Peripapillary retinal nerve fiber layer thinning in patients with progressive supranuclear palsy

Kyung Ah Woo, Joo Young Shin, Heejung Kim, Jeeyun Ahn, Beomseok Jeon, Jee Young Lee

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives: To investigate peripapillary retinal nerve fiber layer (pRNFL) changes in patients with progressive supranuclear palsy (PSP). Methods: We included 21 PSP patients (36 eyes) who underwent peripapillary optical coherence tomography (OCT) scans at 2.5 ± 1.3 years of disease, without ophthalmologic co-morbidities. We compared pRNFL thicknesses in PSP eyes with age-matched 22 controls (22 eyes) using generalized estimating equation model adjusting for intra-subject inter-eye correlations, age and sex. We also analyzed the correlation between the pRNFL thickness and clinical severity using Spearman’s correlation. In twelve PSP patients with 3 T brain MRI volumetric scan within 1 year of OCT exam, we investigated the correlation between the pRNFL thickness and brain atrophy using Pearson’s correlation. Results: PSP patients had global pRNFL thinning compared to controls (beta = − 6.436, p = 0.025). Global pRNFL thickness correlated with Hoehn & Yahr stages (r = − 0.487, p = 0.025), and nasal pRNFL thinning showed a trend of correlation (uncorrected p < 0.05). Exploratory correlation analysis between global pRNFL thickness and nonmotor items in the PSP rating scale showed a trend toward association with sleep disturbances (uncorrected p = 0.008) and urinary incontinence (uncorrected p = 0.031), although not significant after Bonferroni correction (all 28 items). The patients had significant atrophy in the posterior cingulate cortex, third ventricle, pallidum, and midbrain with reduced midbrain-to-pons ratio, but no correlation was found between pRNFL thickness and brain volumes. Conclusion: The pRNFL seems to be affected in PSP, which is more severe with advanced disease stages. Retinal investigation in a larger longitudinal cohort would help elucidate the pathophysiological role of retinal thinning in PSP.

Original languageEnglish
Pages (from-to)3216-3225
Number of pages10
JournalJournal of Neurology
Issue number6
StatePublished - Jun 2022


  • Magnetic Resonance Imaging (MRI)
  • Optical coherence tomography (OCT)
  • Progressive supranuclear palsy (PSP)
  • Retinal Nerve Fiber Layer (RNFL)


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