Hyperreflective foci as important prognostic indicators of progression of retinitis pigmentosa

Abstract Background Retinitis pigmentosa (RP) is a heterogeneous group of inherited ocular diseases that result in progressive retinal degeneration. This study aims to describe different Swept-source Optical Coherence Tomographic (SS-OCT) changes in Palestinian RP patients and to explore possible correlations with Visual Acuity (VA). Methods A cross-sectional observational study was conducted on Retinitis Pigmentosa patients diagnosed with RP in a tertiary eye hospital. Full history and ocular examination were made. SS-OCT imaging was done for all eyes assessing the presence of cystoid macular edema, epiretinal membrane, macular holes, and external limiting membrane, ellipsoid zone status. Also, central macular thickness and choroidal vascular thickness were measured. Results The study was run on 161 eyes of 81 patients; 53 males and 28 females. The average age at examination was 26.1 (6–78) years. Twenty-six eyes (16.1%) were of syndromic RP patients, mostly Usher syndrome; 20 eyes (12.4%). The mean Logaritmic minimal angle of resolution (LogMAR) of Best Corrected Visual Acuity (BCVA)of the study sample was 0.66 ± 0.7. The most prevalent change was cystoid macular edema [28 eyes, (17.4%)], followed by epiretinal membrane [17eye, (10.6%)]. A macular hole was noted only in one eye (0.6%). Ellipsoid zone and external limiting membrane were absent in 55 eyes (35.0%) and 60 eyes 37.5%. Vitreous hyperreflective foci were found in 35 eyes (43.8%). LogMAR of BCVA was associated significantly with cystoid macular edema (p = 0.001), ellipsoid zone(p = 0.001), and external limiting membrane (p = 0.001). Conclusions Detailed SS-OCT assessment in Palestinian patients diagnosed with RP identified different morphologies from other populations. Cystoid macular edema and vitreous hyperreflective foci may reflect signs of early or intermediate stages of the disease. Disease progression can be monitored by measuring the length/width (area) of ellipsoid zone +/− external limiting membrane and choroidal vascular thickness, which should be evaluated serially using high-resolution OCT.

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Swept-Source Optical Coherence Tomography Changes and Visual Acuity Among Palestinian Retinitis Pigmentosa Patients: A Cross-Sectional Study

10.21203/rs.3.rs-108167/v1 ◽

2020 ◽

Author(s):

Orjowan Shalabi ◽

Zaher Nazzal ◽

Muath Natsheh ◽

Salam Erakat ◽

Michel Michaelides ◽

...

Keyword(s):

Visual Acuity ◽

Retinitis Pigmentosa ◽

Macular Edema ◽

Epiretinal Membrane ◽

Cystoid Macular Edema ◽

External Limiting Membrane ◽

Cross Sectional ◽

Swept Source ◽

Ellipsoid Zone ◽

Hyperreflective Foci

Abstract Background: Retinitis pigmentosa (RP) is a heterogeneous group of inherited ocular diseases that result in progressive retinal degeneration. This study aims to describe different Swept-source Optical Coherence Tomographic (SS-OCT) changes in Palestinian RP patients and to explore possible correlations with Visual Acuity (VA)Methods: A cross-sectional observational study was conducted on Retinitis Pigmentosa patients diagnosed with RP in a tertiary eye hospital. Full history and ocular examination were made. SS-OCT imaging was done for all eyes assessing the presence of cystoid macular edema, epiretinal membrane, macular holes, and external limiting membrane, ellipsoid zone status. Also, central macular thickness and choroidal vascular thickness were measured.Results: the study was run on 161 eyes of 81 patients; 53 males and 28 females. The average age at examination was 26.1 (6-78) years. Twenty-six eyes (16.1%) were of syndromic RP patients, mostly Usher syndrome; 20 eyes (12.4%). The mean LogMAR BCVA of the study sample was 0.66 ±0.7. The most prevalent change was cystoid macular edema [28 eyes, (17.4 %)], followed by epiretinal membrane [17eye, (10.6%)]. A macular hole was noted only in one eye (0.6%). Ellipsoid zone and external limiting membrane were absent in 55 eyes (35.0%) and 60 eyes 37.5%. Vitreous hyperreflective foci were found in 35 eyes (43.8%). LogMAR of BCVA was associated significantly with cystoid macular edema (p=0.001), ellipsoid zone(p=0.001), and external limiting membrane (p=0.001). Conclusions: Detailed SS-OCT assessment in Palestinian patients diagnosed with RP identified different morphologies from other populations. Cystoid macular edema and vitreous hyperreflective foci may reflect signs of early or intermediate stages of the disease. Disease progression can be monitored by measuring the length/width (area) of ellipsoid zone +/- external limiting membrane and choroidal vascular thickness, which should be evaluated serially using high-resolution OCT.

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Retinal and choroidal hyperreflective foci on spectral-domain optical coherence tomographic images in a patient with retinitis pigmentosa accompanied by diabetic retinopathy

American Journal of Ophthalmology Case Reports ◽

10.1016/j.ajoc.2016.04.002 ◽

2016 ◽

Vol 3 ◽

pp. 25-30 ◽

Cited By ~ 1

Author(s):

Yuriya Kawaguchi ◽

Atsushi Takahashi ◽

Taiji Nagaoka ◽

Akihiro Ishibazawa ◽

Satoshi Ishiko ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Retinitis Pigmentosa ◽

Spectral Domain ◽

Optical Coherence ◽

Tomographic Images ◽

Hyperreflective Foci

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Intraretinal hyperreflective foci on spectral-domain optical coherence tomographic images of patients with retinitis pigmentosa

Clinical Ophthalmology ◽

10.2147/opth.s58164 ◽

2014 ◽

pp. 435 ◽

Cited By ~ 22

Author(s):

Masako Kuroda ◽

Yasuhiko Hirami ◽

Masayuki Hata ◽

Michiko Mandai ◽

Masayo Takahashi ◽

...

Keyword(s):

Retinitis Pigmentosa ◽

Spectral Domain ◽

Optical Coherence ◽

Tomographic Images ◽

Hyperreflective Foci

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Number of Hyperreflective Foci in the Outer Retina Correlates with Inflammation and Photoreceptor Degeneration in Retinitis Pigmentosa

Ophthalmology Retina ◽

10.1016/j.oret.2017.07.020 ◽

2018 ◽

Vol 2 (7) ◽

pp. 726-734 ◽

Cited By ~ 6

Author(s):

Yosuke Nagasaka ◽

Yasuki Ito ◽

Shinji Ueno ◽

Hiroko Terasaki

Keyword(s):

Retinitis Pigmentosa ◽

Photoreceptor Degeneration ◽

Outer Retina ◽

Hyperreflective Foci

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Doppler -- Sonography of the A.ciliares breves in Patients with Low Tension Glaucoma and with Retinitis Pigmentosa

European Journal of Ultrasound ◽

10.1016/s0929-8266(97)87283-7 ◽

1997 ◽

Vol 6 ◽

pp. S42-S43

Author(s):

V Klingmueller

Keyword(s):

Retinitis Pigmentosa ◽

Doppler Sonography ◽

Low Tension Glaucoma ◽

Low Tension

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Zinc Depletion Increases Readmission in Older Patients: An Example of Interactions Between Nutrition and Disease

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000275 ◽

2017 ◽

Vol 87 (1-2) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

Salah Gariballa ◽

Awad Alessa

Keyword(s):

Nutritional Status ◽

Inductively Coupled Plasma ◽

Older Patients ◽

Controlled Trial ◽

Prognostic Indicators ◽

Hospitalised Patients ◽

Increased Risk ◽

Co Morbidity ◽

The Impact ◽

Poor Nutrition

Abstract. Background: ill health may lead to poor nutrition and poor nutrition to ill health, so identifying priorities for management still remains a challenge. The aim of this report is to present data on the impact of plasma zinc (Zn) depletion on important health outcomes after adjusting for other poor prognostic indicators in hospitalised patients. Methods: Hospitalised acutely ill older patients who were part of a large randomised controlled trial had their nutritional status assessed using anthropometric, hematological and biochemical data. Plasma Zn concentrations were measured at baseline, 6 weeks and at 6 months using inductively- coupled plasma spectroscopy method. Other clinical outcome measures of health were also measured. Results: A total of 345 patients assessed at baseline, 133 at 6 weeks and 163 at 6 months. At baseline 254 (74%) patients had a plasma Zn concentration below 10.71 μmol/L indicating biochemical depletion. The figures at 6 weeks and 6 months were 86 (65%) and 114 (70%) patients respectively. After adjusting for age, co-morbidity, nutritional status and tissue inflammation measured using CRP, only muscle mass and serum albumin showed significant and independent effects on plasma Zn concentrations. The risk of non-elective readmission in the 6-months follow up period was significantly lower in patients with normal Zn concentrations compared with those diagnosed with Zn depletion (adjusted hazard ratio 0.62 (95% CI: 0.38 to 0.99), p = 0.047. Conclusions: Zn depletion is common and associated with increased risk of readmission in acutely-ill older patients, however, the influence of underlying comorbidity on these results can not excluded.

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