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Microvascular and metabolic alterations in retinitis pigmentosa and Stargardt disease

Maria Della Volpe Waizel, Hendrik P N Scholl & Margarita Todorova

abstract

PURPOSE
The aim of our study was to evaluate retinal microvascular changes recorded with optical coherence tomography angiography (OCTA) and the metabolic function measured with retinal oximetry (RO) in patients with retinitis pigmentosa (RP) and Stargardt disease (STGD).

METHODS
In this prospective, noninterventional study, OCTA and RO were performed on 107 eyes (56 subjects): 53 eyes diagnosed with RP without the presence of macular oedema (no-ME-RP), 26 eyes with STGD, and 28 control eyes. Main outcome measures were the mean superficial (FAZ-S; mm ) and deep foveal avascular zone (FAZ-D; mm ) measured with OCTA as well as the mean arterial (A-SO ; %), venular (V-SO ; %) oxygen saturation, their difference (A-V SO ; %) and the corresponding mean diameters of the peripapillary retinal arterioles (D-A; μm) and venules (D-V; μm) determined with RO.

RESULTS
Stargardt disease (STGD) patients differed from controls and no-ME-RP by an enlarged FAZ-S and reduced A-SO and V-SO (p ≤ 0.013). No-ME-RP eyes presented with attenuated vessels (p < 0.001) and increased A-SO and V-SO (p ≤ 0.012) compared to controls and STGD. The FAZ-D showed significant interactions with A-SO (p = 0.003) in no-ME-RP while the FAZ-S correlated with visual acuity in no-ME-RP (p = 0.007) and STGD (p = 0.034).

CONCLUSION
Retinitis pigmentosa (RP) and Stargardt disease (STGD) patients suffer from microvascular and metabolic alterations, however, showing a different pattern. A combined microvascular-metabolic model may therefore allow to more precisely characterize RP and STGD as well as presumably other inherited retinal diseases.
   
citation Della Volpe Waizel M, Scholl H P N, Todorova M. Microvascular and metabolic alterations in retinitis pigmentosa and Stargardt disease. Acta Ophthalmol 2021; 99:e1396-e1404.
   
type journal paper/review (English)
date of publishing 10-05-2021
journal title Acta Ophthalmol (99/8)
ISSN electronic 1755-3768
pages e1396-e1404
PubMed 33973369
DOI 10.1111/aos.14828