April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Retinal Structure and Function are Affected in Areas with Normal Fundus Autofluorescence in Patients with Retinitis Pigmentosa
Author Affiliations & Notes
  • Vivienne C. Greenstein
    Ophthalmology, Columbia University, New York, New York
    Ophthalmology, New York University School of Medicine, New York, New York
  • Beulah A. Abraham
    Ophthalmology, Columbia University, New York, New York
  • Karen Holopigian
    Ophthalmology, New York University School of Medicine, New York, New York
  • Ronald E. Carr
    Ophthalmology, New York University School of Medicine, New York, New York
  • Stephen H. Tsang
    Ophthalmology, Columbia University, New York, New York
  • Donald C. Hood
    Ophthalmology, Columbia University, New York, New York
  • Footnotes
    Commercial Relationships  Vivienne C. Greenstein, None; Beulah A. Abraham, None; Karen Holopigian, None; Ronald E. Carr, None; Stephen H. Tsang, None; Donald C. Hood, Topcon, Inc (F, C)
  • Footnotes
    Support  NIH Grant EY09076 and EY02115
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4997. doi:
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      Vivienne C. Greenstein, Beulah A. Abraham, Karen Holopigian, Ronald E. Carr, Stephen H. Tsang, Donald C. Hood; Retinal Structure and Function are Affected in Areas with Normal Fundus Autofluorescence in Patients with Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4997.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate retinal structure and visual function associated with areas showing normal fundus autofluorescence (FAF) in patients with retinitis pigmentosa (RP).

Methods: : Twenty-four eyes of 24 patients with RP (autosomal dominant=9, Usher type II=4, autosomal recessive=11) aged 10-60 years, with visual acuities 20/20 to 20/40, and either hyperautofluorescent rings or arcs were studied. Visual sensitivity in the central 10° was measured with 10-2 visual fields (Zeiss, Inc) and with the MP-1 microperimeter (Nidek Technologies). Total deviation plots for the MP-1 were generated from a previously collected normative database. FAF was performed with a confocal scanning laser ophthalmoscope (Heidelberg HRA II). The integrity of retinal layers in the central +/-10° was evaluated with spectral domain optical coherence tomography (Cirrus SD-OCT, Zeiss Meditec Inc and Spectralis HRA+OCT; Heidelberg Engineering). The thicknesses of the total receptor layer (R+; Bruch’s membrane to the border between the inner nuclear layer and outer plexiform layer) and outer segment plus RPE layer (OS+; Bruch’s membrane to the inner-outer segment junction) were measured using a computer-aided manual technique and scans through the foveal region.[1] Visual field sensitivities in the central 10°, and the thicknesses of the underlying retinal layers, were examined in areas with normal FAF.

Results: : 13 of the 24 eyes had rings, and 11 arcs, of increased FAF in the parafoveal area. For 9 eyes with rings, and 7 eyes with arcs, visual field abnormalities occurred at locations with normal FAF. Also within this region, the SD-OCT horizontal line scans through the central +/-10° showed disruption and/or loss of the inner-outer segment junction of the photoreceptors in 7 eyes with arcs and 3 eyes with rings. For all eyes with arcs and 12 with rings, there was significant thinning of both R+ and OS+ layers in areas with normal i.e. uniform FAF compared to values for controls; the remaining eye with a ring showed significant thinning of the R+ layer.

Conclusions: : Some areas that appeared normal on FAF were associated with decreased thickness of the R+ and OS+ layers and visual field defects. The results stress the importance of following disease progression with SD-OCT and perimetry.1. Hood, Lin, Lazow et al. IOVS 2008.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • visual fields • retinal degenerations: hereditary 
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