1
|
Wada N, Takagi S, Yoshikawa A, Itokawa T, Maruyama T, Hori Y. Multimodal Imaging of Optic Nerve Head in Retinitis Pigmentosa. Semin Ophthalmol 2024:1-8. [PMID: 38851891 DOI: 10.1080/08820538.2024.2363849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/30/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND A pallor optic nerve head (ONH) is one of the three features of retinitis pigmentosa (RP). This study aimed to assess the ONH prospectively by color tone, presence of hyper-reflective tissue, blood flow, retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) and investigate the change in these parameters with and without ONH pallor. METHODS The presence of ONH pallor was assessed by three independent examiners through careful examination using fundus photographs. The presence of a hyper-reflective structure on the ONH was carefully evaluated using a volume scan optical coherence tomography (OCT). RNFL thickness and ellipsoid zone (EZ) width around the macula were also evaluated by OCT. Laser speckle flowgraphy was used to measure the mean blur rate of the entire ONH area, which was subsequently divided into the vessel area (MV) and tissue area (MT). RESULTS Twenty-eight eyes of 28 patients with RP (55.4 ± 16.23 years of age) were included. The pale ONH was observed in 10 (35%) eyes. Hyper-reflective structures were observed in seven (25%) eyes. No significant correlation was found between the pale ONH and the presence of a hyper-reflective structure (Pearson's chi-squared test, p = .364). The average of the ONH area, MV, and MT was 8.65 ± 3.08 AU, 17.81 ± 7.54 AU, and 6.4 ± 2.66 AU, respectively, which significantly decreased in patients with pallor ONH (all p < .05). The global RNFL thickness was 73.54 ± 18.82 μm. The nasal and superior quadrants and global RNFL thickness in patients with a pale ONH were significantly thinner than in patients without a pale ONH (all p < .05). The global and superior and inferior GCC thickness in patients with a pale ONH were significantly thinner than in patients without a pale ONH(all p < .05).There was no difference in the EZ width between patients with and without a pale ONH (p = .107). CONCLUSION We conducted multiple assessments of the ONH in RP patients and investigated its clinical significance. Our findings suggest that ONH pallor may indicate a comprehensive change that emerges alongside the progression of retinal degeneration in RP. TRIAL REGISTRATION This trial was retrospectively registered in the UMIN Clinical Trial Registry (UMIN ID: 000048168).
Collapse
Affiliation(s)
- Naoko Wada
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| | - Seiji Takagi
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| | - Akiko Yoshikawa
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| | - Takashi Itokawa
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| | - Takahiro Maruyama
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
- Department of Ophthalmology, Tokyo Shinagawa Hospital, Tokyo, Japan
| | - Yuichi Hori
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| |
Collapse
|
2
|
Berni A, Arrigo A, Bianco L, Antropoli A, Saladino A, Mansour AM, Vilela M, Bandello F, Parodi MB. New insights in the multimodal imaging of retinitis pigmentosa. Eur J Ophthalmol 2024; 34:357-366. [PMID: 37113027 PMCID: PMC10898209 DOI: 10.1177/11206721231172863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023]
Abstract
Retinitis pigmentosa (RP) is a group of inherited rod-cone dystrophies, noted for a high genotypical and phenotypical heterogeneity.Traditionally, VA, visual field, and electroretinography have been used to assess RP progression. However, visual acuity and visual field tests are essentially subjective and, especially in the late stages of the disease, are unable to confidently reveal minor progression. Therefore, there is a need for novel examination modalities that rely on quantitative, structural measurements. In this regard, several non-invasive imaging techniques have been studied, including spectral-domain optical coherence tomography, optical coherence tomography angiography, and fundus autofluorescence. By correlating surrogate biomarkers with functional measurements of the disease, these techniques may be able to develop reliable outcome meters that can be used to gain a deeper understanding of the underlying causes of the disease and to assess the effectiveness of therapy even before an actual loss of vision occurs.In this review, we will summarize the recent imaging findings and biomarkers that have been identified in RP patients. Our goal is to provide information that can promptly aid in selecting patients for clinical trials and new gene therapies, monitoring the disease progression, and evaluating treatment outcomes.
Collapse
Affiliation(s)
- Alessandro Berni
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Bianco
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessio Antropoli
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Saladino
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ahmad M. Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Manuel Vilela
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | |
Collapse
|
3
|
Wei Q, Wang XY, Zhang LJ, Yu CY, Shu HY, Liao XL, Xu SH, Su T, Kang M, Shao Y. A Functional Magnetic Resonance Imaging Study Using Dynamic Amplitude of Low-Frequency Fluctuation to Assess Brain Activity in Patients with Moyamoya Disease. Brain Connect 2023; 13:621-630. [PMID: 37930733 DOI: 10.1089/brain.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction: The purpose of this study was to monitor and record the dynamic brain activity of patients with moyamoya disease (MMD), as well as to study the relationship between brain abnormalities and presenting clinical features. Methods: A total of 16 patients with MMD (2 males and 14 females) were invited to participate in the study, as were healthy controls (HCs) with the same number and sex ratio. In this study, the dynamic amplitude of low-frequency fluctuation (dALFF) was utilized to assess changes in spontaneous brain activity. Moreover, we also used correlation analysis to study the relationship among the measured mean of dALFF, behavioral performances, and the retinal nerve fiber layer and the Hospital Anxiety and Depression Scale (HADS) score to explore the potential relationship between MMD and anxiety and depression. Results: Our study reveals that in MMD, dALFF levels decreased in the left lingual gyrus, right insula, and occipital lobe. Discussion: In this study, we found and discussed the potential relationship between the abnormal activities in multiple brain regions and related functional network disorders in patients with MMD, as well as the damage to brain regions that process emotion and vision, in the hopes of providing more ideas for the clinical diagnosis and treatment of MMD.
Collapse
Affiliation(s)
- Qian Wei
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- Queen Mary School, Nanchang University, Nanchang, China
| | - Xiao-Yu Wang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Li-Juan Zhang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Chen-Yu Yu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Hui-Ye Shu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Xu-Lin Liao
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - San-Hua Xu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Ting Su
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Min Kang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Yi Shao
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
| |
Collapse
|
4
|
Cehajic-Kapetanovic J, Singh MS, Zrenner E, MacLaren RE. Bioengineering strategies for restoring vision. Nat Biomed Eng 2023; 7:387-404. [PMID: 35102278 DOI: 10.1038/s41551-021-00836-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 11/30/2021] [Indexed: 12/15/2022]
Abstract
Late-stage retinal degenerative disease involving photoreceptor loss can be treated by optogenetic therapy, cell transplantation and retinal prostheses. These approaches aim to restore light sensitivity to the retina as well as visual perception by integrating neuronal responses for transmission to the cortex. In age-related macular degeneration, some cell-based therapies also aim to restore photoreceptor-supporting tissue to prevent complete photoreceptor loss. In the earlier stages of degeneration, gene-replacement therapy could attenuate retinal-disease progression and reverse loss of function. And gene-editing strategies aim to correct the underlying genetic defects. In this Review, we highlight the most promising gene therapies, cell therapies and retinal prostheses for the treatment of retinal disease, discuss the benefits and drawbacks of each treatment strategy and the factors influencing whether functional tissue is reconstructed and repaired or replaced with an electronic device, and summarize upcoming technologies for enhancing the restoration of vision.
Collapse
Affiliation(s)
- Jasmina Cehajic-Kapetanovic
- Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, UK.
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | | | - Eberhart Zrenner
- Institute for Ophthalmic Research, Center for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Robert E MacLaren
- Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, UK
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
5
|
Ruff A, Tezel A, Tezel TH. Anatomical and functional correlates of cystic macular edema in retinitis pigmentosa. PLoS One 2022; 17:e0276629. [PMID: 36269735 PMCID: PMC9586413 DOI: 10.1371/journal.pone.0276629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Abstract
Cystoid macular edema (CME) is a major cause of central visual deterioration in retinitis pigmentosa. The exact reason for CME and its prognostic significance in this patient population is unknown. We seek to find clues to answer these questions by examining the anatomical correlations between retinal cysts and retinal morphometric parameters in a cohort of patients with retinitis pigmentosa and CME. For this reason, 103 patients (196 eyes) with untreated cystoid macular edema (CME) were identified from a pool of 578 genotyped patients with retinitis pigmentosa. Image analyses were conducted using three central horizontal OCT scans of these patients to calculate cross-sectional areas of the retinal nerve fiber layer, outer retinal, inner retinal, cysts, and total retinal areas. Lengths of the ellipsoid zone and outer limiting membrane were also measured. Best-fit curves were derived for analyzing the factors playing a role in the size of the retinal cysts and the patients’ visual acuity. Generalized Estimating Equation and multivariate linear regression analyses were conducted to determine the correlations between visual acuity, morphometric and clinical data, and the significant cyst size and visual acuity determinants. Twenty-five percent of the screened patients (103/578) had CME. Patients with autosomal dominant retinitis pigmentosa had the highest incidence of CME (43.6%, p<0.001) but also had the best visual acuity (20/34±20/30, p = 0.02). The total cyst area was 0.14±0.18 mm2. Outer retinal area (B = 0.214; p = 0.008), age (B = -0.003; p<0.001) and retinal nerve fiber area (B = 0.411; p = 0.005) were main determinants of the (r = 0.44; p<0.001) cyst size. Cysts resolved with progressing retinal degeneration. Length of the intact ellipsoid zone (B = -5.16E-5; p<0.001), the inheritance pattern (B = 0.04; p = 0.028) and retinal nerve fiber area (B = 0.751; p<0.001) were the main determinants of visual acuity. In patients with retinitis pigmentosa and cystoid macular edema, retinal nerve fiber layer thickness is associated with decreasing visual acuity and cyst size. This finding suggests that intraretinal cysts may compress retinal axons and cause subsequent visual loss in retinitis pigmentosa.
Collapse
Affiliation(s)
- Adam Ruff
- Department of Ophthalmology, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, United States of America
| | - Alangoya Tezel
- University of Michigan Medical School, Ann Arbor, MI, United States of America
| | - Tongalp H. Tezel
- Department of Ophthalmology, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, United States of America
- * E-mail:
| |
Collapse
|
6
|
Analysis of imaging biomarkers and retinal nerve fiber layer thickness in RPGR-associated retinitis pigmentosa. Graefes Arch Clin Exp Ophthalmol 2021; 259:3597-3604. [PMID: 34287692 PMCID: PMC8589744 DOI: 10.1007/s00417-021-05233-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/22/2021] [Accepted: 05/03/2021] [Indexed: 01/23/2023] Open
Abstract
Purpose To investigate multimodal retinal imaging characteristics including the retinal nerve fiber layer (RNFL) thickness in patients with RPGR-associated retinitis pigmentosa (RP). Methods This cross-sectional case–control study included 17 consecutive patients (median age, 21 years) with RPGR-associated RP who underwent retinal imaging including optical coherence tomography (OCT), short-wavelength fundus autofluorescence (AF) imaging, and RNFL scans centered on the optic disc. RNFL thickness was manually segmented and compared to clinical and imaging parameters including the transfoveal ellipsoid zone (EZ) width, the horizontal diameter of the macular hyperautofluorescent ring. RNFL thickness was compared to 17 age- and sex-matched controls. Results In patients with RPGR-associated RP, the EZ width (R2 = 0.65), the central hyperautofluorescent ring on AF images (R2 = 0.72), and visual acuity (R2 = 0.68) were negatively correlated with age. In comparison to controls, a significantly (p < 0.0001) increased global RNFL thickness was identified in RPGR-associated RP, which was, however, less pronounced in progressed disease as indicated by the EZ width or the diameter of the central hyperautofluorescent ring. Conclusions This study describes retinal characteristics in patients with RPGR-associated RP including a pronounced peripapillary RNFL thickness compared to healthy controls. These results contribute to the knowledge about imaging biomarkers in RP, which might be of interest for therapeutic approaches such as gene replacement therapies.
![]() Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05233-w.
Collapse
|
7
|
Nassisi M, Lavia C, Mohand-Said S, Smirnov V, Antonio A, Condroyer C, Sancho S, Varin J, Gaudric A, Zeitz C, Sahel JA, Audo I. Near-infrared fundus autofluorescence alterations correlate with swept-source optical coherence tomography angiography findings in patients with retinitis pigmentosa. Sci Rep 2021; 11:3180. [PMID: 33542393 PMCID: PMC7862375 DOI: 10.1038/s41598-021-82757-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/21/2020] [Indexed: 11/09/2022] Open
Abstract
Thirty-eight patients from 37 families with retinitis pigmentosa (RP) underwent macular 6 × 6-mm swept-source optical coherence tomography angiography (SS-OCTA) and 30° near-infrared fundus autofluorescence (NIR-FAF) acquisitions in one eye. Superficial vascular complex (SVC), deep capillary complex (DCC) and choriocapillaris (CC) angiograms were registered with NIR-FAF acquisitions to comparatively assess subjects with and without central area of preserved NIR-FAF (APA). On the subset of patients showing an APA, the vessel densities for SVC and DCC and flow deficits for CC were assessed in three directions (superior, inferior and temporal) from the fovea and compared to healthy 1:1 age-matched controls. Nine patients with no APA had evidence of severe central OCTA alterations at all levels, especially in the DCC. In the other 29 subjects presenting APA, all OCTA parameters were similar to healthy eyes within the APA, where the retina preserves its structural integrity. Outside the APA, both the DCC and CC were significantly reduced in all directions. These alterations are probably related to the outer retinal atrophy outside the APA. Comparing OCTA to other imaging modalities is helpful to determine the potential interest of OCTA findings as an outcome measure for disease status and progression.
Collapse
Affiliation(s)
- Marco Nassisi
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France. .,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France. .,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. .,Ophthalmological Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carlo Lavia
- Université de Paris, Ophthalmology Department, AP-HP, Hôpital Lariboisière, 75010, Paris, France.,Surgical Department, Ophthalmology Service, Azienda Sanitaria Locale TO 5, 10023, Chieri, Italy
| | - Saddek Mohand-Said
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France.,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France
| | - Vasily Smirnov
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Aline Antonio
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Christel Condroyer
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Serge Sancho
- CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France
| | - Juliette Varin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Alain Gaudric
- Université de Paris, Ophthalmology Department, AP-HP, Hôpital Lariboisière, 75010, Paris, France
| | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France.,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France.,Fondation Ophtalmologique Adolphe de Rothschild, 75019, Paris, France.,Department of Ophthalmology, University of Pittsburgh Medical School, Pittsburgh, PA, 15213, USA.,Académie des Sciences-Institut de France, 75006, Paris, France
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France. .,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France. .,Institute of Ophthalmology, University College of London, London, EC1V 9EL, UK.
| |
Collapse
|
8
|
Falfoul Y, Elleuch I, El Matri K, Ghali H, Hassairi A, Chebil A, Chaker N, El Matri L. Multimodal Imaging in Retinitis Pigmentosa: Correlations among Microvascular Changes, Macular Function and Retinal Structure. J Curr Ophthalmol 2020; 32:170-177. [PMID: 32671301 PMCID: PMC7337022 DOI: 10.4103/joco.joco_99_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/14/2019] [Accepted: 12/08/2019] [Indexed: 11/16/2022] Open
Abstract
Purpose: To analyze microvascular changes in patients with retinitis pigmentosa (RP) with relatively preserved visual acuity (VA), using swept source optical coherence tomography (SS-OCT) angiography to correlate results to macular function and structure. Methods: This was a case–control study conducted over 70 eyes of 35 RP patients with relatively preserved VA. All patients underwent a complete ophthalmic examination, including SS-OCT, OCT angiography (OCT-A), fundus autofluorescence (FAF), and multifocal electroretinogram (mfERG). Thirty-four eyes of 34 healthy controls of age-, sex-, and axial length-matched (control group), were also analyzed. The main outcome measures were foveal and parafoveal vascular densities (FVDs and PFVDs) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ) and its enlargement coefficient and their correlation with macular function (by means of VA and mfERG), and structure (by means of FAF and SS-OCT). Results: In the RP group, PFVD was 25.99 ± 5.2% in the SCP and 34.47 ± 2.37% in the DCP and were significantly lower as compared to control group (P < 0.0001; P = 0.0026, respectively). Enlargement coefficient of FAZ was 1.78 ± 0.79. We found a statistically significant correlation between VA and PFVD in the DCP (P < 0.0001), FAZ disruption in the SCP (P = 0.006) and enlargement coefficient of FAZ (P = 0.01). The parafoveal DCP density was significantly correlated with P1 amplitude (P = 0.005) in rings 2, 3, 4, and 5 of the mfERG. We found a statistically significant correlation between parafoveal density in the DCP, thickness of ganglion cell complex (GCC) (P = 0.001), and the width of ellipsoid band (P = 0.041). Parafoveal SCP density was also correlated to GCC (P = 0.033). Conclusions: We showed that vascular alteration in RP begins at the level of the DCP, which affects the outer retina and leads to a narrowing of the ellipsoid. The alteration of the SCP would occur later in the evolution of the disease. Vascular changes occur early during RP and were highly correlated to retinal function and structure. OCT-A seems to be a good tool to quantify vascular network loss and could play a central role in staging, prognosis, and monitoring disease progression.
Collapse
Affiliation(s)
- Yousra Falfoul
- B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.,Department of Ophthalmology, Hédi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Issam Elleuch
- B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.,Department of Ophthalmology, Hédi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Khaled El Matri
- B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.,Department of Ophthalmology, Hédi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Hela Ghali
- Department of Family and Community Medicine, Faculty of Medicine Ibn El Jazzar Sousse, Sousse, Tunisia
| | - Asma Hassairi
- B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.,Department of Ophthalmology, Hédi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Ahmed Chebil
- B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.,Department of Ophthalmology, Hédi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Nibrass Chaker
- B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.,Department of Ophthalmology, Hédi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Leila El Matri
- B Department, Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.,Department of Ophthalmology, Hédi Raies Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia
| |
Collapse
|
9
|
Ilhan C, Citirik M. Glial proliferation and atrophy: Two poles of optic disc in patients with retinitis pigmentosa. J Curr Ophthalmol 2019; 31:416-421. [PMID: 31844793 PMCID: PMC6896452 DOI: 10.1016/j.joco.2019.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/29/2019] [Accepted: 08/09/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose To clarify the difference of retinal nerve fiber layer (RNFL) thicknesses between patients with retinitis pigmentosa (RP) and normal subjects. Methods The study included right eyes of 30 patients with non-late-stage RP, which had a waxy pallor in OD, attenuation in retinal arterioles, and midperipheral bone spicule pigmentary changes. To compare the RNFL analysis with normal subjects, the right eyes of 30 age- and gender-matched healthy subjects were included as a control group. Results There were no differences between the RP and control groups in terms of demographic and baseline characteristics (P > 0.05, for all). The mean temporal quadrant RNFL thickness was 102.9 ± 31.7 μm (43–222) in the RP group and 72.4 ± 11.8 μm (51–90) in the control group (P < 0.001). The mean nasal quadrant RNFL thickness was 57.6 ± 33.7 μm (21–140) in the RP and 75.0 ± 14.1 μm (56–132) in the control group (P < 0.001). There were no significant RNFL thickness differences between the groups in other sectors and globally (P > 0.05, for all). There was no significant correlation between temporal RNFL thickening and ageing (r = −0.136, P = 0.196) while there was a significant correlation between nasal RNFL thinning and ageing (r = −0.274, P = 0.047). Conclusions RNFL is thicker in temporal quadrants and thinner in nasal quadrants in non-late stage RP. Age-related decreases in RNFL thickness occurred earlier in the nasal quadrant and RNFL thickening in the temporal quadrant occurred earlier than this global thinning.
Collapse
Affiliation(s)
- Cagri Ilhan
- Department of Ophthalmology, Hatay State Hospital, Hatay, Turkey
| | - Mehmet Citirik
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Research and Education Hospital, Ankara, Turkey
| |
Collapse
|
10
|
Fu DJ, Xue K, Jolly JK, MacLaren RE. A detailed in vivo analysis of the retinal nerve fibre layer in choroideremia. Acta Ophthalmol 2019; 97:e589-e600. [PMID: 30575280 DOI: 10.1111/aos.13973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 10/18/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Choroideremia is a currently incurable X-linked recessive retinal degeneration that leads to blindness. Gene therapy approaches to date target the outer retinal layers. However, the choroideremia (CHM) gene is expressed in all retinal layers, and a previous study on a small cohort of choroideremia patients suggested possible thinning of the retinal nerve fibre layer (RNFL). The purpose of the study was to examine the RNFL in detail using advanced imaging techniques in a larger cohort of choroideremia patients. METHODS Spectral domain optical coherence tomography of the peripapillary RNFL acquired with the Heidelberg Spectralis HRA circular scan mode were analysed retrospectively in 41 eyes of 21 choroideremia patients aged 39.6 years (±3.7 SEM). As age-matched controls, 20 eyes from 10 patients with retinitis pigmentosa and 56 eyes from 28 healthy individuals were also assessed. Automated RNFL segmentation was adjusted manually to precisely delineate the RNFL. The data were also compared against an external normative database. RESULTS Mean peripapillary RNFL thickness in choroideremia was 130 ± 3 μm in the right eye (OD) and 133 ± 3 μm in the left eye (OS). This was 24% and 27% thicker than RNFL thickness in the controls (p < 0.001 for both). Patients with retinitis pigmentosa also showed an increase in RNFL thickness, which was no different to the choroideremia cohort (p > 0.05). Compared with manual analysis, the automated function of the inbuilt software was consistently inaccurate in segmenting the RNFL in choroideremia. CONCLUSION The RNFL is significantly thicker in choroideremia compared with age-matched normal controls, which was similar to what was seen in retinitis pigmentosa.
Collapse
Affiliation(s)
- Dun J. Fu
- Oxford Eye Hospital Oxford University Hospitals NHS Foundation Trust Oxford UK
| | - Kanmin Xue
- Oxford Eye Hospital Oxford University Hospitals NHS Foundation Trust Oxford UK
- Nuffield Laboratory of Ophthalmology Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK
| | - Jasleen K. Jolly
- Oxford Eye Hospital Oxford University Hospitals NHS Foundation Trust Oxford UK
- Nuffield Laboratory of Ophthalmology Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK
| | - Robert E. MacLaren
- Oxford Eye Hospital Oxford University Hospitals NHS Foundation Trust Oxford UK
- Nuffield Laboratory of Ophthalmology Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK
| |
Collapse
|
11
|
Esler TB, Kerr RR, Tahayori B, Grayden DB, Meffin H, Burkitt AN. Minimizing activation of overlying axons with epiretinal stimulation: The role of fiber orientation and electrode configuration. PLoS One 2018; 13:e0193598. [PMID: 29494655 PMCID: PMC5833203 DOI: 10.1371/journal.pone.0193598] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 02/14/2018] [Indexed: 12/19/2022] Open
Abstract
Currently, a challenge in electrical stimulation of the retina with a visual prosthesis (bionic eye) is to excite only the cells lying directly under the electrode in the ganglion cell layer, while avoiding excitation of axon bundles that pass over the surface of the retina in the nerve fiber layer. Stimulation of overlying axons results in irregular visual percepts, limiting perceptual efficacy. This research explores how differences in fiber orientation between the nerve fiber layer and ganglion cell layer leads to differences in the electrical activation of the axon initial segment and axons of passage. Approach. Axons of passage of retinal ganglion cells in the nerve fiber layer are characterized by a narrow distribution of fiber orientations, causing highly anisotropic spread of applied current. In contrast, proximal axons in the ganglion cell layer have a wider distribution of orientations. A four-layer computational model of epiretinal extracellular stimulation that captures the effect of neurite orientation in anisotropic tissue has been developed using a volume conductor model known as the cellular composite model. Simulations are conducted to investigate the interaction of neural tissue orientation, stimulating electrode configuration, and stimulation pulse duration and amplitude. Main results. Our model shows that simultaneous stimulation with multiple electrodes aligned with the nerve fiber layer can be used to achieve selective activation of axon initial segments rather than passing fibers. This result can be achieved while reducing required stimulus charge density and with only modest increases in the spread of activation in the ganglion cell layer, and is shown to extend to the general case of arbitrary electrode array positioning and arbitrary target volume. Significance. These results elucidate a strategy for more targeted stimulation of retinal ganglion cells with experimentally-relevant multi-electrode geometries and achievable stimulation requirements.
Collapse
Affiliation(s)
- Timothy B. Esler
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Victoria, Australia
- * E-mail:
| | - Robert R. Kerr
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Victoria, Australia
- Seer Medical, Melbourne, Victoria, Australia
| | - Bahman Tahayori
- Monash Institute of Medical Engineering, Monash University, Clayton, Victoria, Australia
| | - David B. Grayden
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Neural Engineering, The University of Melbourne, Parkville, Victoria, Australia
| | - Hamish Meffin
- National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia
- ARC Centre of Excellence for Integrative Brain Function, Optometry & Vision Science, The University of Melbourne, Parkville, Victoria, Australia
| | - Anthony N. Burkitt
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
12
|
Yoon CK, Yu HG. Ganglion cell-inner plexiform layer and retinal nerve fibre layer changes within the macula in retinitis pigmentosa: a spectral domain optical coherence tomography study. Acta Ophthalmol 2018; 96:e180-e188. [PMID: 29098796 DOI: 10.1111/aos.13577] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/01/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE To investigate how macular ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fibre layer (RNFL) thicknesses within the macula change with retinitis pigmentosa (RP) severity. METHODS Spectral domain optical coherence tomography (SD-OCT) was used to examine 177 patients with RP and 177 normal controls. An optical coherence tomography (OCT) line scan was used to grade RP severity. Retinitis pigmentosa (RP) was categorized as more advanced if there was no identifiable inner segment ellipsoid (ISe) band (NISE) and as less advanced if an ISe band could be identified and peripheral loss of ISe was apparent (IISE). Ganglion cell-inner plexiform layer (GCIPL) and RNFL thicknesses were manually measured on OCT images and analysed. Pearson's correlation analyses were used to examine correlations between GCIPL thickness, RNFL thickness, visual acuity (VA) and visual field extent in patients and controls. RESULTS Ganglion cell-inner plexiform layer (GCIPL) was significantly thicker in IISE than in control eyes (p < 0.001), but significantly thinner in NISE than in IISE eyes (p < 0.001) in both horizontal and vertical OCT scans. Retinal nerve fibre layer (RNFL) was significantly thicker in eyes with IISE and NISE than in control eyes in both horizontal and vertical meridians (all p < 0.001). Ganglion cell-inner plexiform layer (GCIPL) thickness showed a weak positive correlation with vision, and RNFL thickness showed a weak negative correlation with vision and visual field extent. CONCLUSION Based on these results, the inner retina, including the GCIPL and RNFL, maintains its gross integrity longer than the photoreceptor layer in RP. Additionally, thickening of the inner retina may have some functional implications in patients with RP.
Collapse
Affiliation(s)
- Chang Ki Yoon
- Department of Ophthalmology; Inje University Busan Paik Hospital; Busan Korea
- Department of Ophthalmology; Seoul National University College of Medicine; Seoul Korea
| | - Hyeong Gon Yu
- Department of Ophthalmology; Seoul National University College of Medicine; Seoul Korea
- Department of Ophthalmology; Seoul National University Hospital; Seoul Korea
| |
Collapse
|
13
|
Tsai JC. Acute angle closure following periorbital botulinum toxin injection in a patient with retinitis pigmentosa. Taiwan J Ophthalmol 2017; 7:104-107. [PMID: 29018766 PMCID: PMC5602147 DOI: 10.4103/tjo.tjo_41_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 50-year-old female presented with bilateral retinitis pigmentosa (RP) and acute angle closure (AAC) with fixed mid-dilated pupil and high intraocular pressure (IOP) in the left eye following left side periorbital botulinum toxin A injection for blepharospasm. Glaucomatous optic neuropathy and retinal nerve fiber layer defect were observed in the affected eye using optical coherence tomography although the IOP was maintained at <21 mmHg after the treatment. Botulinum toxin acts at the cholinergic synapse and inhibits acetylcholine release; hence, it can cause transient mydriasis and may lead to AAC in high-risk populations such as patients with RP. Patients should be explained about the possible development of mydriasis associated with botulinum toxin injection, and clinicians must evaluate the level of risk for AAC before administration of botulinum toxin around the eyelid. In cases showing side effects associated with botulinum toxin injection, early diagnosis and treatment is required to prevent blindness.
Collapse
Affiliation(s)
- Jen-Chia Tsai
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| |
Collapse
|
14
|
Retinal and choroidal vascular features in patients with retinitis pigmentosa imaged by OCT based microangiography. Graefes Arch Clin Exp Ophthalmol 2017; 255:1287-1295. [PMID: 28314954 DOI: 10.1007/s00417-017-3633-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/06/2017] [Accepted: 03/06/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To image vascular features of retinitis pigmentosa (RP) using optical coherence tomography angiography (OCTA). METHODS Patients with RP were imaged by spectral domain optical coherence tomography based angiography (OCTA). The optical microangiography (OMAG) algorithm was applied to scanned datasets to generate 3D OCTA retinal angiograms, i.e., OMAG angiograms. Motion tracking was used to minimize artifacts due to eye movement, and large field of view OMAG angiograms were achieved through a montage scanning protocol. For better visualization, depth volumes were segmented to separate the superficial retinal layers from deep outer retinal layers. The choriocapillaris and other choroidal layers were also segmented. To investigate the changes in retinal architecture, the inner segment/outer segment (IS/OS) junction to RPE layer was segmented to generate en face structural images through averaging intensity projection. Color fundus images and/or Goldmann visual fields were available for comparison of the findings to OMAG images. RESULTS A total of 25 eyes (13 patients, seven women and six men) diagnosed with RP at various stages were enrolled in this study from October 2014 to January 2016 and imaged by OCTA. The resulting OMAG angiograms provided detailed visualization of retinal and choroidal vascular networks presented within the retina and choroid in a large field of view (FOV) (∼6.7 mm × 6.7 mm). All patients with a severity score greater than 3 showed abnormal microvasculature in both deep retinal and choroidal layers on OMAG images. Images of patients with a score of 4 indicating only peripheral abnormalities demonstrated relatively normal vasculature networks. Microvascular changes in the retinal and choroidal vasculature correlate with structural changes in the slab from IS/OS junction to RPE layer. CONCLUSIONS OCTA is useful in evaluating the microvascular changes in a large FOV encompassing the maculae of patients with RP. The large FOV of OMAG angiograms, enabled by the motion tracking, provides visualization of high definition and high resolution microvascular networks at varying stages of RP. Microvascular imaging may have significant utility in the diagnosis and monitoring of disease progression in RP patients.
Collapse
|
15
|
Ferreira S, Pereira AC, Quendera B, Reis A, Silva ED, Castelo-Branco M. Primary visual cortical remapping in patients with inherited peripheral retinal degeneration. NEUROIMAGE-CLINICAL 2016; 13:428-438. [PMID: 28116235 PMCID: PMC5233796 DOI: 10.1016/j.nicl.2016.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/10/2016] [Accepted: 12/14/2016] [Indexed: 12/17/2022]
Abstract
Human studies addressing the long-term effects of peripheral retinal degeneration on visual cortical function and structure are scarce. Here we investigated this question in patients with Retinitis Pigmentosa (RP), a genetic condition leading to peripheral visual degeneration. We acquired functional and anatomical magnetic resonance data from thirteen patients with different levels of visual loss and twenty-two healthy participants to study primary (V1) visual cortical retinotopic remapping and cortical thickness. We identified systematic visual field remapping in the absence of structural changes in the primary visual cortex of RP patients. Remapping consisted in a retinotopic eccentricity shift of central retinal inputs to more peripheral locations in V1. Importantly, this was associated with changes in visual experience, as assessed by the extent of the visual loss, with more constricted visual fields resulting in larger remapping. This pattern of remapping is consistent with expansion or shifting of neuronal receptive fields into the cortical regions with reduced retinal input. These data provide evidence for functional changes in V1 that are dependent on the magnitude of peripheral visual loss in RP, which may be explained by rapid cortical adaptation mechanisms or long-term cortical reorganization. This study highlights the importance of analyzing the retinal determinants of brain functional and structural alterations for future visual restoration approaches.
Collapse
Key Words
- FPZ, Function Projection Zone
- Functional magnetic resonance imaging (fMRI)
- Human
- LE, Left Eye
- LH, Left Hemisphere
- LPZ, Lesion Projection Zone
- MRI, Magnetic Resonance Imaging
- Plasticity
- Primary visual cortex
- RE, Right Eye
- RH, Right Hemisphere
- RNFL, Retinal Nerve Fiber Layer
- RP, Retinitis Pigmentosa
- Reorganization
- Retinitis pigmentosa
- Retinotopy
- fMRI, functional Magnetic Resonance Imaging
Collapse
Affiliation(s)
- Sónia Ferreira
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Andreia Carvalho Pereira
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Bruno Quendera
- Institute of Nuclear Sciences Applied to Health (ICNAS), Brain Imaging Network of Portugal, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Aldina Reis
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Ophthalmology Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000-075 Coimbra, Portugal
| | - Eduardo Duarte Silva
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Miguel Castelo-Branco
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Institute of Nuclear Sciences Applied to Health (ICNAS), Brain Imaging Network of Portugal, University of Coimbra, 3000-548 Coimbra, Portugal
| |
Collapse
|
16
|
Liu G, Li H, Liu X, Xu D, 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) 2016; 95:e5785. [PMID: 28033301 PMCID: PMC5207597 DOI: 10.1097/md.0000000000005785] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to examine changes in photoreceptor ellipsoid zone (EZ) and postreceptor retinal layer in retinitis pigmentosa (RP) patients by ganglion cell analysis (GCA) combined with optical coherence tomography (OCT) imaging to evaluate the structure-function relationships between retinal layer changes and best corrected visual acuity (BCVA). Sixty-eight eyes of 35 patients with RP and 65 eyes of 35 normal controls were analyzed in the study. The average length of EZ was 911.1 ± 208.8 μm in RP patients, which was shortened with the progression of the disease on the OCT images. The average ganglion cell-inner plexiform layer thickness (GCIPLT) was 54.7 ± 18.9 μm in RP patients, while in normal controls it was 85.6 ± 6.8 μm. The GCIPLT in all quarters became significantly thinner along with outer retinal thinning. There was a significantly positive correlation between BCVA and EZ (r = -0.7622, P < 0.001) and GCIPLT (r = -0.452, P < 0.001). Therefore, we assess the retinal layer changes from a new perspective in RP patients, which suggests that EZ and GCIPLT obtained by GCA combined with OCT imaging are the direct and valid indicators to diagnosis and predict the pathological process of RP.
Collapse
|
17
|
Alshareef RA, You Q, Barteselli G, Rao HL, Goud A, Chhablani J. In Vivo Evidence of Inner Retinal Neurodegeneration in Retinitis Pigmentosa Using Spectral-Domain Optical Coherence Tomography. Ophthalmic Surg Lasers Imaging Retina 2016; 47:828-35. [PMID: 27631478 DOI: 10.3928/23258160-20160901-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 06/23/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the topographic changes in macular ganglion cell inner plexiform layer (GCIPL) thickness in eyes with retinitis pigmentosa (RP). PATIENTS AND METHODS Forty-five eyes of 25 subjects with RP who underwent spectral-domain optical coherence tomography (SD-OCT) using the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA) were analyzed retrospectively. A control group of 67 eyes of 48 age-matched healthy volunteers was also included for comparison. Average, minimum, and sectoral macular GCIPL, as well as retinal nerve fiber layer (RNFL) and outer retinal (OR) thicknesses, were collected and compared between RP and control groups. RESULTS The average and sectoral macular GCIPL thicknesses were significantly reduced in RP eyes compared with controls (P < .0001). Average macular RNFL thickness was reduced in RP eyes compared with controls (P < .054). CONCLUSIONS In eyes with RP, display reduced GCIPL, RNFL, and OR thickness. The identification of alteration in RNFL, OR, and GCIPL thickness may be useful for future therapeutic implications. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:828-835.].
Collapse
|
18
|
Liu G, Liu X, Li H, Du Q, Wang F. Optical Coherence Tomographic Analysis of Retina in Retinitis Pigmentosa Patients. Ophthalmic Res 2016; 56:111-22. [DOI: 10.1159/000445063] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/27/2016] [Indexed: 11/19/2022]
|
19
|
Analysis of the Retinal Nerve Fiber Layer in Retinitis Pigmentosa Using Optic Coherence Tomography. J Ophthalmol 2015; 2015:157365. [PMID: 26351569 PMCID: PMC4553185 DOI: 10.1155/2015/157365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/23/2015] [Accepted: 07/05/2015] [Indexed: 11/18/2022] Open
Abstract
Aim. To evaluate the peripapillary retinal nerve fiber layer (RNFL) changes in retinitis pigmentosa (RP) patients using spectral domain optic coherence tomography (Sd-OCT). Methods. We retrospectively examined medical records of forty-four eyes of twenty-two RP patients. The results were also compared with those of previously reported forty-four eyes of twenty-two normal subjects (controls). Records of average and four quadrants peripapillary RNFL thickness measurements using Sd-OCT were assessed. Results. In RP patients the mean RNFL thickness was 97.57 ± 3.21 μm. The RNFL in the superior, temporal, nasal, and inferior quadrants was 119.18 ± 4.47 μm, 84.68 ± 2.31 μm, 75.09 ± 3.34 μm, and 113.88 ± 4.25 μm, respectively. While the thinning of RNFL was predominantly observed in the inferior quadrant, the thickening was mostly noted in temporal quadrant. The differences between mean, superior, and nasal quadrant RNFL thicknesses were not statistically significant when compared with control group. The RP patients had thinner inferior quadrant and thicker temporal quadrant than control group (p < 0.05). Conclusion. Sd-OCT is highly sensitive and effective instrument to detect RNFL changes in RP patients. RNFL measurements can provide information about the progression of retinitis pigmentosa and may provide prognostic indices for future treatment modalities.
Collapse
|
20
|
Yao X, Wang B. Intrinsic optical signal imaging of retinal physiology: a review. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:090901. [PMID: 26405819 PMCID: PMC4689108 DOI: 10.1117/1.jbo.20.9.090901] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/31/2015] [Indexed: 05/09/2023]
Abstract
Intrinsic optical signal (IOS) imaging promises to be a noninvasive method for high-resolution examination of retinal physiology, which can advance the study and diagnosis of eye diseases. While specialized optical instruments are desirable for functional IOS imaging of retinal physiology, in depth understanding of multiple IOS sources in the complex retinal neural network is essential for optimizing instrument designs. We provide a brief overview of IOS studies and relationships in rod outer segment suspensions, isolated retinas, and intact eyes. Recent developments of line-scan confocal and functional optical coherence tomography (OCT) instruments have allowed in vivo IOS mapping of photoreceptor physiology. Further improvements of the line-scan confocal and functional OCT systems may provide a feasible solution to pursue functional IOS mapping of human photoreceptors. Some interesting IOSs have already been detected in inner retinal layers, but better development of the IOS instruments and software algorithms is required to achieve optimal physiological assessment of inner retinal neurons.
Collapse
Affiliation(s)
- Xincheng Yao
- University of Illinois at Chicago, Department of Bioengineering, Chicago, Illinois 60607, United States
- University of Illinois at Chicago, Department of Ophthalmology and Visual Sciences, Chicago, Illinois 60612, United States
| | - Benquan Wang
- University of Illinois at Chicago, Department of Bioengineering, Chicago, Illinois 60607, United States
| |
Collapse
|
21
|
Ogino K, Oishi M, Oishi A, Morooka S, Sugahara M, Gotoh N, Kurimoto M, Yoshimura N. Radial fundus autofluorescence in the periphery in patients with X-linked retinitis pigmentosa. Clin Ophthalmol 2015; 9:1467-74. [PMID: 26316687 PMCID: PMC4544811 DOI: 10.2147/opth.s89371] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the peripheral autofluorescence images and clinical features of patients with retinal dystrophy who showed radial fundus autofluorescence (FAF) at the posterior pole. Methods The authors retrospectively reviewed pooled wide-field FAF images of 711 patients with retinal dystrophy and 56 family members. Results Eleven eyes of seven women exhibited radial FAF at the posterior pole. Wide-field FAF showed extension of the radial pattern to the periphery in all eyes except one. One woman showed radial hyper-FAF only in the periphery, not at the posterior pole. These eight individuals were X-linked retinitis pigmentosa patients or carriers. The tapetal-like reflex was not observed in their color fundus photographs. The peripheral visual field showed wedge-shaped restriction in some individuals. Conclusion Wide-field FAF imaging can depict radial FAF not only at the posterior pole but also in the periphery in X-linked retinitis pigmentosa carriers. The authors therefore agree with previous reports that radial FAF may be a hallmark of X-linked retinitis pigmentosa.
Collapse
Affiliation(s)
- Ken Ogino
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Maho Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Morooka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masako Sugahara
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Norimoto Gotoh
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan ; Center for Genomic Medicine, Kyoto University, Kyoto, Japan
| | | | - Nagahisa Yoshimura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
22
|
Al Rashaed S, Khan AO, Nowilaty SR, Edward DP, Kozak I. Spectral-domain optical coherence tomography reveals prelaminar membranes in optic nerve head pallor in eyes with retinitis pigmentosa. Graefes Arch Clin Exp Ophthalmol 2015; 254:77-81. [PMID: 25900815 DOI: 10.1007/s00417-015-3015-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/30/2015] [Accepted: 04/07/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To determine the relationship between prelaminar structural changes of the optic nerve head (ONH) and optic nerve waxy pallor in retinitis pigmentosa (RP) using spectral-domain optical coherence tomography (SD-OCT) and fundus photography. METHODS An observational cross-sectional case control study of patients with RP with and without ONH waxy pallor and controls. Subjects underwent clinical examination, fundus photography, and SD-OCT raster imaging of the ONH. Four independent specialists reviewed the images in a masked fashion. RESULTS Fifty-five eyes of 31 subjects with RP and 28 eyes of 14 controls were included. Optic nerve head waxy pallor was seen in 29 RP eyes (52.7 %) and none in controls. SD-OCT showed a hyper-reflective structure suggestive of a glial membrane-like structure on the surface of ONH in 16 of RP eyes (55.1 %). In the RP group, there was a significant positive correlation between the ONH pallor and the presence of a prelaminar structure (p = 0.006). CONCLUSIONS There is a presence of glial membrane-like structures on the optic nerve head surface in eyes with RP compared to healthy eyes. As the presence of glial membranes correlated with the presence of ONH waxy pallor, in such cases these membranes might be responsible for ONH waxy pallor.
Collapse
Affiliation(s)
- Saba Al Rashaed
- King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Kingdom of Saudi Arabia
| | - Arif O Khan
- King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Kingdom of Saudi Arabia
| | - Sawsan R Nowilaty
- King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Kingdom of Saudi Arabia
| | - Deepak P Edward
- King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Kingdom of Saudi Arabia
| | - Igor Kozak
- King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Kingdom of Saudi Arabia.
| |
Collapse
|
23
|
Ohno N, Murai H, Suzuki Y, Kiyosawa M, Tokumaru AM, Ishii K, Ohno-Matsui K. Alteration of the optic radiations using diffusion-tensor MRI in patients with retinitis pigmentosa. Br J Ophthalmol 2015; 99:1051-4. [DOI: 10.1136/bjophthalmol-2014-305809] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 01/12/2015] [Indexed: 11/04/2022]
|
24
|
Ogawa S, Takemura H, Horiguchi H, Terao M, Haji T, Pestilli F, Yeatman JD, Tsuneoka H, Wandell BA, Masuda Y. White matter consequences of retinal receptor and ganglion cell damage. Invest Ophthalmol Vis Sci 2014; 55:6976-86. [PMID: 25257055 DOI: 10.1167/iovs.14-14737] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Patients with Leber hereditary optic neuropathy (LHON) and cone-rod dystrophy (CRD) have central vision loss; but CRD damages the retinal photoreceptor layer, and LHON damages the retinal ganglion cell (RGC) layer. Using diffusion MRI, we measured how these two types of retinal damage affect the optic tract (ganglion cell axons) and optic radiation (geniculo-striate axons). METHODS Adult onset CRD (n = 5), LHON (n = 6), and healthy controls (n = 14) participated in the study. We used probabilistic fiber tractography to identify the optic tract and the optic radiation. We compared axial and radial diffusivity at many positions along the optic tract and the optic radiation. RESULTS In both types of patients, diffusion measures within the optic tract and the optic radiation differ from controls. The optic tract change is principally a decrease in axial diffusivity; the optic radiation change is principally an increase in radial diffusivity. CONCLUSIONS Both photoreceptor layer (CRD) and retinal ganglion cell (LHON) retinal disease causes substantial change in the visual white matter. These changes can be measured using diffusion MRI. The diffusion changes measured in the optic tract and the optic radiation differ, suggesting that they are caused by different biological mechanisms.
Collapse
Affiliation(s)
- Shumpei Ogawa
- Department of Psychology, Stanford University, Stanford, California, United States Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromasa Takemura
- Department of Psychology, Stanford University, Stanford, California, United States Department of Psychology, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Horiguchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Masahiko Terao
- Department of Psychology, The University of Tokyo, Tokyo, Japan Tamagawa University Brain Science Institute, Machida, Japan
| | - Tomoki Haji
- Department of Ophthalmology, Atsugi City Hospital, Kanagawa, Japan
| | - Franco Pestilli
- Department of Psychology, Stanford University, Stanford, California, United States
| | - Jason D Yeatman
- Department of Psychology, Stanford University, Stanford, California, United States
| | - Hiroshi Tsuneoka
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Brian A Wandell
- Department of Psychology, Stanford University, Stanford, California, United States
| | - Yoichiro Masuda
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan The Japan Society for the Promotion of Science, Tokyo, Japan
| |
Collapse
|
25
|
Opie NL, Ayton LN, Apollo NV, Ganesan K, Guymer RH, Luu CD. Optical Coherence Tomography-Guided Retinal Prosthesis Design: Model of Degenerated Retinal Curvature and Thickness for Patient-Specific Devices. Artif Organs 2014; 38:E82-94. [DOI: 10.1111/aor.12287] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Nicholas L. Opie
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; The University of Melbourne; Melbourne Victoria Australia
| | - Lauren N. Ayton
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; The University of Melbourne; Melbourne Victoria Australia
| | - Nicholas V. Apollo
- Melbourne Materials Institute; Department of Physics; The University of Melbourne; Melbourne Victoria Australia
| | - Kumaravelu Ganesan
- Melbourne Materials Institute; Department of Physics; The University of Melbourne; Melbourne Victoria Australia
| | - Robyn H. Guymer
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; The University of Melbourne; Melbourne Victoria Australia
| | - Chi D. Luu
- Centre for Eye Research Australia; Royal Victorian Eye and Ear Hospital; The University of Melbourne; Melbourne Victoria Australia
| |
Collapse
|
26
|
Gorovoy IR, Gallagher DS, Eller AW, Mayercik VA, Friberg TR, Schuman JS. Cystoid macular edema in retinitis pigmentosa patients without associated macular thickening. Semin Ophthalmol 2013; 28:79-83. [PMID: 23448561 DOI: 10.3109/08820538.2012.760614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the occurrence of cystoid macular edema (CME) in the setting of central foveal thickness (CFT) under 250 μm as measured by optical coherence tomography (OCT) in patients with retinitis pigmentosa (RP). METHODS Stratus OCT was used to measure CFT in a total of 90 eyes from 46 patients with RP. Cross-sectional OCT images were also evaluated for CME, which was defined as cystoid changes in the macula seen on at least two linear scans. RESULTS CME was identified in 13 of the 46 patients or in 22 of 90 eyes by OCT. In eyes with macular edema, CFT ranged from 224 to 718 μm (mean = 339 ± 137 μm). In eyes without macular edema, CFT ranged from 99 to 273 μm (mean = 184 ± 40 μm). Bilateral CME occurred in 9 of 13 patients (69%). CFT was considered "normal" in 7 of the 22 eyes (32%) with CME. Two patients had bilateral CME with normal CFTs, under 250 μm. CONCLUSION We demonstrate the occurrence of CME in RP patients without associated thickening, which has not been described. This concept likely is applicable to other diseases with retinal thinning.
Collapse
Affiliation(s)
- Ian R Gorovoy
- University of California, San Francisco, Department of Ophthalmology, San Francisco, California, USA
| | | | | | | | | | | |
Collapse
|
27
|
Oishi A, Ogino K, Nakagawa S, Makiyama Y, Kurimoto M, Otani A, Yoshimura N. Longitudinal analysis of the peripapillary retinal nerve fiber layer thinning in patients with retinitis pigmentosa. Eye (Lond) 2013; 27:597-604. [PMID: 23519274 DOI: 10.1038/eye.2013.34] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE To investigate longitudinal changes in peripapillary retinal nerve fiber layer (RNFL) thickness in patients with retinitis pigmentosa (RP). METHODS We re-examined 103 RP patients whose RNFL thickness was previously examined and reported. RNFL thickness was measured using Stratus optical coherence tomography and was compared with the previous measurements. The results were also compared with that of previously reported normal subjects. Association between the decrease rate and visual acuity, and visual field was also investigated. RESULTS The mean follow-up period was 56.9 months. After excluding the patients in whom RNFL images were of poor quality, 88 patients were eventually analyzed. The average RNFL thickness decreased from 105.8 to 98.2 μm during the period, with the average rate of decrease being 1.6 μm/year. The decrease in RNFL was more evident in superior and inferior sectors. Cross-sectional linear regression analysis also revealed an age-dependent decrease in RNFL, with the slower rate of decrease being 0.94 μm/year. The decrease in RNFL thickness was significantly faster than that reported in normal subjects. The decrease rate was not associated with visual functions. CONCLUSION Age-dependent RNFL thinning occurs at a faster rate in RP patients as compared with that in normal subjects. The result supports the notion that pathologic changes involve inner retina as well as outer retina in eyes with RP. Considering the discrepancy in the rate of RNFL thinning estimated from trend analysis and longitudinal measurement, care should be taken when interpreting the result of cross-sectional analysis.
Collapse
Affiliation(s)
- A Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | | | | | | | | | | | | |
Collapse
|
28
|
Zhang QX, Lu RW, Curcio CA, Yao XC. In vivo confocal intrinsic optical signal identification of localized retinal dysfunction. Invest Ophthalmol Vis Sci 2012; 53:8139-45. [PMID: 23150616 PMCID: PMC3522438 DOI: 10.1167/iovs.12-10732] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/25/2012] [Accepted: 11/04/2012] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The purposes of this study were to investigate the physiological mechanism of stimulus-evoked fast intrinsic optical signals (IOSs) recorded in dynamic confocal imaging of the retina, and to demonstrate the feasibility of in vivo confocal IOS mapping of localized retinal dysfunctions. METHODS A rapid line-scan confocal ophthalmoscope was constructed to achieve in vivo confocal IOS imaging of frog (Rana pipiens) retinas at cellular resolution. In order to investigate the physiological mechanism of confocal IOS, comparative IOS and electroretinography (ERG) measurements were made using normal frog eyes activated by variable-intensity stimuli. A dynamic spatiotemporal filtering algorithm was developed to reject the contamination of hemodynamic changes on fast IOS recording. Laser-injured frog eyes were employed to test the potential of confocal IOS mapping of localized retinal dysfunctions. RESULTS Comparative IOS and ERG experiments revealed a close correlation between the confocal IOS and retinal ERG, particularly the ERG a-wave, which has been widely used to evaluate photoreceptor function. IOS imaging of laser-injured frog eyes indicated that the confocal IOS could unambiguously detect localized (30 μm) functional lesions in the retina before a morphological abnormality is detectable. CONCLUSIONS The confocal IOS predominantly results from retinal photoreceptors, and can be used to map localized photoreceptor lesion in laser-injured frog eyes. We anticipate that confocal IOS imaging can provide applications in early detection of age-related macular degeneration, retinitis pigmentosa, and other retinal diseases that can cause pathological changes in the photoreceptors.
Collapse
Affiliation(s)
| | - Rong-Wen Lu
- From the Departments of Biomedical Engineering
| | | | - Xin-Cheng Yao
- From the Departments of Biomedical Engineering
- Vision Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| |
Collapse
|
29
|
Optical coherence tomography in retinitis pigmentosa: reproducibility and capacity to detect macular and retinal nerve fiber layer thickness alterations. Retina 2012; 32:1581-91. [PMID: 22922847 DOI: 10.1097/iae.0b013e318242b838] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To evaluate the ability of time-domain and Fourier-domain optical coherence tomographies (OCTs) to detect macular and retinal nerve fiber layer atrophies in retinitis pigmentosa (RP). To test the intrasession reproducibility using three OCT instruments (Stratus, Cirrus, and Spectralis). METHODS Eighty eyes of 80 subjects (40 RP patients and 40 healthy subjects) underwent a visual field examination, together with 3 macular scans and 3 optic disk evaluations by the same experienced examiner using 3 OCT instruments. Differences between healthy and RP eyes were compared. The relationship between measurements with each OCT instrument was evaluated. Repeatability was studied by intraclass correlation coefficients and coefficients of variation. RESULTS Macular and retinal nerve fiber layer atrophies were detected in RP patients for all OCT parameters. Macular and retinal nerve fiber layer thicknesses, as determined by the different OCTs, were correlated but significantly different (P < 0.05). Reproducibility was moderately high using Stratus, good using Cirrus and Spectralis, and excellent using the Tru-track technology of Spectralis. In RP eyes, measurements showed higher variability compared with healthy eyes. CONCLUSION Differences in thickness measurements existed between OCT instruments, despite there being a high degree of correlation. Fourier-domain OCT can be considered a valid and repeatability technique to detect retinal nerve fiber layer atrophy in RP patients.
Collapse
|
30
|
Xue K, Wang M, Chen J, Huang X, Xu G. Retinal nerve fiber layer analysis with scanning laser polarimetry and RTVue-OCT in patients of retinitis pigmentosa. ACTA ACUST UNITED AC 2012; 229:38-42. [PMID: 23075489 DOI: 10.1159/000337227] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 02/02/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE To measure the thickness of the retinal nerve fiber layer (RNFL) of patients with retinitis pigmentosa (RP) and that of normal controls by scanning laser polarimetry with enhanced corneal compensation (GDxECC) and RTVue-optical coherence tomography (OCT). METHODS Fifty-two eyes of 26 patients were included. All patients underwent complete ophthalmological examinations and testing with GDxECC. Twenty-eight of 52 eyes of RP patients underwent RTVue-OCT measurements. A group of 50 eyes of 25 normal subjects (controls) was also included. GDxECC measured RNFL thickness in the peripapillary area in all subjects as well as temporal-superior-nasal-inferior-temporal (TSNIT) parameters, including TSNIT means, superior and inferior region means, TSNIT standard deviation (SD), inter-eye symmetry and nerve fiber indicator (NFI). RTVue-OCT measured the mean, superior, inferior, temporal and nasal quadrant RNFL thickness. RESULT In RP patients and controls, TSNIT means by GDxECC were, respectively, 65.00 ± 7.35 and 55.32 ± 5.20. Mean superior quadrant thicknesses were 80.56 ± 10.93 and 69.54 ± 7.45. Mean inferior thicknesses were 80.58 ± 9.34 and 69.12 ± 7.78. SDs were 27.92 ± 5.21 and 28.23 ± 4.01. Inter-eye symmetries were 0.82 ± 0.17 and 0.87 ± 0.09. NFIs were 9.74 ± 8.73 and 16.81 ± 8.13. The differences between mean TSNIT, mean superior and mean inferior quadrant thicknesses and NFIs were statistically significant (p < 0.001). In RTVue-OCT measurements, the differences between mean, superior, inferior and temporal quadrant RNFL thicknesses were statistically significant (p = 0.0322, 0.0213, 0.0387, 0.0005). CONCLUSIONS The RNFL measured by GDxECC was significantly thicker in RP patients than in controls. RNFL thickness measured by RTVue-OCT was significantly greater in RP patients than in controls in the superior, inferior and temporal regions. This contribution provides information on RNFL thickness and discusses the mechanism underlying this phenomenon.
Collapse
Affiliation(s)
- Kang Xue
- Department of Ophthalmology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | | | | | | | | |
Collapse
|
31
|
Hwang YH, Kim SW, Kim YY, Na JH, Kim HK, Sohn YH. Optic Nerve Head, Retinal Nerve Fiber Layer, and Macular Thickness Measurements in Young Patients with Retinitis Pigmentosa. Curr Eye Res 2012; 37:914-20. [DOI: 10.3109/02713683.2012.688163] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
32
|
Evaluation of retinal nerve fiber layer thickness in patients with retinitis pigmentosa using spectral-domain optical coherence tomography. Retina 2012; 32:358-63. [PMID: 21878852 DOI: 10.1097/iae.0b013e31821a891a] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To measure the peripapillary retinal nerve fiber layer (RNFL) thickness using spectral-domain optical coherence tomography in patients with retinitis pigmentosa. METHODS Fifty eyes of 30 patients with retinitis pigmentosa underwent a complete ocular examination, including best-corrected visual acuity using a Snellen chart, slit-lamp biomicroscopic examination, and Goldmann applanation intraocular pressure measurement. Dilated fundus examination was performed using both direct and indirect ophthalmoscopy. In addition, all patients underwent peripapillary RNFL thickness measurements using an OPKO spectral-domain optical coherence tomography (OPKO Instrumentations, Miami, FL). RESULTS The mean (± SD) age of the study cohort was 45.8 (± 16.3) years. Of the 50 eyes, 18 (36%) showed a thinning of the peripapillary RNFL in 1 or more quadrants and 21 (42%) showed a thickening of the peripapillary RNFL in 1 or more quadrants. Four eyes (8%) showed both thinning and thickening of the peripapillary RNFL thickness. The overall circumferential RNFL thickness of the 14 eyes that showed only thinning in at least 1 quadrant was 78.78 μm. For the 17 eyes that showed only thickening in at least 1 quadrant, the RNFL thickness was 119.69 μm. The values of the eyes with thinning and the eyes with thickening were significantly different from normal (t = 6.31 and P < 0.01 for thickening; t = 3.62 and P < 0.01 for thinning). CONCLUSION Using spectral-domain optical coherence tomography testing, we demonstrated in the current study that the peripapillary RNFL thickness in patients with RP can be decreased, increased, or maintained within normal limits. Assessment of the RNFL thickness seems prudent in these patients, particularly for identifying notable degrees of RNFL thinning in those being considered for future therapeutic trials.
Collapse
|
33
|
Sobacı G, Ozge G, Gündoğan FÇ. Cone dysfunctions in retinitis pigmentosa with retinal nerve fiber layer thickening. Clin Ophthalmol 2012; 6:473-8. [PMID: 22536039 PMCID: PMC3334214 DOI: 10.2147/opth.s28938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose To investigate whether or not thicker retinal nerve fiber layer (RNFL) in retinitis pigmentosa (RP) patients relates to functional abnormalities of the photoreceptors. Methods Optical coherence tomography-based RNFL thickness was measured by Stratus-3™ (Zeiss, Basel, Switzerland) optical coherence tomography and electroretinogram (ERG) recordings made using the RETI-port® system (Roland, Wiesbaden, Germany) in 27 patients with retinitis pigmentosa and in 30 healthy subjects. Results Photopic ERG b-wave amplitude, cone ERG b-wave latency, 30 Hz flicker amplitude, and 30 Hz flicker latency had significant correlations to the RNFL-temporal (r = −0.55, P = 0.004, r = 0.68, P = 0.001, r = −0.65, P = 0.001, and r = −0.52, P = 0.007, respectively). Eyes with thicker RNFL (ten eyes) differed significantly from those with thinner RNFL (eight eyes) regarding cone ERG b-wave latency values only (P = 0.001). Conclusion Thicker RNFL in patients with retinitis pigmentosa may be associated with functional abnormality of the cone system.
Collapse
Affiliation(s)
- Güngör Sobacı
- Department of Ophthalmology, Gülhane Military Medical Academy and Medical School, Etlik, Ankara, Turkey
| | | | | |
Collapse
|
34
|
Abstract
Vigabatrin is an irreversible inhibitor of γ-aminobutyric acid (GABA) transaminase. It is effective as adjunctive therapy for adult patients with refractory complex partial seizures (rCPS) who have inadequately responded to several alternative treatments and as monotherapy for children aged 1 month to 2 years with infantile spasms. The well-documented safety profile of vigabatrin includes risk of retinopathy characterized by irreversible, bilateral, concentric peripheral visual field constriction. Thus, monitoring of visual function to understand the occurrence and manage the potential consequences of peripheral visual field defects (pVFDs) is now required for all patients who receive vigabatrin. However, screening for pVFDs for patients with epilepsy was conducted only after the association between vigabatrin and pVFDs was established. We examined the potential association between pVFDs and epilepsy in vigabatrin-naïve patients and attempted to identify confounding factors (e.g., concomitant medications, method of vision assessment) to more accurately delineate the prevalence of pVFDs directly associated with vigabatrin. Results of a prospective cohort study as well as several case series and case reports suggest that bilateral visual field constriction is not restricted to patients exposed to vigabatrin but has also been detected, although much less frequently, in vigabatrin-naïve patients with epilepsy, including those who received treatment with other GABAergic antiepileptic therapy. We also reviewed published data suggesting an association between vigabatrin-associated retinal toxicity and taurine deficiency, as well as the potential role of taurine in the prevention of this retinopathy.
Collapse
Affiliation(s)
- G T Plant
- Department of Neuro-Ophthalmology, National Hospital for Neurology and Neurosurgery, London, UK.
| | | |
Collapse
|
35
|
Vámos R, Tátrai E, Németh J, Holder GE, DeBuc DC, Somfai GM. The structure and function of the macula in patients with advanced retinitis pigmentosa. Invest Ophthalmol Vis Sci 2011; 52:8425-32. [PMID: 21948552 PMCID: PMC3253539 DOI: 10.1167/iovs.11-7780] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 09/13/2011] [Accepted: 09/14/2011] [Indexed: 01/23/2023] Open
Abstract
PURPOSE To assess the structure and function of the macula in advanced retinitis pigmentosa (RP). METHODS Twenty-nine eyes of 22 patients with RP were compared against 17 control eyes. Time-domain optical coherence tomography (OCT) data were processed using OCTRIMA (optical coherence tomography retinal image analysis) as a means of quantifying commercial OCT system images. The thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer and inner plexiform layer complex (GCL+IPL), inner nuclear layer and outer plexiform layer complex (INL+OPL), and the outer nuclear layer (ONL) were measured. Multifocal electroretinography (mfERG) was performed; two groups were formed based on the mfERG findings. Fourteen eyes had no detectable central retinal function (NCRF) on mfERG; detectable but abnormal retinal function (DRF) was present in the mfERG of the other 15 eyes. RESULTS The thickness of the ONL in the central macular region was significantly less in the NCRF eyes compared with that in both DRF eyes and controls. The ONL was significantly thinner in the pericentral region in both patient groups compared with that in controls, whereas the thickness of the GCL+IPL and INL+OPL was significantly decreased only in the NCRF eyes. The RNFL in the peripheral region was significantly thicker, whereas the thickness of the GCL+IPL and ONL was significantly thinner in both patient groups compared with that in controls. CONCLUSIONS The results are consistent with degeneration of the outer retina preceding inner retinal changes in RP. OCT image segmentation enables objective evaluation of retinal structural changes in RP, with potential use in the planning of therapeutic interventions and conceivably as an outcome measure.
Collapse
Affiliation(s)
- Rita Vámos
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Erika Tátrai
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - János Németh
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Graham E. Holder
- the Moorfields Eye Hospital, London, United Kingdom
- the Institute of Ophthalmology, University College London, London, United Kingdom; and
| | - Delia Cabrera DeBuc
- the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Gábor Márk Somfai
- From the Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
36
|
Clayton LM, Dévilé M, Punte T, Kallis C, de Haan GJ, Sander JW, Acheson J, Sisodiya SM. Retinal nerve fiber layer thickness in vigabatrin-exposed patients. Ann Neurol 2011; 69:845-54. [PMID: 21246602 DOI: 10.1002/ana.22266] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 09/10/2010] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Vigabatrin-associated visual field loss (VAVFL) occurs in 25 to 50% of exposed patients and is routinely monitored using perimetry, which has inherent limitations. Using optical coherence tomography (OCT), retinal nerve fiber layer (RNFL) thinning has been described in a small number of vigabatrin-exposed patients. We explored the relationship between RNFL thickness and visual field size, to determine whether OCT is a suitable tool to use in patients exposed to vigabatrin. METHODS Two hundred one vigabatrin-exposed subjects with epilepsy, divided into 2 groups, and 90 healthy controls participated. Visual fields were obtained using Goldmann kinetic perimetry and quantified using mean radial degrees (MRD). RNFL imaging was performed using either spectral-domain (Group 1) or time-domain (Group 2) OCT. RESULTS Thirty-nine of 201 (19.4%) patients were unable to perform perimetry. Thirteen (6.5%) patients were unable to perform OCT. A total of 51.6% of patients showed VAVFL. Average RNFL thickness was significantly thinner in patients (77.9 μm) compared to healthy controls (93.6 μm) (p < 0.001). There was a strong correlation between MRD and average RNFL thickness for Group 1 (r = 0.768, p < 0.001) and Group 2 (r = 0.814, p < 0.001). OCT RNFL imaging showed high repeatability. INTERPRETATION OCT provides a useful tool to assess people exposed to vigabatrin, and can provide an accurate estimate of the extent of visual field loss in the absence of a reliable direct measure of the visual field. The strong linear relationship found between RNFL thickness and visual field size provides some evidence that irreversible VAVFL may be related to loss of retinal ganglion cell axons.
Collapse
Affiliation(s)
- Lisa M Clayton
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
37
|
García-Ayuso D, Salinas-Navarro M, Agudo M, Cuenca N, Pinilla I, Vidal-Sanz M, Villegas-Pérez MP. Retinal ganglion cell numbers and delayed retinal ganglion cell death in the P23H rat retina. Exp Eye Res 2010; 91:800-10. [DOI: 10.1016/j.exer.2010.10.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 08/17/2010] [Accepted: 10/09/2010] [Indexed: 02/07/2023]
|
38
|
Blood pressure treatment in acute ischemic stroke: a review of studies and recommendations. Curr Opin Neurol 2010; 23:46-52. [PMID: 20038827 DOI: 10.1097/wco.0b013e3283355694] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Elevated blood pressure (BP) is frequent in patients with acute ischemic stroke. Pathophysiological data support its usefulness to maintain adequate perfusion of the ischemic penumba. This review article aims to summarize the available evidence from clinical studies that examined the prognostic role of BP during the acute phase of ischemic stroke and intervention studies that assessed the efficacy of active BP alteration. RECENT FINDINGS We found 34 observational studies (33,470 patients), with results being inconsistent among the studies; most studies reported a negative association between increased levels of BP and clinical outcome, whereas a few studies showed clinical improvement with higher BP levels, clinical deterioration with decreased BP, or no association at all. Similarly, the conclusions drawn by the 18 intervention studies included in this review (1637 patients) were also heterogeneous. Very recent clinical data suggest a possible beneficial effect of early treatment with some antihypertensives on late clinical outcome. SUMMARY Observational and interventional studies of management of acute poststroke hypertension yield conflicting results. We discuss different explanations that may account for this and discuss the current guidelines and pathophysiological considerations for the management of acute poststroke hypertension.
Collapse
|
39
|
Intrinsic optical signal imaging of retinal activation. Jpn J Ophthalmol 2009; 53:327-33. [PMID: 19763749 DOI: 10.1007/s10384-009-0685-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2008] [Accepted: 02/25/2009] [Indexed: 10/20/2022]
Abstract
Fast intrinsic optical signals (IOSs) correlated with stimulus-activated retinal responses are reviewed. Fast IOSs have a time course comparable to the stimulus-evoked electrophysiological kinetics of the retina, and thus promise a new methodology for high-resolution evaluation of the physiological health of the retina. However, practical application of fast IOSs for retinal study and diagnosis is challenging because of their low sensitivity and limited specificity. Using isolated amphibian retinas, a series of experiments to optimize and characterize fast IOSs has been conducted. Fast, high-resolution nearinfrared light imaging disclosed both positive (increasing) and negative (decreasing) optical responses in adjacent retinal areas, which satisfied spatial resolution essential to the differentiation of IOSs from opposite polarities. At the subcellular (approximately microm) level, fast IOSs often exceeded 5% DeltaI/I, where I is the dynamic optical change, and I is the background light intensity. Experiments with isolated frog retinas suggest that negative IOSs stem primarily from the photoreceptor layer, while positive IOSs come from inner retinal layers.
Collapse
|
40
|
Hood DC, Lin CE, Lazow MA, Locke KG, Zhang X, Birch DG. Thickness of receptor and post-receptor retinal layers in patients with retinitis pigmentosa measured with frequency-domain optical coherence tomography. Invest Ophthalmol Vis Sci 2008; 50:2328-36. [PMID: 19011017 DOI: 10.1167/iovs.08-2936] [Citation(s) in RCA: 156] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To better understand the effects of retinitis pigmentosa (RP) on post-receptor anatomy, the thicknesses of the receptor, inner nuclear, retinal ganglion cell (RGC), and retinal nerve fiber layers (RNFL) were measured with frequency-domain optical coherence tomography (fdOCT). METHODS FdOCT scans were obtained from the horizontal midline in 30 patients with RP and 23 control subjects of comparable age. Raw images were exported and the thicknesses of photoreceptor/RPE, inner nuclear, RGC plus inner plexiform, and nerve fiber layers were measured with a manual segmentation procedure aided by a computer program. The RNFL thickness was also measured in 20 controls and 25 patients using circular peripapillary fdOCT scans. RESULTS Results from controls were consistent with known anatomy. In patients with RP, the pattern of photoreceptor loss with eccentricity was consistent with the field constriction characteristic of RP. INL and RGC layer measures were comparable to normal subjects, although some patients showed slightly thicker RGC layers. However, RNFL layer thickness was significantly greater than normal; a majority of patients showed a thicker RFNL on both horizontal midline scans and peripapillary scans. CONCLUSIONS To make optimal use of OCT RNFL thickness as a measure of the integrity of RGCs in patients with RP, a better understanding of the causes of the thickening seen in the majority of the patients is needed. As the RGC layer thickness can be measured with fdOCT, RGC layer thickness may turn out to be a more direct and valid indicator of the presence of RGCs in patients with RP.
Collapse
Affiliation(s)
- Donald C Hood
- Department of Psychology, Columbia University, New York, NY 10027, USA.
| | | | | | | | | | | |
Collapse
|