Optical coherence tomography of cystoid macular edema associated with retinitis pigmentosa

Abstract

Purpose: To detect cystoid macular edema in consecutive eyes with retinitis pigmentosa by means of optical coherence tomography and to study the correlation between cross-sectional structures and angiographic findings in cystoid macular edema.

Methods: In a prospective study, cross-sectional images through the fovea were evaluated by means of optical coherence tomography in 89 phakic eyes of 46 patients with retinitis pigmentosa. Eyes showing cystoid appearance in the macula in the optical coherence tomographic images were further studied with measurement of the dimensions of cystoid lesions and with a fluorescein angiogram either at 18 minutes after dye injection or later.

Results: Cystoid lesions were observed in the macula in optical coherence tomographic images in 12 eyes in six (13%) of 46 patients. In these eyes, the width of total area of the cystoid lesions was positively correlated with the grade of fluorescein angiogram (Spearman rank correlation coefficient, r = .629; P = .029), but the thickness of the neurosensory retina at the center of the fovea was not. Among three variables for grading cystoid macular edema, consisting of angiographic grade, thickness of the neurosensory retina at the center of the fovea, and width of total area of the cystoid lesions, only the last measure was significantly correlated with best-corrected visual acuity (Pearson correlation coefficient, r = .693; P = .012).

Conclusion: Cystoid macular edema in eyes with retinitis pigmentosa could easily be detected with the use of optical coherence tomography independent of the angiographic degree of dye leakage. The size of cystoid lesions demonstrated in the optical coherence tomographic images, especially the thickness of the neurosensory retina at the center of the fovea, was not necessarily correlated with the angiographic grading of dye leakage. Measurement of the width of total area of the cystoid lesions in the optical coherence tomographic images is significantly correlated with the loss of visual acuity.