The impact of macular edema on microvascular and metabolic alterations in retinitis pigmentosa

Todorova, Margarita G.; Scholl, Hendrik P. N.; Waizel, Maria della Volpe

doi:10.1007/s00417-020-04913-3

Cited by 9 publications

(15 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, the amount of peripapillary RNFL structural changes correlates well with the metabolic alterations detected by RO in IRDs [ 39 ]. In addition, the presence of cystoid macular edema (CME) in OCT imaging, reported to occur in 10%–50% of retinitis pigmentosa patients [ 51 , 52 , 53 , 54 ], has been well associated with the best-corrected visual acuity [ 55 , 56 ] and also with the degree of metabolic alterations and foveal vascular anomalies in RCD [ 42 , 57 ].…”

Section: Introductionmentioning

confidence: 99%

Retinal Oxygenation in Inherited Diseases of the Retina

Türksever

Torres

Valmaggia

et al. 2021

Genes

Self Cite

View full text Add to dashboard Cite

(1) Background: The aim of our study was to investigate the relationship between retinal metabolic alterations (retinal vessel oximetry, RO) and structural findings (retinal vessel diameter, central retinal thickness and retinal nerve fiber layer thickness, RNFL) in patients with inherited retinal diseases (IRDs). (2) Methods: A total of 181 eyes of 92 subjects were examined: 121 eyes of 62 patients with IRDs were compared to 60 eyes of 30 healthy age-matched controls. The retinal vessel oximetry was performed with the oxygen saturation measurement tool of the Retinal Vessel Analyser (RVA; IMEDOS Systems UG, Jena, Germany). The oxygen saturation in all four major peripapillary retinal arterioles (A-SO2; %) and venules (V-SO2; %) were measured and their difference (A-V SO2; %) was calculated. Additionally, retinal vessel diameters of the corresponding arterioles (D-A; µm) and venules (D-V; µm) were determined. The peripapillary central retinal thickness and the RNFL thickness were measured using spectral domain optical coherence tomography (SD-OCT) (Carl Zeiss Meditec, Dublin, CA, USA). Moreover, we calculated the mean central retinal oxygen exposure (cO2-E; %/µm) and the mean peripapillary oxygen exposure (pO2-E; %/µm) per micron of central retinal thickness and nerve fiber layer thickness by dividing the mean central retinal thickness (CRT) and the RNFL thickness with the mean A-V SO2. (3) Results: Rod-cone dystrophy patients had the highest V-SO2 and A-SO2, the lowest A-V SO2, the narrowest D-A and D-V and the thickest RNFL, when compared not only to controls (p ≤ 0.040), but also to patients with other IRDs. Furthermore, in rod-cone dystrophies the cO2-E and the pO2-E were higher in comparison to controls and to patients with other IRDs (p ≤ 0.005). Cone-rod dystrophy patients had the lowest cO2-E compared to controls and patients with other IRDs (p ≤ 0.035). Evaluated in central zones, the cO2-E was significantly different when comparing cone-rod dystrophy (CRD) against rod-cone dystrophy (RCD) patients in all zones (p < 0.001), whereas compared with controls and patients with inherited macular dystrophy this was observed only in zones 1 and 2 (p ≤ 0.018). The oxygen exposure was also the highest in the RCD group for both the nasal and the temporal peripapillary area, among all the evaluated groups (p ≤ 0.025). (4) Conclusions: The presented metabolic-structural approach enhances our understanding of inherited photoreceptor degenerations. Clearly demonstrated through the O2-E comparisons, the central and the peripapillary retina in rod-cone dystrophy eyes consume less oxygen than the control-eyes and eyes with other IRDs. Rod-cone dystrophy eyes seem to be proportionally more exposed to oxygen, the later presumably leading to more pronounced oxidative damage-related remodeling.

show abstract

Section: Introductionmentioning

confidence: 99%

Retinal Oxygenation in Inherited Diseases of the Retina

Türksever

Torres

Valmaggia

et al. 2021

Genes

Self Cite

View full text Add to dashboard Cite

show abstract

“…Also, the presence of an intact ellipsoid zone (inner-/outer segment junction of photoreceptors) in RP appears to be an indicator of proper photorecep-torsʼ integrity and function, and strongly associates with better visual function, brighter parafoveolar autofluorescent density, and higher retinal sensitivity [17, 20 -23]. Interestingly, the presence of macular oedema correlated well with the degree of metabolic and microvascular alterations in RP [24,25]. Following the discussed above, and since the macula has an abundance of cone photoreceptors and retinal ganglion cells, it seems likely that this remaining island of central vision might be transcendental for the development of future therapies.…”

Section: Introductionmentioning

confidence: 99%

Linking the Presence of Macular Oedema to Structural and Functional Alterations in Retinitis Pigmentosa

Friesacher

Torres

Valmaggia

et al. 2021

Klin Monbl Augenheilkd

Self Cite

View full text Add to dashboard Cite

Objective To investigate the association between the central retinal thickness (CRT), the retinal nerve fibre layer thickness (RNFL), and the functional alterations in retinitis pigmentosa (RP) patients. Methods Forty-three patients with typical RP and nineteen age-matched controls, who underwent SD-OCT (macular and optic disc OCT protocols) and electrophysiology, were included. The RP group was divided into two subgroups: with clinical appearance of macular oedema (ME-RP; 30 eyes) and without macular oedema (no-ME; 44 eyes). Central retinal thickness OCT data were averaged in three zones (zone 1 [0°–3°], zone 2 [3°–8°], and zone 3 [8°–15°]) and were evaluated in relation to the RNFL thickness and electrophysiological data. Results The ME-RP group showed increased CRT (zone 1) and RNFL thickness compared to the controls and no-ME-RP (p ≤ 0.002). The no-ME-RP group had reduced CRT thickness (all zones; p ≤ 0.018) compared to the controls and ME-RP, whereas the RNFL thickness in the no-ME-RP group was reduced only compared to the ME-RP group (p < 0.001). The ME-RP group showed significantly more attenuated functional responses than the no-ME-RP patients. A significant positive interaction was found between the CRT (zones 1 and 2) and the RNFL thickness within ME-RP (p ≤ 0.010). Significant negative interactions were found between CRT, RNFL thickness, and functional findings within ME-RP (p ≤ 0.049). Conclusion The presence of macular oedema correlated well with increased RNFL thickness and residual function in RP patients. Such association provides evidence of an underlying transneuronal mechanism of retinal degeneration. Simultaneous monitoring of CRT and RNFL thickness may help in the future to evaluate the progression of the disease and the efficacy of treatments in RP patients.

show abstract

“…In the RPnE group, there was a significant change only for the maximum vertical FAZ diameter in the SVC, which was reduced in length, while no other changes for FAZ diameter or area were observed in all other layers. Previous studies showed that changes of the FAZ differ between studies [11][12][13][14][15][16]. A recent meta-analysis concluded that FAZ tended to be larger in SVC, but not significantly, whereas FAZ area in DCP was significantly enlarged in RP.…”

Section: Discussionmentioning

confidence: 97%

“…The only other study comparing RPnE and RPwE patients included a rather similar number of patients but evaluated both eyes in a part of the patients [16]. They described a significant increase of FAZ area in SVC and DCP in RPwE.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography angiography (OCT-A) in retinitis pigmentosa and macular dystrophy patients: a retrospective study

Deutsch

Lommatzsch

Weinitz

et al. 2022

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Purpose To evaluate macular vascular abnormalities in patients with macular dystrophies (MD) and retinitis pigmentosa (RP) through application of optical coherence tomography angiography (OCT-A). Methods In this retrospective study, patients with MD and RP were examined by OCT-A and compared to healthy individuals. OCT-A images were analyzed regarding the diameter and surface area of the foveal avascular zone (FAZ) as well as flow (FL) in different retinal layers (superficial vascular complex (SVC), intermediate capillary complex (ICP), deep capillary complex (DCP), choriocapillaris (CC), and choroid (CD)). Results Twenty-one patients with MD, 21 patients with RP without macular edema (RPnE), 8 patients with RP with edema (RPwE), and 41 healthy individuals were enrolled. The group of MD and RPnE patients showed none or only minor changes in FAZ. In RPwE patients, the FAZ was significantly smaller in vertical and horizontal measurements and surface area in SVC, whereas it was markedly enlarged in ICP. FL was significantly reduced compared to healthy individuals by an average of 13.2% in CD, 14.2% in CC, and 8.4% in DCP in all patient groups. In ICP, the reduction was 9.2% for RPnE and 12.7% for RPwE patients. The SVC showed reduced FL in the MD (8.1%) and RPnE (10.3%) group. Conclusions OCT-A is a valuable tool to examine retinal vascular abnormalities in patients with MD and RP. OCT-A revealed a reduced flow in various retinal layers in MD, RPnE, and RPwE. Alterations of the FAZ were less distinct in these groups which add to the variation reported previously.

show abstract

The impact of macular edema on microvascular and metabolic alterations in retinitis pigmentosa

Cited by 9 publications

References 57 publications

Retinal Oxygenation in Inherited Diseases of the Retina

Retinal Oxygenation in Inherited Diseases of the Retina

Linking the Presence of Macular Oedema to Structural and Functional Alterations in Retinitis Pigmentosa

Optical coherence tomography angiography (OCT-A) in retinitis pigmentosa and macular dystrophy patients: a retrospective study

Contact Info

Product

Resources

About