The prevalence of cystoid macular oedema on optical coherence tomography in retinitis pigmentosa patients without cystic changes on fundus examination.

PURPOSE: To determine the prevalence of cystoid macular oedema (CME) by optical coherence tomography (OCT) in retinitis pigmentosa (RP) patients with no evidence of cystic macular lesions on fundus examination. METHODS: We included 63 RP patients with no evidence of cystic-appearing macular changes on fundus examination. All patients underwent a complete ocular examination including best-corrected visual acuity using an ETDRS (Early Treatment Diabetic Retinopathy Study) chart, intraocular pressure measurement, anterior segment examination, and a detailed fundus examination. On 50 of the 63 patients, Fourier-domain OCT was performed using the radial slicer protocol. An additional 13 of the 63 patients were scanned using the macular thickness protocol on a time-domain OCT unit. The diagnosis of CME was defined by the presence of hyporeflective lacunae with well-defined boundaries on at least two of the scans. RESULTS: The mean age of patients included in the study was 36 years (range 9-71 years). Out of the 63 patients examined, 20 showed CME in at least one eye (32%), whereas 11 patients showed CME in both eyes (18%). CONCLUSIONS: Our findings demonstrate that a substantial number of RP patients with CME, as determined by OCT, may not show cystic changes by direct ophthalmoscopy or contact lens biomicroscopy. Knowledge of the high frequency for CME in such patients can serve to identify those who may be amenable to current or future treatment strategies of their macular oedema and can potentially impact on future therapeutic trials where visual acuity is used as an outcome measure.

Prevalence of cystic macular lesions in patients with Usher II syndrome.

PURPOSE: To evaluate the prevalence of cystic macular lesions in patients with Usher II syndrome. METHODS: All Usher type II patients seen in the inherited eye disease clinic at the University of Illinois at Chicago between January 2002 and December 2007 were included (n=76). Each participating patient underwent a detailed clinical examination, including best-corrected visual acuity, slit-lamp biomicroscopy and dilated fundus examination. The presence of cystoid lesions was determined by optical coherence tomography (OCT), fundus fluorescein angiogram (FFA), fundus photographs and/or clinical examination. RESULTS: A cystic-appearing macular change was observed in at least one eye in 19 out of the 76 patients (25%), 13 on the basis of OCT, five using FFA (two solely with the use of FFA and three based on clinical notes and FFA findings) and one based solely on clinical notes. Of the 18 patients with CME, determined by OCT or FFA, five (27.8%) showed either a funduscopically normal-appearing macula (n=4) or an atrophic appearing macular change (n=1). CONCLUSIONS: One-fourth of our total cohort of Usher II patients had cystic macular lesions. Moreover, a funduscopically normal-appearing macula was observed in 22% (n=4) of our 18 patients with cystic-appearing macular lesions on OCT and/or FFA testing. On the basis of the reasonably high prevalence of cystic macular lesions in our cohort, it would seem prudent to evaluate Usher II patients for the presence of cystoid macular oedema.

The prevalence of cystoid macular oedema in retinitis pigmentosa patients determined by optical coherence tomography.

AIMS: To determine the prevalence of cystoid macular oedema (CMO) in retinitis pigmentosa (RP) patients of various genetic subtypes using optical coherence tomography (OCT). METHODS: We performed a complete ocular examination on 124 RP patients including best corrected visual acuity, intraocular pressure measurement, anterior segment and a detailed fundus exam. OCT images were then acquired using two different units. The presence of hypo-reflective lacunae was used to diagnose CMO. RESULTS: Of the 124 patients, 47 showed CMO in at least one eye (38%), while 34 showed CMO in both eyes (27%). The prevalence of CMO in at least one eye for autosomal dominant (AD) patients was 52%, for autosomal recessive (AR) 39%, isolated 39%, Usher II 35% and none in the X linked recessive (XL) group. Using a chi-square analysis, no statistical significant difference was found for the prevalence of "bilateral CMO" (p = 0.60) or "CMO in at least one eye" (p = 0.59) among the AD, AR, isolated and Usher II genetic subtypes. CONCLUSION: Because of its notable prevalence, it would seem prudent to screen RP patients by OCT for the possible presence of CMO, to identify those amenable to treatment and also for future treatment trials when monitoring visual acuity.