Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate retinal structure and visual function associated with areas showing normal fundus autofluorescence (FAF) in patients with retinitis pigmentosa (RP).
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. Visual field sensitivities in the central 10°, and the thicknesses of the underlying retinal layers, were examined in areas with normal FAF.
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.
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.
This PDF is available to Subscribers Only