Inner retinal thickening affects microperimetry thresholds in the presence of photoreceptor thinning in patients with RPGR retinitis pigmentosa.
Jolly Jasleen Kaur, Menghini Moreno, Johal Piers A, Buckley Thomas M W, Bridge Holly, Maclaren Robert E
AI Summary
RPGR retinitis pigmentosa shows inner retinal thickening despite photoreceptor loss, impacting microperimetry vision tests. This suggests inner retinal remodeling influences functional assessment in this disease.
Abstract
Background
Loss of photoreceptors cause degeneration in areas of the retina beyond the photoreceptors. The pattern of changes has implications for disease monitoring and measurement of functional changes. The aim of the study was to study the changes in inner retinal structure associated with photoreceptor disease, and the impact of these on microperimetry threshold.
Methods
This retrospective cohort study was conducted on optical coherence tomography (OCT) images and microperimetry tests collected between 2013 and 2019. 22 eyes with RPGR retinitis pigmentosa completed both OCT imaging and microperimetry assessment. 18 control eyes underwent OCT imaging. Photoreceptor layer and inner retinal thickness calculated for different eccentric areas were obtained. The relationship between the photoreceptor layer and inner retinal thickness, and microperimetry threshold was explored.
Results
Central 1° photoreceptor layer and inner retinal thickness were 96±34 and 139±75 μm in RPGR patients, and 139±15 and 62±14 μm in controls. Photoreceptor layer thickness differed between patient and control groups across increasing visual field areas (p<0.01, Kruskal-Wallis 1-way ANOVA), whereas the inner retinal thickness significantly differed between groups for the central 1° and 3° only. Microperimetry thresholds were explained by a combination of photoreceptor thickness (coefficient 0.15, 95% CI 0.13 to 0.18) and inner retinal thickness (coefficient 0.05, 95% CI 0.03 to 0.06).
Conclusion
OCT shows evidence of remodelling in the inner retinal layers secondary to photoreceptor disease. This appears to have an impact on microperimetry threshold measurements.
MeSH Terms
Shields Classification
Key Concepts6
In patients with RPGR retinitis pigmentosa, central 1 photoreceptor layer thickness was 9634 m and inner retinal thickness was 13975 m.
In control eyes, central 1 photoreceptor layer thickness was 13915 m and inner retinal thickness was 6214 m.
Photoreceptor layer thickness differed between patients with RPGR retinitis pigmentosa and control groups across increasing visual field areas (p<0.01, Kruskal-Wallis 1-way ANOVA).
Inner retinal thickness significantly differed between patients with RPGR retinitis pigmentosa and control groups for the central 1 and 3 only.
Microperimetry thresholds in patients with RPGR retinitis pigmentosa were explained by a combination of photoreceptor thickness (coefficient 0.15, 95% CI 0.13 to 0.18) and inner retinal thickness (coefficient 0.05, 95% CI 0.03 to 0.06).
Optical coherence tomography (OCT) shows evidence of remodelling in the inner retinal layers secondary to photoreceptor disease in patients with RPGR retinitis pigmentosa.
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