Visual dysfunction in patients with Parkinson's disease and essential tremor
Ivanka Štenc Bradvica1, Mario Bradvica, Suzana Matić
1Department for Neurology, Osijek University Hospital Center, Osijek, Croatia, ivanka.stenc@vip.hr.
Summary
The Pelli-Robson and Ishihara tests show potential for early Parkinson
Area of Science:
- Neurology
- Ophthalmology
- Diagnostic Imaging
Background:
- Parkinson's disease (PD) diagnosis can be challenging, especially differentiating it from essential tremor (ET).
- Early visual dysfunction, including color and contrast deficits, may be an indicator of early-stage PD.
- DaTSCAN (dopamine transporter scan) is a key diagnostic tool, but less invasive methods are sought.
Purpose of the Study:
- To evaluate the specificity and sensitivity of the Pelli-Robson and Ishihara tests in distinguishing Parkinson's disease from essential tremor.
- To determine if visual impairments are present in the early stages of Parkinson's disease.
- To compare these visual tests against DaTSCAN findings.
Main Methods:
- A study involving 164 patients: 59 with Parkinson's disease, 51 with essential tremor, and 54 healthy controls.
- Patients with Parkinson's disease had symptoms for 6-12 months.
- Pelli-Robson (contrast sensitivity) and Ishihara (color vision) tests were administered and compared to DaTSCAN results.
Main Results:
- Pelli-Robson test showed 53% specificity and 81.4% sensitivity for Parkinson's disease.
- Ishihara test demonstrated 88.2% specificity and 55.9% sensitivity for Parkinson's disease.
- Both tests indicated that color and contrast dysfunction are early symptoms of Parkinson's disease.
Conclusions:
- The Pelli-Robson test is highly sensitive, while the Ishihara test is highly specific for differentiating Parkinson's disease from essential tremor.
- Neither test alone meets full validity criteria for diagnosis.
- Performing both Pelli-Robson and Ishihara tests may help identify patients suitable for DaTSCAN imaging.
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