Abstract
Purpose :
To evaluate vitreo-macular findings including cystoid macular changes, epiretinal membrane (ERM), vitreomacular traction (VMT) and foveal atrophy in patients with retinitis pigmentosa (RP) using spectral-domain optical coherence tomography (SD-OCT).
Methods :
A retrospective chart review of 176 patients with non-syndromic RP was performed, and, 299 eyes were finally included who had undergone SD-OCT (Spectralis) testing. Appropriate demographic data obtained on each patient were noted. All SD-OCT scans were performed using a 6 x 6 volumetric scan with 30 raster lines spaced 200 microns apart. Central subfield (CSF) thickness was analyzed using the retinal thickness profile. Cross-sectional scans were viewed to document the presence or absence of ERM. Those eyes that showed an ERM were then divided into 4 groups: Group 1 with extrafoveal ERM (>500 microns from fovea); Group 2A with foveal ERM and normal foveal architecture; Group 2B with foveal ERM with cystic changes due to ERM or distorted foveal contour; and, Group 3 with ERM and associated VMT. Presence of foveal atrophy (defined as a CSF thickness of 224 µm or less) was also noted.
Results :
The age range of the patients was 9-94 years (average age = 52 yrs) and the visual acuity ranged from 20/20 to light perception. Out of 328 eyes that were evaluated, ERM was detected in 155 eyes (47.25%). ERM was present in at least one eye in 80 patients, and out of these 75 patients had ERM in both eyes. Of the 155 eyes with ERM, 95 (61.3%) were in Group 1, 22 (14.2%) in Group 2A, 32 (20.6%) in Group 2B, and 6 (3.9%) were in Group 3. Out of 145 patients with RP, 41 (28%) had CME in at least one eye – of them, 17 (41%) had bilateral and 24 (59%) had unilateral CME. Foveal atrophy, was noted in 104 (31.9%) eyes.
Conclusions :
The new generation Spectralis SD-OCT is useful in identifying vitreo-macular changes in patients with RP that may be missed on clinical examination. This study also provides evidence that ERM is a common finding and also provides a classification based on anatomical description that maybe helpful to decide the treatment. Apart from the diagnostic and prognostic implications, it can also be useful in selecting and predicting treatment outcomes in patients with RP and associated vitreo-macular changes.
This is a 2020 ARVO Annual Meeting abstract.