Choriocapillaris flow loss in center-involving retinitis pigmentosa: a quantitative optical coherence tomography angiography study using a novel classification system

Abstract Purpose Transcorneal electrical stimulation (TES) is a novel treatment approach for patients with retinitis pigmentosa (RP). The aim of our study was to observe changes in optical coherence tomography angiography (OCTA) that would be attributed to TES treatment. Methods A total of 73 eyes were included: 43 eyes of 22 subjects (11 ♀, 11 ♂) suffering from RP were examined at baseline (BL), after first stimulation (TS), 1 week (1W), and 6 months (6M) after treatment initiation and were compared with 30 control eyes of 15 subjects (8 ♀, 7 ♂). TES was performed simultaneously on both eyes for 30 min weekly. OCTA scans of 9 × 15 mm were recorded with a PLEX Elite 9000 swept-source OCTA device (Carl Zeiss Meditec AG, Jena). Vascular density metrics such as perfusion density (PD) and vessel density (VD) were calculated automatically for the macular area by using standardised extended early treatment diabetic retinopathy study (ETDRS) grids centred around the fovea. In addition, the capillary perfusion density (CPD) and the capillary flux index (CFI) of the peripapillary nerve fibre layer microvasculature in all four quadrants of an annulus centred at the optic disc were measured. All parameters were determined over all retinal layers and separately for the superficial (SCP) and deep capillary plexus (DCP). ANOVA-based linear mixed-effects models were calculated with SPSS®. Results Throughout the course of TES treatment, the macular VD and PD of all retinal layers in all subsections showed a slight decrement without reaching statistical significance, also when analysed separately in the SCP and DCP (p > 0.08). In analogy, the average CPD and CFI also presented with a slight decrement (p > 0.20). However, when compared with controls, most OCTA parameters showed a significant decrement (p < 0.05). When analysed systematically in all subsections of the extended ETDRS grid, the temporal macular subsections within the outer ring (radius 1.5–3 mm) and also of the peripheral C1, C2, and C3 rings (radius 3–7.5 mm) showed lower VD and PD values when compared with the other subsections (p < 0.05). Conclusion Vascular density metrics in the macular region and the peripapillary microvasculature appear to remain unaffected by continuous TES treatment within a period of 6 months.

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OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN PATIENTS WITH RETINITIS PIGMENTOSA

Retina ◽

10.1097/iae.0000000000001904 ◽

2017 ◽

Vol Publish Ahead of Print ◽

Cited By ~ 12

Author(s):

Maged Alnawaiseh ◽

Friederike Schubert ◽

Peter Heiduschka ◽

Nicole Eter

Keyword(s):

Optical Coherence Tomography ◽

Retinitis Pigmentosa ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence

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In depth understanding of retinitis pigmentosa pathogenesis through optical coherence tomography angiography analysis: a narrative review

International Journal of Ophthalmology ◽

10.18240/ijo.2021.12.25 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1979-1985

Author(s):

Bing-Wen Lu ◽

◽

Gai-Ping Wu ◽

Li-Ke Xie ◽

◽

...

Keyword(s):

Optical Coherence Tomography ◽

Retinitis Pigmentosa ◽

Optical Coherence Tomography Angiography ◽

Vascular Dysfunction ◽

Treatment Options ◽

Animal Experiments ◽

Optical Coherence ◽

Key Factors ◽

Choroidal Vasculature ◽

Retinal Disorder

Retinitis pigmentosa (RP) is the most recognized inherited retinal disorder involving progressive photoreceptors degeneration which eventually causes blindness. However, the pathogenesis of RP is still unclear, making it difficult to establish satisfying treatments. Evidence have been found to support the theory that vascular dysfunction is associated with the progression of RP. Optical coherence tomography angiography (OCTA) is a newly developed technology that enables visualization as well as quantitative assessment of retinal and choroidal vasculature non-invasively. Advances in OCTA have opened a window for in-depth understanding of RP pathogenesis. Here, we propose a hypothesis of RP pathogenesis based on the current OCTA findings in RP, which includes four stages and two important key factors, vascular dysfunction and microglia activation. Further, we discuss the future animal experiments needed and how advanced OCTA technology can help to further verity the hypothesis. The final goal is to explore potential treatment options with enhanced understanding of RP pathogenesis.

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Optical Coherence Tomography Angiography of RPGR-Associated Retinitis Pigmentosa Suggests Foveal Avascular Zone is a Biomarker for Vision Loss

Ophthalmic Surgery Lasers and Imaging Retina ◽

10.3928/23258160-20190129-18 ◽

2019 ◽

Vol 50 (2) ◽

pp. e44-e48 ◽

Cited By ~ 2

Author(s):

Peter H. Tang ◽

Ruben Jauregui ◽

Stephen H. Tsang ◽

Alexander G. Bassuk ◽

Vinit B. Mahajan

Keyword(s):

Optical Coherence Tomography ◽

Retinitis Pigmentosa ◽

Optical Coherence Tomography Angiography ◽

Vision Loss ◽

Foveal Avascular Zone ◽

Optical Coherence ◽

Avascular Zone

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Retinal Vascular Changes on Optical Coherence Tomography Angiography and Ultra-widefield Fluorescein Angiography in Patients With Chronic Leukemia

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419865819 ◽

2019 ◽

Vol 3 (6) ◽

pp. 420-427 ◽

Cited By ~ 2

Author(s):

T. Y. Alvin Liu ◽

B. Douglas Smith ◽

Karen Mackey ◽

Marguerite O. Linz ◽

Adrienne W. Scott

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Multimodal Imaging ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Vascular Changes ◽

Chronic Leukemia ◽

Vascular Flow ◽

Flow Loss ◽

Sd Oct

Purpose: This article describes pathological retinal vascular changes on multimodal imaging in patients with chronic leukemia. Methods: A prospective, observational study was conducted. Patients with chronic leukemia and concurrent leukocytosis were recruited from a tertiary-referral, academic medical center. Eligible patients received complete ophthalmic examinations and multimodal retinal imaging: spectral-domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), and ultra-widefield fluorescein angiography (UWF FA). Results: Six patients (11 eyes) were consecutively enrolled. At presentation, mean age was 56.9 years, median visual acuity was Snellen 20/20, and median leukocyte count was 114.5 K/mm3 (upper limit of normal: 11.00). Three of 11 eyes had SD-OCT abnormalities, including focal retinal thinning and hyperreflective material at the level of the retinal pigment epithelium. Five of 11 eyes showed OCTA abnormalities, including focal vascular flow loss and a diffuse decrease in vascular density. Four of 11 eyes had peripheral retinal abnormalities on UWF FA, including microaneurysms and nonperfusion. Five of 11 eyes showed pathological vascular changes on retinal imaging, and of these 5 eyes, 3 had unremarkable retinal examinations. Conclusions: Retinal vascular pathologies are frequently seen in patients with chronic leukemia and concurrent leukocytosis, though these patients are rarely symptomatic. Multimodal imaging allows for more sensitive detection of these pathologies compared with clinical examination alone. On OCTA, pathological vascular flow loss is more evident in the superficial capillary plexus. There may be a correlation between pathologies seen in the central and peripheral retina, but this observation will need to be confirmed by a future study with a larger cohort.

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