Study Rationale:
We have pioneered a technique in which we can photograph nerves on the surface of the eye. This technique can be used to monitor the severity of various neurological conditions. In our previous work, we have shown that nerves on the surface of the eye are damaged in Parkinson's disease (PD); this damage is more severe in individuals with more advanced symptoms of PD.
In this study, we aim to determine how quickly and how reliably these nerves become damaged in PD. We will perform clinical examinations on participants and take photographs of the surface of the eye using a specialized camera at baseline, one year and two years.
Hypothesis:
We aim to validate the use a photograph of the surface of the eye to monitor the progression of PD in a manner that is more accurate and cost-efficient than is currently possible with clinical examination and/or brain scans.
Study Design:
Individuals with early PD (less than five years after diagnosis) will be recruited as participants. They will undergo clinical examination and photographs will be taken of the surface of the eye. Participants will return for follow up one year later and two years later to undergo the same evaluation. We aim to demonstrate how quickly and reliably the nerves on the surface of the eye become damaged and how this relates to changes in PD symptoms.
Impact on Diagnosis/Treatment of Parkinson's disease:
Many new drugs are being developed that may slow PD progression. Currently, the main way to measure whether these drugs are working is to examine individuals at regular intervals but this examination varies greatly from one day to the next, such that it takes hundreds of participants over several years to find out if a new drug works. We hope to use a simple eye test to measure whether these drugs can slow nerve damage associated with PD. By using a more reliable and accurate measure, we hope to make an earlier diagnosis possible and to improve clinical trials to speed up the approval of new drugs.
Next Steps for Development:
If we demonstrate that we can monitor PD by studying the nerves on the surface of the eye, the next stage will be to perform a larger follow-up study and evaluate the ability of this test in early phase clinical trials of new PD drugs.