Association between abnormal autofluorescence and photoreceptor disorganization in retinitis pigmentosa

To evaluate the association between the third high-reflectance band on high-resolution optical coherence tomography (OCT), fundus autofluorescence (AF), and kinetic perimetry results in patients with typical retinitis pigmentosa (RP).

Retrospective, observational case series.

Thirty-four patients with typical RP who were referred to our institute were examined, with a diagnosis made by full-field electroretinography. We evaluated the fundus AF and the third high-reflectance band by high-resolution OCT, both qualitatively and quantitatively. We investigated whether the vertical length of the AF diameter or the third high-reflectance band correlated with Goldmann kinetic perimetry results.

We classified three types of abnormal fundus AF: ring AF, central AF, and the absence of both patterns. In eyes with ring AF, the length of the third high-reflectance band was almost equal to the diameter of the abnormal ring AF with significant correlation (P < .001), whereas the band length did not correlate with the diameter of the visual field (P = .237). Eyes with central AF did not have a continuous third high-reflectance band. In eyes with neither ring nor central AF, the length of the third high-reflectance band correlated with the AF length and the diameter of the visual field (P = .024 and P < .001, respectively).

A novel classification based on the fundus AF and the third high-reflectance band determined by OCT suggests different patterns of pathogenesis in the retinal pigment epithelium and photoreceptor degeneration in the progression of RP.