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Retinal nerve fiber layer thinning in Parkinson disease
Open accessAbstract
Retinal dopamine loss in Parkinson disease (PD) is reflected by visual neurophysiological dysfunction. We measured the thickness of the circumpapillary retinal nerve fiber layer (RNFL) in PD patients using optical coherence tomography. The thickness in the inferior quadrant of PD patients (147 +/- 20 microns) was significantly thinner than that of controls (173 +/- 12 microns; p=0.002), while the inferotemporal area was the thinnest (146 +/- 24 vs. 191 +/- 21 microns; p=0.0003). The results show significant loss of RNFL thickness in PD at specific sites.
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“As mentioned above, PD is a motor disorder associated with degeneration of dopaminergic neurons in the substantia nigra (Inzelberg et al., 2004).”
From The role of microglia in retinal neurodegeneration: Alzheimer’s disease, parkinson, and glaucoma. (2017) · cites this paper as Inzelberg et al., 2004
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Baek, S. U., Kang, S. Y., Kwon, S., Park, I. W., & Suh, W. (2021) · Journal of Korean Medical Science · doi:10.3346/jkms.2021.36.e50 · Cited by 9
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Dereci, S., Pirgon, Ö., Akçam, M., Türkyılmaz, K., & Dündar, B. N. (2015) · European Journal of Ophthalmology · doi:10.5301/ejo.5000587 · Cited by 9
“Various neurodegenerative diseases can affect RNFL thickness (11-14).”
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Ge, J. Y., Teo, Z. L., & Loo, J.-L. (2024) · Clinical and Experimental Ophthalmology · doi:10.1111/ceo.14341 · Cited by 8
“100,101 Recent research has focused on OCT changes in individuals with rapid eye movement sleep behaviour disorders (RBD), considered a prodromal stage of PD, revealing both pRNFL and mGCIPL thinning in these individuals.”
BackgroundVerghese, S., Berkowitz, S. T., Shah, V. M., Shah, P. K., Priya, S., Saravanan, V., Narendran, V., & Selvan, V. (2022) · Indian Journal of Ophthalmology · doi:10.4103/ijo.ijo_1409_21 · Cited by 8
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Akmaz, O., Köşkderelioğlu, A., Eşkut, N., Şahan, B., & Küsbeci, T. (2022) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2022.103169 · Cited by 8
Obís, J., García‐Martín, E., Orduna, E., Viladés, E., Alarcia, R., Rodrigo, M. J., Pablo, L. E., Polo, V., Poves, J. M. L., & Satué, M. (2020) · Arquivos Brasileiros de Oftalmologia · doi:10.5935/0004-2749.20200008 · Cited by 8
“Moreover, decreased thickness of the retinal nerve fiber layer (RNFL) in the peripapillary area has been noted, especially in the temporal and inferior quadrants(6-9).”
BackgroundResultReduction of Retinal Thickness Ipsilateral to Hippocampal Sclerosis in Epilepsy
Xiong, W., Lu, L., Chen, Q., Xiao, Y., An, D., Sander, J. W. A. S., Zhang, M., & Zhou, D. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.663559 · Cited by 8
“There is growing evidence that retinal changes may provide a directly observable “window” to identify CNS abnormalities mainly in neurodegenerative diseases such as AD (8), PD (9), multiple sclerosis (10), and other conditions such as epilepsy (4), and schizophrenia (11).”
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“The retinas of PD patients show photoreceptor and RGC dysfunction, morphological deterioration of the perifoveal dopaminergic plexus [165], and thinning of the RNFL [52, 53, 164, 166, 167].”
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“Grupo, año n OCT Análisis Correlaciones 5 Inzelberg et al., 2004 10 EP, 10 C TD CFNR peripapilar; ↓ en Inf (↓15,03”
BackgroundSensory symptoms in Parkinson's disease
Djaldetti, R., & Melamed, E. (2007) · Handbook of clinical neurology · doi:10.1016/s0072-9752(07)83016-8 · Cited by 7
Minor retinal degeneration in Parkinson’s disease
Huang, Y. M., & Yin, Z. Q. (2010) · Medical Hypotheses · doi:10.1016/j.mehy.2010.09.016 · Cited by 7
“process, as a significant reduction in RNFL thickness was observed in L-DOPA treated PD patients [35].”
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“27,28 29-31 Retinal thinning (RNFL and GCL reduction) has been observed in patients with neurodegenerative diseases such as Parkinson disease 17,32,33 and AD.”
BackgroundMitochondrial morphology and synaptic structure altered in the retina of parkin-deficient mice
Hu, Z.-X., Pu, J., Zheng, R., Yan, Y.-Q., Liu, K.-Y., Liu, Y., Zheng, R., Chen, Y., Lin, Z., Xue, N., et al. (2022) · Neuroscience Letters · doi:10.1016/j.neulet.2022.136888 · Cited by 7
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Köşkderelioğlu, A., Küsbeci, T., Küsbeci, Ö. Y., & Gedizlioğlu, M. (2016) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2016.08.003 · Cited by 7
“Previous studies pointed at a decreased peripapillary RNFL thickness in the inferior, inferotemporal and superotemporal quadrants in patients with PD [10,13,21].”
BackgroundSvetozarskiy, S. N., Kopishinskaya, S. V., & Глебович, С. И. (2020) · Medical Hypothesis Discovery & Innovation in Optometry · doi:10.51329/mehdioptometry103 · Cited by 6
“The study of retinal structures in neurodegenerative diseases has been performed by various teams since 2004 [24].”
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Zhang, Y., Li, Y., Lai, C., Wang, X., Luo, F., Qin, Y., Qin, Y., Zhang, Y., & Zhang, H. (2024) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2024.107037 · Cited by 5
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Retinal imaging: what the neurologist needs to know
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Can optical coherence tomography findings be related with suicide attempt in bipolar disorder?
Onur, Ö. Ş., Yeşilkaya, Ü. H., Subaş, E., Açar, Ö. P. A., Onur, İ. U., Karamustafalıoğlu, N., & Eriş, E. (2023) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2022.103268 · Cited by 5
Do you have restless leg syndrome? I understood from your eyes
Özlece, H. K., Solmaz, V., Özal, S. A., & Çelik, Y. (2018) · Sleep And Breathing · doi:10.1007/s11325-018-1740-5 · Cited by 5
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Imaging in Neuro-ophthalmology
Othman, B. A. A., Kini, T. A., Costello, F., & Lee, A. G. (2022) · Springer eBooks · doi:10.1007/978-3-030-42634-7_39 · Cited by 4
OCT Findings in Patients with Methamphetamine Use Disorder
Kaya, Ş., & Kaya, M. K. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13020308 · Cited by 4
“OCT is prominent in the diagnosis and follow-up of retinal diseases and the number of studies examining retinal and neural network changes in neurodegenerative diseases such as Alzheimer’s and Parkinson’s Diseases is increasing [12,13].”
BackgroundÇoban, F., Kaplan, F. B., Akkaya, S., Okuroğlu, N., & Açıkalın, B. (2023) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2023.103713 · Cited by 4
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“Previous studies have already reported thinning of the outer plexiform layer, inner plexiform layer (IPL), ganglion cell layer, and RNFL in PD [9 – 14].”
The Role of the Ganglion Cell Layer as an OCT Biomarker in Neurodegenerative Diseases
Ruggeri, F., Fumi, D., Bassis, L., Pippo, M. D., & Abdolrahimzadeh, S. (2025) · Journal of Integrative Neuroscience · doi:10.31083/jin26039 · Cited by 5
Psychiatric Disorders And Eye: Optical Coherent Tomography In Psychiatry Aspect
Karadağ, A. S., & Kalenderoğlu, A. (2017) · Journal of Clinical Psychiatry · doi:10.5505/kpd.2017.69077 · Cited by 4
“hastalýðýn kliniðine paralel olarak retinada dejenerasyonu tespit edilmiþtir (5-8).”
OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN PARKINSON'S AND ALZHEIMER'S DISEASE
Bayram, D., Yüksel, G. A., Bayram, T., & Tireli, H. (2019) · Nöro Psikiyatri Arşivi · doi:10.29399/npa.23640 · Cited by 4
“In this study including 10 Parkinson’s patients, they showed significant decrease in the inferior RNFL thickness (18).”
Suciu, V.-I., Suciu, C.-I., Nicoară, S., & Perju‐Dumbravă, L. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12010080 · Cited by 6
“In 2004, Inzelberg and colleagues studied the thickness of the peripapillary retinal nerve fiber layer in PD by using an OCT device, and demonstrated that the temporal-inferior (TI) sector was thinner in PD compared to the healthy controls [13].”
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Usefulness of Optical Coherence Tomography Measures as Biomarkers in Schizophrenia
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Retinal changes in generalized anxiety disorder patients
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Assessment of RNFL and macular changes in the eye related to multiple substance use using OCT
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Primary Visual and Visuocognitive Deficits
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Retinal nerve fiber layer thickness in patients with essential tremor and Parkinson’s disease
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“Akin to these previous studies [8,25,26], in our study, peripapillary RNFL thickness in all quadrants was thinner in Parkinson’s patients compared to the controls.”
BackgroundResultMRI findings of visual system alterations in Parkinson’s disease
Arrigo, A., Calamuneri, A., Mormina, E., Aragona, P., Gaeta, M., & Quartarone, A. (2017) · Brain · doi:10.1093/brain/awx244 · Cited by 3
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Evaluation of Optical Coherence Tomography Findings in Antisocial Personality Disorder Patients
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Evaluation of insomnia effect on ganglion cell complex, middle retina, and choroid
Sozen-Delil, F. I., Comba, O. B., & Ucar, G. (2024) · International Ophthalmology · doi:10.1007/s10792-024-03303-6 · Cited by 2
“Thinning of the RNFL thickness, shown on OCT in neurodegenerative and demyelinating diseases, has been observed in previous studies [14, 15].”
Macular and Retinal Nerve Fibre Layer Thinning in Xeroderma Pigmentosum: A Cross-sectional Study
Gruener, A. M., & Morley, A. M. S. (2018) · Neuro-Ophthalmology · doi:10.1080/01658107.2018.1452038 · Cited by 2
Discharge responses of the optic tract to flash stimuli in Parkinson's disease
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“…thickness in PD associated with visual alterations and reduced contrast sensitivity which should be explored further as potential early markers in PD (Inzelberg et al. 2004; Armstrong 2011; Bertrand et al. 2012; Adam et al. 2013; Li et al. 2015; Polo et al. 2016; Yang et al. 2016; Shi et al. 2020).”
BackgroundNeurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure
Amini, E., Rohani, M., Fasano, A. A., Azad, Z., Miri, S., Habibi, S. A. H., Emamikhah, M., Mirshahi, R., Joghataei, M. T., Gholibeigian, Z., et al. (2023) · Movement Disorders · doi:10.1002/mds.29644 · Cited by 2
“20-25 Although the retina ’ s unique neurovascular structure makes it an attractive target for studying neurodegenerative disorders, speci fi c research on NBIA disorders is limited.”
BackgroundNeuro-Ophthalmologic Evaluation as a Biomarker for Diagnosis and Progression in Parkinson Disease
Satué, M., Polo, V., Otin, S., Larrosa, J. M., Obís, J., & García‐Martín, E. (2016) · InTech eBooks · doi:10.5772/62877 · Cited by 2
Pinkhardt, E. H., Ding, Y., Slotnick, S., Kassubek, J., Ludolph, A. C., Glazman, S., Selesnick, I., & Bodis-Wollner, I. G. (2020) · Journal of Neural Transmission · doi:10.1007/s00702-020-02224-9 · Cited by 2
Gaynes, B. I. (2006) · Brain · doi:10.1093/brain/awl292 · Cited by 2
Non-glaucomatous peripapillary retinal nerve fiber layer defect
Wei, W., Pan, C., & Zhou, J. (2013) · Chinese Medical Journal · doi:10.3760/cma.j.issn.0366-6999.20130148 · Cited by 1
The Effects of Pyridoxine on Retinal Nerve Fiber Layer in Tuberculous Treatment
Fındık, H., Gümüş, A., Okutucu, M., ASLAN, M. G., Koç, H., & Feyzahan, U. Z. U. N. (2019) · Düzce Tıp Fakültesi Dergisi · doi:10.18678/dtfd.515313 · Cited by 1
“Several neurodegenerative (10,11) and some metabolic diseases (12,13) affect RNFL thickness.”
BackgroundLinan, V. S., Hébert, M., & Lévesque, M. (2025) · Journal of Parkinson s Disease · doi:10.1177/1877718x251331863 · Cited by 1
Tonkaz, G. Y., Önal, B. S., Özyurt, G., ÇAKIR, A., Utlu, B., & Şahin, B. (2025) · Namık Kemal Tıp Dergisi · doi:10.4274/nkmj.galenos.2025.53244 · Cited by 1
Bozkurt, E., Muhafız, E., Erdoğan, C. E., Nizamoğulları, Ş., Toprak, G., & Meydan, B. (2025) · BMC Ophthalmology · doi:10.1186/s12886-025-04219-0 · Cited by 1
“Structural retinal changes have been noted in PD, including thinning of the inner retinal layers, particularly the ganglion cell layer (GCL) and inner nuclear layer (INL), possibly related to alpha-synuclein accumulation [4, 13, 14].”
Retinal Imaging Techniques for Neurodegenerative Diseases: Parkinson's Disease and Beyond
Tang, C., Zhang, X., Miao, H., Wang, X., & Liu, J. (2025) · MedComm – Future Medicine · doi:10.1002/mef2.70034 · Cited by 1
Svetel, M., Maric, G. D., Božić, M., Tatjana, P., Petrović, I. N., Jakšić, J., Dimitrijevic, A. M., Lazić, U., Kostić, S., Knežević, M., et al. (2026) · Biomedicines · doi:10.3390/biomedicines14010249 · Cited by 1
Glokom, Parkinson hastalığı ve nörodejenerasyon
Balci, S. Y., Eraslan, M., & Temel, A. (2015) · Marmara medical journal · doi:10.5472/mmj.2015.03691.1 · Cited by 1
Visual impairment in Parkinson's disease
Arrigo, A., Calamuneri, A., Aragona, E., Mormina, E., & Gaeta, M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-815946-0.00012-0 · Cited by 1
Neurodegenerative changes of retina in Parkinson disease
Fedotova, E. Y., Полькина, Н. В., Mikhailova, E. N., & Illarioshkin, S. N. (2022) · Russian neurological Journal · doi:10.30629/2658-7947-2021-26-6-29-34 · Cited by 1
Retinal Changes in Panic Disorder Patients
Baykara, S., Yıldırım, H., Kılıçaslan, A. K., Tabara, M. F., Keleş, D. D., Gürok, M. G., & Atmaca, M. (2022) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2022.111496 · Cited by 3
Başkan, C., Akman, A. Ö., Akçay, E., Gökçe, S. E., & Taş, D. (2024) · Arquivos Brasileiros de Oftalmologia · doi:10.5935/0004-2749.2023-0047 · Cited by 1
Manchanda, R., Samanta, R., Narayan, M. L., Kumar, M., Tiwari, A., Agarwal, A., Bahurupi, Y. A., Kumari, S., & Kumar, N. (2024) · Annals of Indian Academy of Neurology · doi:10.4103/aian.aian_31_24 · Cited by 1
Parkinson Hastalığında Retina Sinir Lifi Tabakası ve Makula Kalınlığının Değerlendirilmesi
Dikkaya, F., Özkök, A., & Delil, Ş. (2018) · Dicle Medical Journal / Dicle Tip Dergisi · doi:10.5798/dicletip.457264 · Cited by 1
La retina como marcador biológico de daño neuronal
Pueyo, V., Ara, J. R., & Martín, J. (2010) · Archivos de la Sociedad Española de Oftalmología · doi:10.1016/s0365-6691(10)55001-9 · Cited by 1
The retina as a biological marker of neuronal damage
Pueyo, V., Ara, J. R., & Martín‐Vallejo, J. (2010) · Archivos de la Sociedad Española de Oftalmología (English Edition) · doi:10.1016/s2173-5794(10)70030-x · Cited by 1
Castelo-Branco, M. S., Silva, M. F., Januário, C., & Freire, A. (2006) · Brain · doi:10.1093/brain/awl293 · Cited by 1
“First, as can be easily appreciated from the title of the single paper that is cited in this context (Inzelberg et al., 2004), it is not true that the diameter of retinal ganglion cell axons is being measured.”
Peripapillary retinal nerve fibre layer thickness in individuals with epilepsy exposed to vigabatrin
Clayton, L. M. S. (2011) · UCL Discovery (University College London)
Jindahra, P. (2011) · UCL Discovery (University College London)
Stellenwert einer perimetrischen Differenzialdiagnostik beim primären Offenwinkelglaukom
Erb, C., & Göbel, K. (2013) · Der Ophthalmologe · doi:10.1007/s00347-012-2691-z
Erratum zu: Therapie posterior gelegener Orbitatumoren
Maier, W., Ridder, G. J., Kaminsky, J., & Grosu, A. (2011) · Der Ophthalmologe · doi:10.1007/s00347-011-2417-7
Metadata
- Authors
- Inzelberg, R., Ramirez, J. A., Nisipeanu, P., & Ophir, A.
- Affiliations
- Technion – Israel Institute of Technology (IL)
- Hillel Yaffe Medical Center (IL)
- Corresponding author
- Ophir, Avinoam
- ORCID
- Inzelberg, Rivka
- Venue
- Vision Research
- Publisher
- Elsevier BV
- Published
- 2004-11
- Volume
- 44
- Issue
- 24
- Pages
- 2793-2797
- ISSN
- 0042-6989 (ISSN-L)
- OpenAlex
- W1974244012
- Cited by
- 343
- References
- 17
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 15 · 2023: 13 · 2022: 25 · 2021: 15 · 2020: 30 · 2019: 20 · 2018: 21 · 2017: 26 · 2016: 21 · 2015: 27 · 2014: 23 · 2013: 21 · 2012: 22
- FWCI
- 3.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Vision Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Health, State of Israel
- Topics
- Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Ophthalmology › Drug-Induced Ocular Toxicity
- Keywords
- Parkinson's disease, retinal nerve fiber layer, retinal nerve fiber layer thickness, optic nerve head, retinal neurodegeneration
- MeSH terms
- Adult, Aged, Female, Humans, Male, Middle Aged, Nerve Fibers, Parkinson Disease, Retina, Tomography, Optical Coherence
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