Macular microvasculature in unilateral pigmentary retinopathy: optical coherence tomography angiography study

To investigate macular vascular abnormalities in patients with unilateral pigmentary retinopathy (UPR) using swept-source optical coherence tomography angiography (OCTA).

Patients with UPR who had pigmentary retinopathy in 1 eye and no functional or structural abnormalities suggestive of pigmentary retinopathy in the fellow eye were included. Age- and sex-matched healthy controls were also recruited. Quantitative microvascular parameters were compared between the affected and unaffected eyes of UPR, and between the unaffected eyes of UPR patients and those of healthy controls.

Eleven patients with UPR and 11 healthy individuals were included. Affected eyes demonstrated significantly lower perfusion density (PD) in the superficial capillary plexus (SCP; 35.64% ± 6.18%) and deep capillary plexus (DCP; 14.35% ± 6.34%) than in unaffected eyes (SCP; 43.47% ± 1.72%; p = 0.004; DCP; 25.95% ± 5.22%; p = 0.003). There were no significant differences in OCTA variables between the unaffected eyes of patients and control eyes except for the length and size of the DCP foveal avascular zone (FAZ). The preserved width of the inner segment ellipsoid (ISE) was negatively correlated with interocular differences in PD, vessel length density (VLD), FAZ size, and perimeter. Univariable analyses identified preserved ISE width, PD and VLD in both the SCP and DCP, and SCP FAZ size as factors associated with best-corrected visual acuity.

OCTA revealed reduced macular microvasculature in the affected eyes with UPR. Greater structural loss in the affected eye was associated with more pronounced interocular differences in retinal microvasculature. Microvascular alterations and structural deterioration of the photoreceptors show considerable correlation with functional outcomes in these patients.