Adaptive optics ophthalmoscopy in retinitis pigmentosa: typical patterns

Abstract

Purpose : Due to advances in optics, electronics and computation, morphological changes of the photoreceptor mosaic can be made visible by adaptive optics ophthalmoscopy (AOO). Retinitis pigmentosa (RP) is a degenerative retinal disease that affects primarily the rod photoreceptors followed by the loss of cone receptors. This paper aims to present typical findings in RP with the adaptive optics flood illumination retinal camera rtx1.

Methods : 174 patients with syndromic or non-syndromic RP were examined with the commercially available adaptive optics flood illumination retinal camera rtx1 and spectral domain optical coherence tomography (OCT) and fundus autofluorescence (FAF) imaging at the Center for Ophthalmology, University of Tuebingen. AOO patterns were studied in the context of multimodal retinal imaging.

Results : Five different patterns in RP could be observed: 1) unspecific atrophy, 2) central visibility of cones, 3) “puffy” cones, 4) the “cheetah” pattern, and 5) atrophic pigment clumping. These patterns in AOO correlated with findings on OCT and FAF imaging. We hypothesize that these patterns represent specific stages of photoreceptor degeneration in RP.

Conclusions : AOO provides an additional dimension to high-resolution retinal imaging in RP, enabling to determine patterns of retinal degeneration. Future evaluation of cone photoreceptor mosaic using AOO imaging is warranted to determine changes on an even more microscopical level, e.g. photoreceptor integrity.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.