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S. Walia, G. A. Fishman, M. Lindeman; Peripapillary Retinal Nerve Fiber Layer Thickness in RP Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3729.
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Retinitis pigmentosa (RP) includes a group of hereditary retinal disorders that primarily affect photoreceptor function. We investigated the peripapillary retinal nerve fiber layer thickness among RP patients with different degrees of disease severity using optical coherence tomography, OCT-3.
One eye in each of 19 RP patients was included. All patients underwent a complete ocular examination, including the measurement of IOP, corneal thickness and detailed fundus exam. Visual fields were evaluated by Goldmann perimetery and field loss was graded as mild, moderate, marked, or severe. The retinal nerve fiber layer (RNFL) thickness protocol was used to acquire circle scans of 3.4mm in diameter around the optic nerve. For each eye, we studied the RNFL thickness in the temporal (316-45°), superior (46-135°), nasal (136-225°) and inferior (226-315°) quadrants. We also measured three smaller segments within each quadrant all automatically calculated by using the existing OCT software. The severity of damage to the peripapillary nerve fiber layer was compared to the severity of field loss.
The mean age of patients included in the study was 48.7 years (range 24-66 years). Out of the 19 patients examined, 5 showed an abnormal thinning of the peripapillary RNFL in 2 or more quadrants and 1 had abnormal thinning in a single quadrant. On examining the smaller segments, it was observed that 8 patients had abnormal thinning of the RNFL in 2 or more segments, of which 6 had an abnormality in 3 or more segments. No consistent association was noted between the remaining visual field and the presence of a RNFL defect.
Patients with retinitis pigmentosa may have a measurable degree of RNFL thinning as determined by OCT. These observations could impact on future treatment strategies and imply that patients considered for various treatment options would benefit by an evaluation of their nerve fiber layer thickness.
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