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Carmela Carnevale, Serena Fragiotta, Erika Rigoni, Enzo Maria Vingolo; Vitreo-macular interface alterations in retinitis pigmentosa patients determined by spectral domain optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3253. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence and to analyze structural characteristics of vitreo-macular interface (VMI) alterations in Retinitis Pigmentosa (RP) patients using spectral domain optical coherence tomography (SD-OCT). We categorized the presence of different macular abnormalities such as epiretinal membrane (ERM), vitreo-macular traction (VMT) syndrome, macular hole (MH) and cystoid macular edema (CME).
A retrospective cross-sectional study was performed in 167 RP patients. They underwent a complete ocular examination including assessment of best-corrected visual acuity (BCVA), slit-lamp and fundus examination. All SD-OCT images were acquired by only examiner using the Heidelberg SD-OCT (software version 188.8.131.52) in a pattern of 20-x15-degree (5.8x4.3 mm) rectangle centered on the fovea.The scanning protocol comprised 25 line scans each composed of 50 averaged frame. Continuous variables were expressed as mean±SD. Categorical variables were compared using Chi-squared test. P values <0.05 were considered statistically significant and P<0.001 was considered highly statistically significant.
Out of the 167 RP patients included, 76 of them (121 eyes, 41 ♂ and 35♀, mean age 49.70±13.91 years) showed VMI alterations on OCT. The average BCVA for all patients was 0.42 logMAR units. VMI alterations were found as isolated (eg, VMT or ERM) in 63,78% of cases and in association (eg, ERM+VMT) in 36,22% of cases. ERM was observed in 75 eyes (59.05%) of 76 patients. The discontinuity of ERM was found in 73 eyes and it was continuous in 38 eyes (31.4%) (P<0.001). The cleavage’s area was detectable in only 34 eyes (28.1%). VMT was detected in 13 eyes; it was broad in 11 eyes and focal in 2 eyes (P=0.02). MH are full thickness in 2 of 14 cases (14.3%) and lamellar hole in 6 of 14 cases (42.8%). CME was observed in association only with ERM in 25 eyes (19.68%) and combined with ERM and MH in 2 eyes (1.57%).
SD-OCT is a powerful tool to detect VMI alterations in RP patients. It allows to monitor the clinical course of these abnormalities and the effectiveness of therapy for patients by providing reproducible measurements. VM complications in RP patients are well noted but we reported for the first time the structural characterization of those abnormalities in order to establish which patients could benefit from current or innovative therapeutic strategies.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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