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V. C. Greenstein, T. Duncker, K. Holopigian, S. H. Tsang, R. E. Carr, D. C. Hood; Structural and Functional Assessment of Areas of Normal and Abnormal Autofluorescence in Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1363.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze retinal structure and function associated with areas of normal and abnormal fundus autofluorescence (FAF) in patients with retinitis pigmentosa (RP).
Fifteen eyes of 15 patients with RP (autosomal dominant=5, Usher type II=3, autosomal recessive=7) aged 10-62 years, with visual acuities 20/20 to 20/40, were studied. Visual sensitivity in the central 10° was measured with the Humphrey Visual Field Analyzer (Zeiss), using the 10-2 program and with the MP-1 Microperimeter (Nidek Technologies). Fundus autofluorescence imaging (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). The thicknesses of the total receptor (Bruch’s membrane to the inner nuclear layer), and outer nuclear layer plus outer plexiform layer (ONL+) through the foveal region were measured using a computer-aided manual technique (1). Visual field sensitivities in the central 10° were compared to areas of abnormal FAF and to thicknesses of the underlying retinal layers in corresponding retinal areas.
All 15 eyes had rings or arcs of increased FAF in the parafoveal area. For 12 eyes, visual sensitivity was preserved within areas of normal FAF; decreased across the areas of increased FAF; and markedly decreased or non-measurable outside the rings or arcs. The SD-OCT horizontal line scans through the central 10° showed disruption and/or loss of the inner-outer segments of the photoreceptors (IS-OS junction loss) and decreased ONL thickness that were associated with areas of decreased visual sensitivity and increased FAF. However for 3 eyes, IS-OS junction loss, decreased ONL thickness and decreased sensitivity occurred in areas that appeared to be normal on FAF.
In general, areas of increased FAF were associated with disruption of the IS-OS junction, decreased ONL thickness and decreased visual sensitivity. However 3 of 15 patients showed similar structural and functional changes in areas that appeared normal on FAF, stressing the importance of following disease progression with multimodal imaging (SD-OCT and FAF) and functional studies (perimetry).1. Hood, Lin, Lazow et al. IOVS 2008.
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