Abstract

PurposeUsing quantitative fundus autofluorescence (qAF), we analyzed short-wavelength autofluorescent (SW-AF) rings in RP.MethodsShort-wavelength autofluorescent images (486 nm excitation) of 40 patients with RP (69 eyes) were acquired with a confocal scanning laser ophthalmoscope equipped with an internal fluorescent reference. Mean qAF was measured in eight preset segments (qAF8) and in region of interest (ROI)-qAF (200–700 μm) within and external to the borders of the rings at superior, temporal, and inferior sites relative to the ring. For both groups, qAF in patients with RP was compared to age-similar and race/ethnicity-matched healthy eyes at equivalent retinal locations.ResultsIn 71% of eyes of RP patients, qAF8 acquired internal to the inner border of the ring, was within the 95% confidence interval (CI) for healthy eyes, while in the remaining RP eyes qAF8 was either higher or lower than the CI. Measured external to the ring, qAF8 values were within the CI in 47% of RP eyes with the other eyes being higher or lower. In 28% of sites measured by ROI-qAF within the SW-AF ring, values were above the 95% CI of healthy controls. Region of interest-qAF measured just external to the ring was within the CI of healthy eyes in 74% of locations. The average local elevation in qAF within the ring was approximately 15%. In SD-OCT scans, photoreceptor-attributable reflectivity bands were thinned within and external to the ring.ConclusionsIncreased fluorophore production may be a factor in the formation of the SW-AF rings in RP.

Highlights

  • In 28% of sites measured by region of interest (ROI)-quantitative fundus autofluorescence (qAF) within the short-wavelength autofluorescent (SW-AF) ring, values were above the 95% confidence interval (CI) of healthy controls

  • Retinitis pigmentosa comprises a group of genetically heterogeneous retinal degenerative diseases characterized by progressive loss of photoreceptor cells and constriction of the visual field over time

  • Outside the SWAF ring, photoreceptor cell degeneration is evidenced by loss of the ellipsoid zone (EZ) and external limiting membrane (ELM) and thinning or absence of the reflectivity layer corresponding to outer nuclear layer (ONL) in SD-OCT scans.[6,7]

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Summary

Methods

Short-wavelength autofluorescent images (486 nm excitation) of 40 patients with RP (69 eyes) were acquired with a confocal scanning laser ophthalmoscope equipped with an internal fluorescent reference. Mean qAF was measured in eight preset segments (qAF8) and in region of interest (ROI)-qAF (200–700 lm) within and external to the borders of the rings at superior, temporal, and inferior sites relative to the ring. For both groups, qAF in patients with RP was compared to age-similar and race/ethnicity-matched healthy eyes at equivalent retinal locations. The mean age of the cohort was 33 years (range, 10–64 years); 23 patients were female. Systemic disease leading to retinal degeneration and medications such as chloroquine or hydroxychloroquine that affect macular function were reasons for exclusion

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