Adaptive Optics in Retinitis Pigmentosa: A Systematic Review

To provide a comprehensive overview of quantitative adaptive optics imaging (AOI) photoreceptor parameters in retinitis pigmentosa (RP).

A systematic literature search was conducted on Ovid Medline, Embase, and Cochrane Library from January 2000 to June 2023 for articles reporting on quantitative photoreceptor measurements from AOI systems in RP. Our primary outcomes were cone density, regularity, and spacing measurements at various eccentricities.

Twenty-six studies reporting on 299 eyes with various forms of RP that underwent AOI were included. Seventeen studies reported on cone density parameters in RP, which mostly decreased with increasing eccentricity from the fovea and were reduced in RP eyes relative to normal control eyes. Four studies reported on cone regularity in RP, which was reduced relative to normal control eyes. Twelve studies reported on cone spacing parameters in RP, which were often increased relative to normal control eyes.

RP eyes showed a reduced cone density, reduced cone regularity, and increased cone spacing relative to control eyes. There is considerable variability in the reporting of AOI parameters in this setting, a paucity of data comparing AOI parameters in RP eyes to age-matched controls, and best practices of AOI use have yet to be established.