Abstract
Purpose:
To study the relationship between the macular microstructure measured by optical coherence tomography (OCT) and visual acuity after cataract surgery in patients with retinitis pigmentosa (RP).
Methods:
Thirty-six eyes of 29 consecutive RP patients who underwent cataract surgery at the Chiba University Hospital were studied. The best-corrected visual acuity (BCVA) was measured before and 3 months after the surgery. The foveal thickness (FT) and the length of junction between inner and outer segments of photoreceptors (IS/OS) were measured by spectral-domain OCT. The appearance of the IS/OS junction in the OCT images at the fovea was graded: Grade 1, IS/OS not visible; Grade 2, abnormal or discontinuous IS/OS; and Grade 3, normal IS/OS.
Results:
The mean BCVA was improved significantly from 0.81±0.45 in logMAR units at baseline to 0.35±0.47 in logMAR units at 3 months after surgery (P <0.0001). There was no significant correlation between the postoperative BCVA and the length of the IS/OS (r= -0.102, P =0.70), but a significant correlation was found between the postoperative BCVA and FT (r =0.47, P =0.0006). Eyes with Grade 2 IS/OS and Grade 3 IS/OS had significant improvements of the postoperatively BCVA (P =0.0077 and P=0.0003, respectively), while those with Grade 1 IS/OS did not have a significant change (P =0.063). The postoperative BCVA increase was significantly greater in eyes with Grade 3 IS/OS than those with Grade 1 and Grade 2 IS/OS (P=0.0003 and P<0.0001, respectively).
Conclusions:
The presence of normal IS/OS junction in the OCT images is associated with good visual recovery after cataract surgery in RP patients. The state of the IS/OS may be a crucial factor for predicting the postoperative visual acuity.
Keywords: 696 retinal degenerations: hereditary •
445 cataract