Characterizing macular edema in retinitis pigmentosa through a combined structural and microvascular optical coherence tomography investigation

The aim of the study was to characterize macular edema (ME) in retinitis pigmentosa (RP) by means of quantitative optical coherence tomography (OCT)-based imaging. The study was designed as observational, prospective case series, with 1-year follow-up. All RP patients underwent complete ophthalmologic assessment, including structural OCT, OCT angiography, and microperimetry (MP). The primary outcome was the characterization through quantitative OCT-based imaging of RP eyes complicated by ME. A total of 68 RP patients' eyes (68 patients) and 68 eyes of 68 healthy controls were recruited. Mean BCVA was 0.14 +/- 0.17 LogMAR at baseline and 0.18 +/- 0.23 LogMAR at 1-year follow-up (p > 0.05). Thirty-four eyes (17 patients; 25%) showed ME, with a mean ME duration of 8 +/- 2 months. Most of the eyes were characterized by recurrent ME. The ME was mainly localized in the inner nuclear layer in all eyes. LogMAR BCVA was similar in all RP eyes, whether with or without ME, although those with ME were associated with higher vessel density values, as well as thicker choroidal layers, than those without ME. In conclusion, the inner retina is closely involved in the pathogenesis of ME. The impairment of retinal-choroidal exchanges and Muller cell disruption might be a major pathogenic factor leading to the onset of ME in RP.

Automated summary

The study aimed to use quantitative optical coherence tomography (OCT)-based imaging to characterize macular edema (ME) in retinitis pigmentosa (RP). The study was an observational, prospective case series with a 1-year follow-up. RP patients underwent complete ophthalmologic assessment, including OCT, OCT angiography, and microperimetry. ME was found in 25% of RP eyes, mainly localized in the inner nuclear layer. RP eyes with ME showed higher vessel density values and thicker choroidal layers compared to those without ME. The impairment of retinal-choroidal exchanges and Muller cell disruption might play a role in the pathogenesis of ME in RP.