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Multimodal High-Resolution Imaging in Retinitis Pigmentosa: A Comparison Between Optoretinography, Cone Density, and

Benjamin J Wendel¹, Vimal Prabhu Pandiyan¹, Teng Liu¹

¹Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington, United States.

Investigative Ophthalmology & Visual Science

|August 29, 2024

Summary

Retinitis pigmentosa (RP) patients show reduced cone function (ORG) even with normal structure. Optoretinograms (ORGs) may detect RP dysfunction before vision loss, aiding disease monitoring.

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Area of Science:

Ophthalmology
Retinal Diseases
Vision Science

Background:

Retinitis pigmentosa (RP) is the most common inherited retinal disease, causing progressive photoreceptor degeneration.
The functional capacity of surviving photoreceptors in RP remains poorly understood.

Purpose of the Study:

To correlate structural and functional measures in RP patients.
To investigate the extent to which surviving photoreceptors transduce light and support vision in RP.

Main Methods:

Employed adaptive optics scanning laser ophthalmoscopy (AOSLO), adaptive optics microperimetry, and AO-OCT-based optoretinograms (ORGs).
Assessed cone density, visual sensitivity, and ORG amplitude across the transition zone in four RP patients.
Measured individual cone outer segment (COS) lengths.

Main Results:

RP patients exhibited reduced cone density and ORG amplitude, even in areas with normal cone density.
ORG response and COS length were not correlated in RP patients, unlike in controls.
Three out of four RP patients maintained visual sensitivity comparable to controls despite structural and functional deficits.

Conclusions:

Optoretinogram (ORG)-based measures of retinal dysfunction may precede structural and visual sensitivity deficits in RP.
ORG is a sensitive indicator of RP disease status and progression.
ORG holds potential for monitoring treatment efficacy in RP.