Retinal structural alterations in Parkinson’s disease: association between temporal optic disc thickening and visual hallucinations

Visual hallucinations (VH) are clinically significant non-motor symptoms in Parkinson’s disease (PD). Optical coherence tomography (OCT) provides objective retinal measurements, yet the relationship between optic disc structure and VH remains unclear. This study examined whether temporal optic disc alterations are associated with VH in PD. In this exploratory cross-sectional study, 30 patients with PD underwent OCT imaging and clinical assessment. Retinal measurements included RNFL thickness and temporal optic disc thickness. VH were identified through structured interviews. Group comparisons and ANCOVA adjusting for non-motor symptom severity were performed. Patients with VH showed greater right temporal optic disc thickness than those without hallucinations (Cohen’s d = 1.04, <i>p</i> = 0.009), and this association remained significant after adjustment for UPDRS-I. No differences in retinal measures were observed between tremor-dominant and akinetic-rigid PD subtypes. In this preliminary analysis, temporal optic disc thickening showed a nominal association with VH in PD independent of non-motor symptom severity. OCT may provide structural insights into neuropsychiatric heterogeneity in PD. Further studies are needed to clarify the biological basis of this finding and its potential clinical relevance.