Morphologic characteristics and clinical significance of the macular‑sparing area in patients with retinitis pigmentosa as revealed by multicolor imaging

Liu,Guodong; Du,Qing; Keyal,Khusbu; Wang,Fang

doi:10.3892/etm.2017.5227

Morphologic characteristics and clinical significance of the macular‑sparing area in patients with retinitis pigmentosa as revealed by multicolor imaging

Authors:
- Guodong Liu
- Qing Du
- Khusbu Keyal
- Fang Wang
View Affiliations

Affiliations: Department of Ophthalmology, Shanghai Tenth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai 200072, P.R. China
Published online on: September 29, 2017 https://doi.org/10.3892/etm.2017.5227
Pages: 5387-5394
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Retinitis pigmentosa (RP) is an inherited retinal disease caused by the degeneration of photoreceptors and retinal pigment epithelium cells within the eye. The present study aimed to evaluate the effectiveness of multicolor imaging as a novel technique for the depiction of morphological features in the macular area of patients with RP. Additionally, the correlation between the size of the macular‑sparing area and the best corrected visual acuity (BCVA), central visual field function and subfoveal choroidal thickness (SFCT) was analyzed. A total of 25 individuals with RP (n=50 eyes) and 35 healthy individuals (n=70 eyes) were enrolled in the current study. Images of the macular area were captured using multicolor imaging and traditional fundus photography, and their ability to depict retinal features was compared. The size of the macular‑sparing area in patients with RP was measured using built‑in measurement software programs. The correlations between the macular‑sparing area and the BCVA, visual field and SFCT were analyzed using a Spearman's rank correlation test. The results demonstrated that multicolor imaging revealed clinical features of the macular area in greater detail than traditional fundus photography irrespective of whether the patient also had complications, including cataracts and epiretinal membranes. Multicolor imaging clearly defined the borders of the macular‑sparing area corresponding to the relatively intact outer retinal structures on optical coherence tomography images, particularly the status of the ellipsoid zone and external limiting membrane. There was a significant positive correlation between the macular‑sparing area and BCVA (r=‑0.631; P<0.001), and the visual field in terms of MD (r=0.402; P<0.05) and PSD (r=0.595; P<0.001), however, there was not a statistically significant correlation between the macular‑sparing area and SFCT. The present study demonstrated that multicolor imaging is capable of detecting macular changes and complications in patients with RP. Multicolor imaging may be particularly useful in assessing the detailed characteristics of the macular‑sparing area, as this appears to be associated with visual function.

View Figures

View References

1	Mrejen S, Audo I, Bonnel S and Sahel JA: Retinitis pigmentosa and other dystrophies. Dev Ophthalmol. 58:191–201. 2017. View Article : Google Scholar : PubMed/NCBI
2	Hartong DT, Berson EL and Dryja TP: Retinitis pigmentosa. Lancet. 368:1795–1809. 2006. View Article : Google Scholar : PubMed/NCBI
3	Berson EL: Long-term visual prognoses in patients with retinitis pigmentosa: The ludwig von sallmann lecture. Exp Eye Res. 85:7–14. 2007. View Article : Google Scholar : PubMed/NCBI
4	Flynn MF, Fishman GA, Anderson RJ and Roberts DK: Retrospective longitudinal study of visual acuity change in patients with retinitis pigmentosa. Retina. 21:639–646. 2001. View Article : Google Scholar : PubMed/NCBI
5	Aizawa S, Mitamura Y, Hagiwara A, Sugawara T and Yamamoto S: Changes of fundus autofluorescence, photoreceptor inner and outer segment junction line, and visual function in patients with retinitis pigmentosa. Clin Exp Ophthalmol. 38:597–604. 2010. View Article : Google Scholar : PubMed/NCBI
6	Drexler W, Sattmann H, Hermann B, Ko TH, Stur M, Unterhuber A, Scholda C, Findl O, Wirtitsch M, Fujimoto JG and Fercher AF: Enhanced visualization of macular pathology with the use of ultrahigh-resolution optical coherence tomography. Arch. Ophthalmol. 121:695–706. 2003.
7	Sun LW, Johnson RD, Langlo CS, Cooper RF, Razeen MM, Russillo MC, Dubra A, Connor TB Jr, Han DP, Pennesi ME, et al: Assessing photoreceptor structure in retinitis pigmentosa and usher syndrome. Invest Ophthalmol Vis Sci. 57:2428–2442. 2016. View Article : Google Scholar : PubMed/NCBI
8	Liu G, Li H, Liu X, Xu D and Wang F: Structural analysis of retinal photoreceptor ellipsoid zone and postreceptor retinal layer associated with visual acuity in patients with retinitis pigmentosa by ganglion cell analysis combined with OCT imaging. Medicine (Baltimore). 95:e57852016. View Article : Google Scholar : PubMed/NCBI
9	Fischer MD, Fleischhauer JC, Gillies MC, Sutter FK, Helbig H and Barthelmes D: A new method to monitor visual field defects caused by photoreceptor degeneration by quantitative optical coherence tomography. Invest Ophthalmol Vis Sci. 49:3617–3621. 2008. View Article : Google Scholar : PubMed/NCBI
10	Chan TCY, Lam SC, Mohamed S and Wong RLM: Survival analysis of visual improvement after cataract surgery in advanced retinitis pigmentosa. Eye (Lond). Aug 4–2017.(Epub ahead of print). doi: 10.1038/eye.2017.164. View Article : Google Scholar
11	Ikeda Y, Yoshida N, Murakami Y, Nakatake S, Notomi S, Hisatomi T, Enaida H and Ishibashi T: Long-term surgical outcomes of epiretinal membrane in patients with retinitis. Sci Rep. 5:130782015. View Article : Google Scholar : PubMed/NCBI
12	Pang CE and Freund KB: Ghost maculopathy: An artifact on near-infrared reflectance and multicolor imaging masquerading as chorioretinal pathology. Am J Ophthalmol. 158:171–178. 2014. View Article : Google Scholar : PubMed/NCBI
13	Wen Y, Klein M, Hood DC and Birch DG: Relationships among multifocal electroretinogram amplitude, visual field sensitivity, and SD-OCT receptor layer thicknesses in patients with retinitis pigmentosa. Invest Ophthalmol Vis Sci. 53:833–840. 2012. View Article : Google Scholar : PubMed/NCBI
14	Sergott RC: Retinal segmentation using multicolor laser imaging. J Neuroophthalmol. 34 Suppl:S24–S28. 2014. View Article : Google Scholar : PubMed/NCBI
15	Zeng J, Li J, Liu R, Chen X, Pan J, Tang S and Ding X: Choroidal thickness in both eyes of patients with unilateral idiopathic macular hole. Ophthalmology. 119:2328–2333. 2012. View Article : Google Scholar : PubMed/NCBI
16	Lemke S, Cockerham GC, Glynn-Milley C, Lin R and Cockerham KP: Automated perimetry and visual dysfunction in blast-related traumatic brain injury. Ophthalmology. 123:415–424. 2015. View Article : Google Scholar : PubMed/NCBI
17	Andjelic S, Drašlar K, Hvala A and Hawlina M: Anterior lens epithelium in cataract patients with retinitis pigmentosa - scanning and transmission electron microscopy study. Acta Ophthalmol. 95:e212–e220. 2017. View Article : Google Scholar : PubMed/NCBI
18	Fujiwara K, Ikeda Y, Murakami Y, Nakatake S, Tachibana T, Yoshida N, Nakao S, Hisatomi T, Yoshida S, Yoshitomi T, et al: Association between aqueous flare and epiretinal membrane in retinitis pigmentosa. Invest Ophthalmol Vis Sci. 57:4282–4286. 2016. View Article : Google Scholar : PubMed/NCBI
19	Strong S, Liew G and Michaelides M: Retinitis pigmentosa-associated cystoid macular oedema: Pathogenesis and avenues of intervention. Br J Ophthalmol. 101:31–37. 2017. View Article : Google Scholar : PubMed/NCBI
20	Semoun O, Guigui B, Tick S, Coscas G, Soubrane G and Souied EH: Infrared features of classic choroidal neovascularisation in exudative age-related macular degeneration. Br J Ophthalmol. 93:182–185. 2009. View Article : Google Scholar : PubMed/NCBI
21	Ben Moussa N, Georges A, Capuano V, Merle B, Souied EH and Querques G: MultiColor imaging in the evaluation of geographic atrophy due to age-related macular degeneration. Br J Ophthalmol. 99:842–847. 2015. View Article : Google Scholar : PubMed/NCBI
22	Yoon CK and Yu HG: The structure-function relationship between macular morphology and visual function analyzed by optical coherence tomography in retinitis pigmentosa. J Ophthalmol. 2013:8214602013. View Article : Google Scholar : PubMed/NCBI
23	Smith TB, Parker M, Steinkamp PN, Weleber RG, Smith N and Wilson DJ: VPA Clinical Trial Study Group; EZ Working Group: Structure-function modeling of optical coherence tomography and standard automated perimetry in the retina of patients with autosomal dominant retinitis pigmentosa. PLoS One. 11:e01480222016. View Article : Google Scholar : PubMed/NCBI
24	Fischer MD, Fleischhauer JC, Gillies MC, Sutter FK, Helbig H and Barthelmes D: A new method to monitor visual field defects caused by photoreceptor degeneration by quantitative optical coherence tomography. Invest Ophthalmol Vis Sci. 49:3617–3621. 2008. View Article : Google Scholar : PubMed/NCBI
25	Wakabayashi T, Sawa M, Gomi F and Tsujikawa M: Correlation of fundus autofluorescence with photoreceptor morphology and functional changes in eyes with retinitis pigmentosa. Acta Ophthalmol. 88:e177–e183. 2010. View Article : Google Scholar : PubMed/NCBI
26	Wen Y and Birch DG: Outer segment thickness predicts visual field response to QLT091001 in patients with RPE65 or LRAT mutations. Transl Vis Sci Technol. 4:82015. View Article : Google Scholar : PubMed/NCBI
27	Rao HL, Raveendran S, James V, Dasari S, Palakurthy M, Reddy HB, Pradhan ZS, Rao DA, Puttaiah NK and Devi S: Comparing the performance of compass perimetry with humphrey field analyzer in eyes with glaucoma. J Glaucoma. 26:292–297. 2017. View Article : Google Scholar : PubMed/NCBI
28	Miyata M, Hata M, Ooto S, Ogino K, Gotoh N, Morooka S, Hasegawa T, Hirashima T, Sugahara M, Kuroda Y, et al: Choroidal and retinal atrophy of bietti crystalline dystrophy patients with CYP4V2 mutations compared to retinitis pigmentosa patients with eys mutations. Retina. 37:1193–1202. 2017. View Article : Google Scholar : PubMed/NCBI
29	Saint-Geniez M, Kurihara T, Sekiyama E, Maldonado AE and D'Amore PA: An essential role for RPE-derived soluble VEGF in the maintenance of the choriocapillaris. Proc Natl Acad Sci USA. 106:pp. 18751–18756. 2009, View Article : Google Scholar : PubMed/NCBI
30	Ohlmann A, Scholz M, Koch M and Tamm ER: Epithelial-mesenchymal transition of the retinal pigment epithelium causes choriocapillaris atrophy. Histochem Cell Biol. 146:769–780. 2016. View Article : Google Scholar : PubMed/NCBI
31	Adhi M, Regatieri CV, Branchini LA, Zhang JY, Alwassia AA and Duker JS: Analysis of the morphology and vascular layers of the choroid in retinitis pigmentosa using spectral-domain OCT. Ophthalmic Surg Lasers Imaging Retina. 44:252–259. 2013. View Article : Google Scholar : PubMed/NCBI