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Nithya Rajagopalan, Kathleen Ellen Guinn, Mohammad Ali Sadiq, Mostafa Saad Hanout, Salman Sarwar, Jose Maya, Liz Julieth Zapata, Stuart G Coupland, Quan Dong Nguyen, Yasir Sepah; Assessment of retinal structural and functional characteristics in eyes with autoimmune retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):330.
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To evaluate the thicknesses of individual retinal layers, and the correlation between structural changes and functional loss using spectral domain optical coherence tomography (SD-OCT) scans and electroretinograms (ERG).
The Heidelberg Spectralis HRA+OCT device was utilized to obtain SD-OCT raster scans of 20 eyes from 10 patients serologically diagnosed with AIR. The Heidelberg Heyex software (version 5.2) was used to segment selected retinal layers along a 5 mm horizontal scan passing through the fovea. Retinal layers analyzed include full retinal thickness (FRT), retinal pigment epithelium (RPE), photoreceptor layer (PRL), bipolar cell layer (BPL), combined ganglion cell and inner plexiform layers (GCL+), nerve fiber layer (NFL), and combined GCL+ and NFL layers (GCL+/NFL). Changes in the thicknesses of the layers were assessed in 0.5 mm increments along the B-scan in the central, nasal, and temporal regions. These recorded values were compared to corresponding values of 51 eyes from 51 subjects with no known ocular pathology. Full-field ERGs were obtained at corresponding visits and were interpreted by a grader blinded to the diagnoses and OCT findings.
Three patients (6 eyes) were excluded from the analysis due to the presence of confounding ocular pathologies. For the remaining 7 patients (14 eyes) included in the analysis, mean/median age was 56 (range: 33 to 83), with 5 males (62.5%). Among the 51 controls, mean age was 52 (range: 40 to 75), with 26 males (51%). ERG findings demonstrated a functional deficit that showed a strong correlation with structural loss.
Eyes with AIR show a loss of retinal tissue compared to eyes with no known ocular pathology. The greatest loss appears to occur in the RPE and PRL. ERG findings correlate strongly with the loss of tissue seen in these layers. Thus, therapeutic options may be targeted to preserve these two regions of the retina.
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