Seeing ophthalmologic problems in Parkinson disease: Results of a visual impairment questionnaire

Abstract

Objective: To determine the prevalence and clinical effect of ophthalmologic symptoms in patients with Parkinson disease (PD), compared with controls, using a standardized questionnaire.

Methods: In this observational, cross-sectional, multicenter study, 848 patients with PD and 250 healthy controls completed the Visual Impairment in Parkinson's Disease Questionnaire (VIPD-Q). The VIPD-Q addressed 4 domains according to structures: (1) ocular surface; (2) intraocular; (3) oculomotor; and (4) optic nerve. The questionnaire also assessed the effect of ophthalmologic symptoms on daily activities.

Results: One or more ophthalmologic symptoms were reported by 82% (95% confidence interval [CI], 80-85) of patients, compared with 48% (95% CI, 42-54) of controls (p < 0.001). Patients with PD experienced more ophthalmologic symptoms across all domains than controls (p < 0.001), as reflected by a higher VIPD-Q total score among patients (median 10 [interquartile range (IQR) 13]) than controls (median 2 [IQR 5]; p < 0.001). Ophthalmologic symptoms interfered with daily activities in 68% (95% CI, 65-71) of patients, compared with 35% (95% CI, 29-41) of controls (p < 0.001).

Conclusion: Patients with PD have a higher prevalence of ophthalmologic symptoms than controls. Moreover, these frequently interfere with daily activities. A screening questionnaire such as the VIPD-Q may help with identifying ophthalmologic symptoms in PD, thereby enabling more timely treatment.

Figure 1. Boxplot of the total Visual Impairment in Parkinson's Disease Questionnaire (VIPD-Q) score

Boxplot of the median total score of the VIPD-Q in Parkinson disease (PD) and the control group (n = 773, PD group; n = 224, control group). ***p < 0.05.

Figure 2. Number of ophthalmologic symptoms reported per domain compared between patients with Parkinson disease (PD) and controls

Each pair of bars represents patients with PD and healthy controls. The bars are divided into the cumulative percentages of participants reporting no ophthalmologic symptoms, 1 ophthalmologic symptom, 2 ophthalmologic symptoms, 3 ophthalmologic symptoms, or 4 ophthalmologic symptoms. For example, in the domain of the ophthalmologic surface, only 37% of the patients with PD reported no symptoms, compared with 76% in the control group. In the control group in the domains intraocular, oculomotor, and optic nerve the option “4 symptoms” is 0%. In the control group in the domains oculomotor and optic nerve the option “3 symptoms” is 0%. ***p < 0.001.

Figure 3. Effect of ophthalmologic symptoms: Interference with daily activities

Reported interference with daily activities due to ophthalmologic symptoms in the Parkinson disease (PD) group (n = 848) compared with controls (n = 250). Each pair of bars represents patients with PD compared with healthy controls. ***p < 0.001.