. A tomografia de coerência óptica confirmou discreta diminuição da depressão foveal no primeiro caso e desorganização das camadas retinianas no segundo. Houve resolução anatômica e funcional completa a tomografia de coerência óptica no primeiro paciente, enquanto o segundo evoluiu com baixa visual permanente e desorganização da arquitetura retiniana. A tomografia de coerência óptica é um exame complementar útil na avaliação do trauma retiniano, ajudando a entender sua fisiopatologia e predizer prognóstico a partir da análise anatômica da região acometida.

Keywords: Retina; Retinopatia; Tomografia de coerência óptica; Traumatismos oculares; Fundus oculi; Humano; Adulto; Masculino

Abstract

PURPOSE: This study aimed to evaluate the total macular thickness as well as the thickness of the inner and outer retinal layers in patients with Parkinson's disease. It also aimed to verify the correlation of these parameters with motor symptoms and cognitive function.
METHODS: A total of 46 eyes of 23 patients with Parkinson's disease and 40 eyes of 20 healthy controls were included in the study. The patients' cognitive, functional, and nonmotor symptoms were evaluated using the Katz Index of Independence and Pfeffer's Activities of Daily Living, Mini-Mental State Examination, Frontal Assessment Battery, Schwab and England Staging Scales, and Movement Disorders Society Nonmotor Symptoms Scale. The macular thickness measurements obtained via total, inner, and outer optical coherence tomography were recorded. Furthermore, the correlation of the parameters of optical coherence tomography with cognitive, functional, and nonmotor symptoms was assessed.
RESULTS: The scores of the Katz Index of Independence and Pfeffer's Activities of Daily Living as well as the Movement Disorders Society Nonmotor Symptoms Scale were significantly lower in patients with Parkinson's disease than in healthy controls. Moreover, the former had greater total macular thickness. The temporal and inferior outer sectors were significantly greater for the ganglion cell complex thickness in patients. A significant correlation was observed between the total macular thickness and the Movement Disorder Society-Unified Parkinson's Disease Rating Scale, Parte III (MDS-UPDRS-III) values. Contrarily, there was a negative correlation between the outer macular thickness and the MDS-UPDRS-III values. Meanwhile, the total macular thickness and ganglion cell complex thickness were significantly correlated with the scores of the Mini-Mental State Examination, Schwab and England Staging Scale, Frontal Assessment Battery, and Katz Index of Independence and Pfeffer's Activities of Daily Living. In addition, the Schwab and England scale was correlated with the outer macular thickness.
CONCLUSION: The total and inner macular thicknesses at the temporal and inferior outer sectors were greater in patients with Parkinson's disease than in the control group. These findings indicate that macular thickness may be greater in those with Parkinson's disease, particularly when associated with mild motor symptoms. In addition, the parameters of the total, inner, and outer optical coherence tomography were significantly associated with motor and nonmotor symptoms as well as cognitive function impairment.

Keywords: Parkinson's disease; Tomography, optical coherence; Neurodegenerative diseases; Cognitive dysfunction; Cognition; Motor perception; Visual acuity; Retina