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Igal M. Zand-Hadas, Gustavo Sánchez-Bermúdez, Fernando Schoonewolff, Jans Fromow-Guerra, Juan Manuel Jiménez-Sierra; Analysis of the Macular Area in Retinitis Pigmentosa with Spectral Domain Optical Coherence Tomography in 38 Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4584.
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To determine the retinal changes in the macular area in retinitis pigmentosa (RP) with spectral domain optical coherence tomography (SD-OCT).
Prospective, descriptive, transversal study. We took images of the macular area with SD-OCT in patients with RP. We included 75 eyes of patients with RP. Diagnosis was done by clinical examination, as well as retinal fluorescein angiography, electroretinogram and electrooculogram. SD-OCT (Spectralis®, Heidelberg Engineering) of the macular area was performed in all cases, using a macular cube of 20º, with an Average Real Time of 26. Central macular thickness (CMT), central and total macular volume, structural findings of the retinal layers and retinal pigment epithelium (RPE) were analyzed. We made a correlation between the best corrected visual acuity (BCVA) and the findings in the macular area seen by SD-OCT.
We analyzed images of 75 eyes from 38 patients with SD-OCT (22 male, 16 female). Age ranged from 13 to 75 years, mean age of 42.82 years. BCVA was 20/80 (LogMAR 0.596). Mean CMT of 197.48 μ, mean minimal macular thickness of 188.50 μ. Mean total macular volume of 7.267 mm3. Mean central macular volume of 0.1908 mm3. OCT findings showed hyper-reflective intraretinal deposits above the RPE in 56 eyes (74.66%), RPE atrophy in 53 eyes (70.66%), abnormal inner segments and outer segments junction (IS/OS) at the foveal area in 34 eyes (45.33%) and epiretinal membrane in 15 eyes (20.0%). Cystoid macular edema was observed in 18 eyes (24.0%) which correlated with a mean BCVA of 20/100. There was a significant difference in the BCVA in patients with an abnormal IS/OS with a mean of LogMAR 0.97 +/- 0.87 (20/200) vs. without an abnormal IS/OS LogMAR 0.28 +/- 0.24 (20/40); P <0.0001. There was a significant difference in the BCVA in patients with a normalfoveal depression with a mean of LogMAR 0.35 +/- 0.32 (20/50) vs. abnormalfoveal depression LogMAR 0.98 +/- 0.93 (20/200); P < 0.001.
Our results suggest that SD-OCT shows characteristic findings in retinitis pigmentosa, mainly hyper-reflective intraretinal deposits above the RPE, RPE atrophy. An abnormal IS/OS and an abnormal foveal depression significantly reduces BCVA.
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