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V. Franco-Cardenas, J. Dalma-Weiszhausz, J. Guerrero-Naranjo, J. Fromow-Guerra, V. Morales-Canton, H. Quiroz-Mercado, J. Jimenez-Sierra; 3-D Spectral Domain Ocular Coherence Tomography Macular Findings in Patients With Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2009;50(13):998.
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Retinitis pigmentosa (RP) is the most common chorioretinal dystrophy. It is characterized by progressive centripetal loss of vision. Unfortunately, many patients with RP experience macular alterations as well, that may lead to an early loss of vision. There are few reports about the frequency of macular alterations in RP patients. This is the first report using a 3-D spectral domain OCT.
Seventeen consecutive patients (33 eyes) with clinical, electrophysiologic and angiographic diagnosis of RP were included. We performed a 3-D spectral domain, cube pattern OCT (512*128 lines) (Cirrus HD-OCT Carl Zeiss-Meditec Inc.) to analyze the macula. Patients without confirmed diagnosis, media opacity or extremely bad fixation in which the study was not reliable were excluded. We analyzed the frequency of macular changes previously reported in the literature as well as new findings.
Fifty three percent of our patients were female, mean age 37.7 years. We found 82% of classic RP, 12% of sine pigmenti RP, and 6% of RP sectorial type.Of the macular changes previously reported: 15% presented with cystoid macular edema, 45% had intraretinal foveolar cysts without edema, 64% generalized EPR atrophy and 0.33% macular hole. Of alterations not previously reported: 45% presented with an epiretinal membrane, 82% had a subfoveal hyperreflective plaque and 0.33% vitreomacular traction syndrome. Of the entire sample, only 2 eyes showed no macular abnormalities (0.66%).
This is the first report of macular findings in patients with RP using a 3-D spectral domain OCT. We found that OCT macular alterations are frequent in patients with RP. Cystoid macular edema was not as frequent as previously reported (15% vs 38%). Epiretinal membranes and hyperreflective subfoveal plaques were common findings not previously reported. These suggest that poor vision in patients with RP is not only due to the disease itself, but also to macular changes. A more comprehensive understanding of these alterations can lead us to preserve better vision for a longer time.
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