Correlation between Macular Morphology and Sensitivity in Patients with Retinitis Pigmentosa and Hyperautofluorescent Ring

Abstract

To assess the correlation between retinal morphology and function in patients with retinitis pigmentosa (RP) using spectral domain optical coherence tomography (SD-OCT), fundus autofluorescence imaging (FAF), and fundus-related perimetry and to use coregistration of data sets to achieve high-resolution structure-function correlation of human macula. Twelve patients with RP and hyperautofluorescent parafoveal ring in FAF imaging were tested. Ophthalmological examination, static and kinetic fundus-related perimetry, and SD-OCT were performed. Custom software allowed coregistration of fundus-related perimetry, SD-OCT, and FAF data sets. A high correlation between retinal sensitivity and outer retinal thickness was observed (ρ = 0.72, P < 0.0001). The median retinal sensitivity over the central circular area of normal autofluorescence was significantly higher when compared with the area over the surrounding hyperautofluorescent ring and to the area outside the ring (H = 34.2, P < 0.0001). The outer retina at the site where kinetic stimuli were perceived was better preserved and had higher retinal thickness, corresponding to higher sensitivity (H = 289, P < 0.0001). The site of the hyperautofluorescent ring correlated in SD-OCT scans with a zone of impaired integrity of the photoreceptor layer (ρ = 0.67, P = 0.0003). Retinal sensitivity to static and kinetic stimuli correlates better with outer than with overall retinal thickness. The hyperautofluorescent ring in FAF represents a transition zone from relatively well-preserved to abnormal retinal morphology and function, rendering FAF imaging a clinically significant tool for assessing the severity and progression of dysfunction in RP patients. Accurate coregistration of different modalities drastically increases the power of structure-function correlation studies and allows consistent associations to be drawn.