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Multimodal Imaging in Retinitis Pigmentosa: Correlations among Microvascular Changes, Macular Function and Retinal
Yousra Falfoul1,2, Issam Elleuch1,2, Khaled El Matri1,2
1B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.
Microvascular changes in retinitis pigmentosa (RP) begin in the deep capillary plexus (DCP), impacting retinal structure and function. Optical coherence tomography angiography (OCT-A) can quantify these early vascular alterations in RP patients.
Area of Science:
- Ophthalmology
- Retinal Vascular Diseases
- Optical Coherence Tomography Angiography
Background:
- Retinitis pigmentosa (RP) is a group of inherited retinal diseases characterized by progressive vision loss.
- Early detection of microvascular changes in RP is crucial for understanding disease progression and potential interventions.
- Swept source optical coherence tomography (SS-OCT) angiography offers high-resolution imaging of retinal vasculature.
Purpose of the Study:
- To analyze microvascular changes in patients with retinitis pigmentosa (RP) with relatively preserved visual acuity (VA).
- To correlate these vascular changes with macular function and structure using SS-OCT angiography.
- To investigate the role of OCT angiography in assessing vascular network loss in RP.
Main Methods:
- A case-control study involving 70 eyes of 35 RP patients and 34 healthy controls.
- Ophthalmic examination included SS-OCT, OCT angiography (OCT-A), fundus autofluorescence (FAF), and multifocal electroretinogram (mfERG).
- Key outcome measures: foveal and parafoveal vascular densities (FVDs/PFVDs) in superficial (SCP) and deep capillary plexuses (DCP), foveal avascular zone (FAZ) size and enlargement coefficient.
Main Results:
- RP patients showed significantly lower parafoveal vascular densities (PFVDs) in both SCP and DCP compared to controls.
- Enlargement of the foveal avascular zone (FAZ) was observed in RP patients.
- Significant correlations were found between visual acuity (VA), PFVD in DCP, FAZ enlargement, and mfERG responses (P1 amplitude).
Conclusions:
- Vascular alterations in RP initiate in the deep capillary plexus (DCP), affecting outer retinal layers and ellipsoid band width.
- Superficial capillary plexus (SCP) alterations appear later in the disease progression.
- OCT-A is a valuable tool for quantifying vascular loss in RP, aiding in staging, prognosis, and monitoring disease progression.
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