Abstract
To investigate radial peripapillary capillary (RPC) network in patients affected by retinitis pigmentosa (RP). Eleven patients (22 eyes) with previous diagnosis of RP and 16 age-matched healthy subjects (16 eyes) were enrolled. The diagnosis of RP was made based on both clinical features and electrophysiological examination. All patients underwent a complete ophthalmologic examination, including optical coherence tomography angiography and visual field (VF). The primary outcomes were the RPC vessel density in the peripapillary and disk areas; the secondary outcomes were the peripapillary retinal nerve fiber layer (RNFL) thickness and the mean defect at VF. A total of 19 eyes of 11 RP patients (5 males, 6 females) and 16 eyes of 16 healthy subjects (10 males, 6 females) were included for the analysis. RPC vessel density in the disk area was 46.5 ± 7.1% in the RP group and 45.4 ± 10.6% in the control group (p = 0.754). RPC vessel density in the peripapillary area was significantly reduced in the RP group after the comparison with the control group (52.5 ± 5.0 and 57.2 ± 5.1%, respectively, p = 0.011). RNFL thickness was 85.9 ± 20.4 μm in the RP group and 104.0 ± 6.4 μm in the control group (p = 0.002). RPC vessel density was significantly correlated with RNFL thickness values in RP patients, both in the disk and in the peripapillary area (Rho = 0.599 and p = 0.007 in the disk area, Rho = 0.665 and p = 0.002 in the peripapillary area, respectively). We showed that density of RPC is reduced in these patients in the peripapillary area. Moreover, the RPC vessel density correlates with the RNFL thickness.
Highlights
Retinitis pigmentosa (RP) is the name used for a group of inherited retinal disorders that are characterized by progressive loss of the outer retinal cells, and resulting retinal dysfunction [1,2,3,4,5].Optic Disc Vessels in RPClinically, RP manifests initially as night blindness and is eventually followed by clear visual field (VF) loss [1, 4, 5]
Several studies recently showed vascular alterations in RP by means of Optical coherence tomography angiography (OCTA) [15,16,17,18]. These studies did not evaluate the radial peripapillary capillary (RPC) network features in RP patients. In this cross-sectional study, we investigated the RPC network changes in eyes affected by RP, and we assessed the relationships between vascular structure and retinal nerve fiber layer (RNFL) thickness
Patients were selected with a best-corrected visual acuity (BCVA) of at least 0.8 LogMAR to ensure proper execution of the examinations, intraocular pressure (IOP)
Summary
Retinitis pigmentosa (RP) is the name used for a group of inherited retinal disorders that are characterized by progressive loss of the outer retinal cells, and resulting retinal dysfunction [1,2,3,4,5].Optic Disc Vessels in RPClinically, RP manifests initially as night blindness (nyctalopia) and is eventually followed by clear visual field (VF) loss [1, 4, 5]. Characteristic findings by fundus examination include peripheral pigmented bone spicule-like lesions, retinal arteriolar attenuation, and optic disk pallor [6]. RP can be considered a photoreceptor disease; there is increasing evidence that the inner retina becomes disorganized, with retinal ganglion cell (RGC) death and retinal nerve fiber layer (RNFL) thinning, following the outer retina damage [7,8,9]. There is abundant evidence showing that vascular changes (e.g., perivascular cuffing, arteriolar attenuation, and reduced ocular blood flow) featured RP and were hypothesized to be part of the pathogenic process [10]. Optical coherence tomography angiography (OCTA) has recently been developed to study retinal and choroidal microvasculature without needing a dye injection [11]. The RPC can be considered a unique vascular plexus in the RNFL and has been showed to be highly associated with the RNFL thickness [13, 14]
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