ARVO 2025: Sex-specific biomarkers for Parkinson's disease in retinal microvascular imaging

At the ARVO 2025 meeting in Salt Lake City, Utah, Cameron Cummings presented a poster on how retinal microvascular imaging metrics may show sex-specific biomarkers for Parkinson's disease.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity

Cameron Cummings:

Hi, my name is Cameron Cummings. I'm a medical student at the Duke University School of Medicine, and my project is on retinal structure and microvasculature in patients with Parkinson's disease and how it differs by sex. Our lab and other labs have shown that retinal structure and microvasculature differ in Parkinson's disease regardless of sex, and we know that Parkinson's disease presents differently in males and females. So we wanted to look at any differences, by sex, that structural and microvasculature alterations might have. So we had a cross sectional study where we had participants with Parkinson's disease, males and females, as well as age matched controls. And we looked at OCT and OCT-A images, and essentially found that comparing female controls, with females with Parkinson's disease, the females with Parkinson's disease had reduced perfusion density and vessel density in the 3mm circle and ring.

Those differences were not observed in males when we did the comparison between male controls and males with Parkinson's disease. This led us to believe that the previously observed differences brought upon by Parkinson's disease may be primarily driven by females, and we're hoping to do future work to figure out why that might be the case. So in terms of treatment, it may not have too much of an impact, but it's possible that retinal microvasculature could be used as an early screening tool for Parkinson's disease.

We need to understand a lot more about it before it's used in any sort of diagnostic manner. But if that were the case, if there were to be OCT-A scans done as indicators of potential early Parkinson's disease, our data suggests that diagnostic validity may be slightly more prominent in females, such that if one were to use that criteria for males, they would have to consider that.

We would like to investigate hypotheses as to why our data looks the way it does. Our current thinking is that it might have something to do with estrogen and its decline in menopause. Etrogen is vasoprotective, and during menopause it's obviously declines, and we were thinking that it the decline may predispose females to microvascular damage by Parkinson's.