Abstract
Purpose: :
To determine the retinal changes in the macular area in each of the retinal dystrophies with Spectral Domain optical coherence tomography (SD-OCT).
Methods: :
Descriptive, transversal study. We took images of the macular area with SD-OCT in patients with retinitis pigmentosa (RP) and Stargardt’s disease (SD). We included 39 eyes of patients with retinal dystrophies: 31 eyes with RP and 8 eyes with SD. Each one of the patients had a diagnosis based on clinical examination; in all patients a retinal fluorescein angiography, electroretinogram and electrooculogram were performed. An SD-OCT (Spectralis®, Heidelberg Engineering) of the macular area was performed in all cases, using a macular cube. Central macular thickness (CMT), structural characteristics of the retina 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.
Results: :
We analyzed images of 39 eyes from 20 patients with SD-OCT (12 female, 8 male). Age ranged from 21 to 64 years. In eyes with RP, BCVA was 20/100, mean CMT of 227.2 µ. OCT findings showed RPE atrophy in 25 eyes (80.6%), hyper-reflective intraretinal deposits above the RPE in 15 eyes (48.3%) and epiretinal membrane (ERM) in 6 eyes (19.35%). Cystoid macular edema was observed in 8 eyes (25.8%) which correlated with a mean BCVA of 20/200. In SD, mean BCVA was 20/200, mean CMT of 62.87 µ. OCT findings showed RPE atrophy in 8 eyes (100%), increased visualization of choroidal vessels in 7 eyes (87.5%) and hyper-reflective intraretinal deposits in 7 eyes (87.5%). Four eyes had "bulls eye" RPE changes and 4 eyes had fundus flavimaculatus. Both RP and SD had a poor differentiation of the retinal layers.
Conclusions: :
Our results suggest that SD-OCT shows characteristic findings in each one of these 2 inherited retinal diseases, which could help to identify each one of them.
Keywords: retinal degenerations: hereditary • imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)