The prevalence of cystoid macular oedema on optical coherence tomography in retinitis pigmentosa patients without cystic changes on fundus examination

Abstract

Purpose To determine the prevalence of cystoid macular oedema (CME) by optical coherence tomography (OCT) in retinitis pigmentosa (RP) patients with no evidence of cystic macular lesions on fundus examination. Methods We included 63 RP patients with no evidence of cystic-appearing macular changes on fundus examination. All patients underwent a complete ocular examination including best-corrected visual acuity using an ETDRS (Early Treatment Diabetic Retinopathy Study) chart, intraocular pressure measurement, anterior segment examination, and a detailed fundus examination. On 50 of the 63 patients, Fourier-domain OCT was performed using the radial slicer protocol. An additional 13 of the 63 patients were scanned using the macular thickness protocol on a time-domain OCT unit. The diagnosis of CME was defined by the presence of hyporeflective lacunae with well-defined boundaries on at least two of the scans. Results The mean age of patients included in the study was 36 years (range 9-71 years). Out of the 63 patients examined, 20 showed CME in at least one eye (32%), whereas 11 patients showed CME in both eyes (18%). Conclusions Our findings demonstrate that a substantial number of RP patients with CME, as determined by OCT, may not show cystic changes by direct ophthalmoscopy or contact lens biomicroscopy. Knowledge of the high frequency for CME in such patients can serve to identify those who may be amenable to current or future treatment strategies of their macular oedema and can potentially impact on future therapeutic trials where visual acuity is used as an outcome measure.

Anatomical and functional correlates of cystic macular edema in retinitis pigmentosa

“…This study demonstrates that CME is expected, with a prevalence of around 25% in patients with retinitis pigmentosa. This proportion falls within the limits of previously reported rates of CME in different studies [21,22]. In conjunction with previous reports [23,24], our cohort demonstrated a higher incidence of CME among patients with autosomal dominant inheritance than other inheritance patterns.…”

Anatomical and functional correlates of cystic macular edema in retinitis pigmentosa

“…This study demonstrates that CME is expected, with a prevalence of around 25% in patients with retinitis pigmentosa. This proportion falls within the limits of previously reported rates of CME in different studies [21,22]. In conjunction with previous reports [23,24], our cohort demonstrated a higher incidence of CME among patients with autosomal dominant inheritance than other inheritance patterns.…”

Novel grading system for quantification of cystic macular lesions in Usher syndrome

“…Our findings of 37 % having CML in OCT scans are comparable to Hajali et al’s, namely 35 % USH2 and 39 % autosomal recessive RP patients had CML in OCT scans [ 25 , 26 ]. It must be acknowledged that there is a great difference in the incidence of CML among the various cohorts of RP patients, ranging from 8-15 % [ 12 , 16 , 17 ] to 25-56 % [ 14 , 15 , 19 , 25 ].…”

Clinical Characteristics and Visual Prognostic Biomarkers in Pericentral Retinitis Pigmentosa: A Study in a South Korean Cohort

“…Considering the use of a smaller stimulus in the present study of pericentral RP patients (II4e vs. V4e), the difference in displaying a wider preserved GVF area in the pericentral type than in typical RP can be significant. In terms of OCT-based classification, our study had a higher percentage of cases without macular abnormalities and a lower incidence of CME and VMT/ERM than previous studies on typical RP [ 19 , 27 , 29 , 30 ]. These differences suggest that in pericentral RP, the macula may be better preserved, leading to a lower incidence of macular complications such as CME and VMT/ERM.…”

Anatomical and functional correlates of cystic macular edema in retinitis pigmentosa

“…This study demonstrates that CME is expected, with a prevalence of around 25% in patients with retinitis pigmentosa. This proportion falls within the limits of previously reported rates of CME in different studies [21,22]. In conjunction with previous reports [23,24], our cohort demonstrated a higher incidence of CME among patients with autosomal dominant inheritance than other inheritance patterns.…”

Novel grading system for quantification of cystic macular lesions in Usher syndrome

“…Our findings of 37 % having CML in OCT scans are comparable to Hajali et al’s, namely 35 % USH2 and 39 % autosomal recessive RP patients had CML in OCT scans [ 25 , 26 ]. It must be acknowledged that there is a great difference in the incidence of CML among the various cohorts of RP patients, ranging from 8-15 % [ 12 , 16 , 17 ] to 25-56 % [ 14 , 15 , 19 , 25 ].…”

Clinical Characteristics and Visual Prognostic Biomarkers in Pericentral Retinitis Pigmentosa: A Study in a South Korean Cohort

“…Considering the use of a smaller stimulus in the present study of pericentral RP patients (II4e vs. V4e), the difference in displaying a wider preserved GVF area in the pericentral type than in typical RP can be significant. In terms of OCT-based classification, our study had a higher percentage of cases without macular abnormalities and a lower incidence of CME and VMT/ERM than previous studies on typical RP [ 19 , 27 , 29 , 30 ]. These differences suggest that in pericentral RP, the macula may be better preserved, leading to a lower incidence of macular complications such as CME and VMT/ERM.…”

Anatomical and functional correlates of cystic macular edema in retinitis pigmentosa

“…This study demonstrates that CME is expected, with a prevalence of around 25% in patients with retinitis pigmentosa. This proportion falls within the limits of previously reported rates of CME in different studies [21,22]. In conjunction with previous reports [23,24], our cohort demonstrated a higher incidence of CME among patients with autosomal dominant inheritance than other inheritance patterns.…”

Novel grading system for quantification of cystic macular lesions in Usher syndrome

“…Our findings of 37 % having CML in OCT scans are comparable to Hajali et al’s, namely 35 % USH2 and 39 % autosomal recessive RP patients had CML in OCT scans [ 25 , 26 ]. It must be acknowledged that there is a great difference in the incidence of CML among the various cohorts of RP patients, ranging from 8-15 % [ 12 , 16 , 17 ] to 25-56 % [ 14 , 15 , 19 , 25 ].…”

Clinical Characteristics and Visual Prognostic Biomarkers in Pericentral Retinitis Pigmentosa: A Study in a South Korean Cohort

“…Considering the use of a smaller stimulus in the present study of pericentral RP patients (II4e vs. V4e), the difference in displaying a wider preserved GVF area in the pericentral type than in typical RP can be significant. In terms of OCT-based classification, our study had a higher percentage of cases without macular abnormalities and a lower incidence of CME and VMT/ERM than previous studies on typical RP [ 19 , 27 , 29 , 30 ]. These differences suggest that in pericentral RP, the macula may be better preserved, leading to a lower incidence of macular complications such as CME and VMT/ERM.…”