Effect of Choroidal Vessel Density on the Ellipsoid Zone and Visual Function in Retinitis Pigmentosa Using Optical Coherence Tomography Angiography

Abstract

PURPOSE. We evaluate the effect of choroidal vessel density on the residual length of the ellipsoid zone (EZ) and visual function in patients with retinitis pigmentosa (RP) using optical coherence tomography angiography (OCTA). METHODS. Fifty-three patients with RP (n ¼ 101 eyes) and 53 normal participants (n ¼ 76 eyes) were enrolled in this study. Patients with RP were assigned to three groups according to their best-corrected visual acuity (BCVA). All patients underwent ophthalmologic examinations, including BCVA, fundus examination performed with a slit-lamp using an indirect 90 diopter (D) lens, OCTA, full-field electroretinogram (ERG), and visual field. The choroidal vessel density in the choriocapillaris-Sattler's layer (D C-S), Haller's layer (D H), horizontal length of the ellipsoid (HEL), and vertical length of the ellipsoid (VEL) were assessed using OCTA and Adobe Photoshop CS3 extended software. RESULTS. A significantly increasing impairment of choroidal vessel density (D C-S and D H) was characterized in the RP groups compared to those of the controls (P < 0.05 for all). The magnitude of the reduction in the DC-S and DH was much easier to identify for more severely impaired BCVA in the RP groups (P < 0.05 for all). The D C-S had the strongest correlation with the HEL, VEL, BCVA, visual field, and b-wave amplitude (r ¼ 0.735, r ¼ 0.753, r ¼ À0.843, r ¼ 0.579, and r ¼ 0.671, respectively). CONCLUSIONS. Using noninvasive OCTA, choroidal microcirculation, especially in the small/ middle choroidal vessel layers, was a prominent factor affecting the EZ, visual acuity, visual field, and recordable ERG b-wave amplitude of patients with RP. This may provide new insights into the progress mechanism and treatment of RP.

The role of magnification correction in macular vessel density assessment: a contralateral eye study in anisometropia patients

“…This result inspired the hypothesis that visual acuity can be an indicator of retinal vessel circulation change. Similar results were derived from Liu's study (31) that vessel density was a prominent factor affecting visual acuity. The underlying mechanism may be that nerve fiber and ganglion cell layer receive blood from the superficial retinal vascular plexus and the degree of perfusion may impact visual performance (32).…”

Optical coherence tomography angiography findings in patients undergoing transcorneal electrical stimulation for treating retinitis pigmentosa

“…Several recent studies conducted with OCTA have reported a reduction of retinal vessel density and retinal perfusion density, impaired choroidal blood flow, or significantly altered sizes of the foveal avascular zones in eyes of patients suffering from RP [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Given the known microvascular alterations in RP, it might be beneficial to use OCTA in the context of TES treatment.…”

Short-Term Effects of Dark Chocolate on Retinal and Choriocapillaris Perfusion in Young, Healthy Subjects Using Optical Coherence Tomography Angiography

“…Successive improvement in technology and instrumentation provided the possibility of using enhanced depth imaging (EDI) using spectral domain optical coherence tomography to study the choroid. This method has opened a new window in understanding choroidal physiopathology in normality and disease [23][24][25][26][27][28][29][30]. OCT methods have rapidly improved, and angiography has been included, thus giving rise to OCT-A, which has revolutionized the evaluation of retinal and choroidal perfusion.…”

“…The choroid is the principal source of nutrients and oxygen to the retinal pigment epithelium-photoreceptor layer, as the outer retinal layers do not have a vascular network [30,31]. The photoreceptors have a high metabolic activity, and more than 90% of the oxygen received by the retina is used by the photoreceptors.…”

“…The photoreceptors have a high metabolic activity, and more than 90% of the oxygen received by the retina is used by the photoreceptors. Choroidal circulation provides 90% of the oxygen to the retina during darkness [30]. Blood flow in the choroid is one of the highest per unit weight among the body tissues, approximately ten times higher than the brain [31][32][33][34]; this enables oxygen to be transported across Bruch's membrane and reach the retinal pigment epithelium.…”