ABSTRACT
To determine the prevalence of primary angle?closure disease (PACD) in patients with retinitis pigmentosa (RP). Methods: This was a retrospective review of the electronic medical records of all RP patients over the age of 10 years attending the Genetics Eye Clinic of a tertiary?care hospital during a 7?year period. Information regarding age, gender, vision, refraction, lens, intraocular pressure (IOP), type of RP, and inheritance pattern using pedigree charts for all patients were obtained. Patients with a shallow anterior chamber, high IOP, or glaucomatous optic discs were referred to the glaucoma department where they underwent additional IOP measurements, a gonioscopy, and disc evaluation by a glaucoma specialist. The prevalence of PACD was determined. Results: A total of 618 RP patients were examined during the study period, of which 95.1% had typical RP. The prevalence of primary angle?closure suspects was 2.9%, primary angle closure was 0.65%, and primary angle?closure glaucoma (PACG) was 2.27%. In contrast, the prevalence of primary open?angle glaucoma was 1.29%. The prevalence of PACG in those older than 40 years was 3.8% (95% confidence interval: 1.6–6.0). Conclusion: The prevalence of PACG in RP patients over 40 years was higher than that found in the general population of a similar age (3.8% vs. 0.8%). In our cohort of RP patients, 5.9% had PACD. Hence, gonioscopy is warranted in all RP patients to identify this condition and treat it appropriately.
ABSTRACT
Purpose: To compare multicolor imaging (MCI) with Optos color fundus photography (OCFP) for the evaluation of morphology and extent of preretinal membranes in diabetic tractional retinal detachments (TRD). Methods: In this retrospective study, 30 eyes with diabetic TRDs were imaged using the MCI feature of the Heidelberg Spectralis Spectral?domain optical coherence tomography (SD?OCT) and color photo using the Optos Daytona ultra?widefield fundus camera. Two investigators independently graded and determined the agreeability between the two modalities with respect to the extent of the TRD and preretinal membranes on the SD?OCT B?scan images. Results: The MCI provided better visualization of the attachments and traction points of the posterior hyaloid face and preretinal membranes and is comparable to the SD?OCT B?scan images. The inter?rater agreeability rates for OCFP had a Kappa (?) value of 0.37, while the MCI had a ? value of 0.46. When comparing between images of different wavelengths, grading using infrared reflectance (IR) had a poor agreement (?0.04 ± 0.04) while green reflectance (GR) (0.46 ± 0.32) and blue reflectance (BR) (0.53 ± 0.19) had a moderate agreement. The composite MCI and GR images also had comparatively higher intraclass coefficient when compared to the OCFP (0.25 [?0.09–0.55]) and IR (?0.03 [?0.39–0.34]) images. Conclusion: MCI is more sensitive for determining the extent of TRDs and for the detection of secondary membranes when compared to OCFP, thus, aiding in better surgical planning.
ABSTRACT
Purpose: To study fundus autofluorescence (FAF) and spectral domain-optical coherence tomography (SD-OCT) characteristics in patients with typical retinitis pigmentosa (RP) and correlate them to visual acuity. Design: Retrospective observational case series. Methods: 110 eyes of 56 RP patients were included. FAF and SD-OCT imaging were done for all eyes. Extent of the autofluorescence ring, central foveal thickness, photoreceptor outer-segment length (PROS), foveal outer segment pigment epithelial thickness (FOSPET), and inner segment-outer segment (IS-OS) extent were defined and measured and correlated to logMAR best corrected visual acuity (BCVA) using linear regression. Results: Study included 110 eyes of 56 patients (34 male and 22 female). Mean BCVA was 0.33 logMAR with no difference between genders. The mean age of patients was 15.4 ± 15.1 years. Mean autofluorescence extent was 3590 ± 1994 μm horizontally, and 2880 ± 1836 μm vertically. These values were significantly correlated with preserved IS/OS junction extent (mean values horizontally = 2865 μm and vertically = 2464 μm). Mean central retinal thickness (218.74 μm) and PROS (44.85 μm) were significantly correlated to BCVA with correlation coefficient r = –0.189, P = 0.015; and r = –0.874, P = 0.0001, respectively. FOSPET (mean = 71.15 μm) did not show a significant correlation with BCVA, independent of PROS. Conclusions: Retinal microstructural changes as studied on SD-OCT, especially PROS length can be used as a surrogate marker to monitor degenerative diseases such as RP. Further, studies are required to clearly delineate the microstructuralfunctional relationship in the human retina.