Common spectral domain OCT and electrophysiological findings in different pattern dystrophies

Hannan, S.R., de Salvo, G., Stinghe, A., Shawkat, F. and Lotery, A. J. (2013) Common spectral domain OCT and electrophysiological findings in different pattern dystrophies. British Journal of Ophthalmology, 97 (5), 605-610. (doi:10.1136/bjophthalmol-2011-301257). (PMID:23426737)

Abstract

OBJECTIVES: (1) To investigate and integrate the tomographic, angiographic and electrodiagnostic findings in pattern dystrophy. (2) To correlate visual acuity (VA) with central macular thickness (CMT), the electrooculogram (EOG) and pattern electroretinogram (PERG).

DESIGN: A retrospective study of patients with pattern dystrophy. 52 eyes of 26 patients were examined.

RESULTS: Thirty-three eyes had adult-onset foveomacular vitelliform dystrophy, 8 had multifocal pattern dystrophy, 6 had butterfly pattern dystrophy and 2 had reticular pattern dystrophy. SD-OCT demonstrated hyperreflectivity between the retinal pigment epithelium (RPE)/ Bruch's complex, and the junction of the inner and outer segments (IS/OS) of the photoreceptors. Disruption of the IS/OS was observed in 20, and disruption of the end tips of photoreceptors was clearly visible in eight eyes. 11 eyes showed abnormal focal hyper-reflectivity originating from the RPE towards the outer nuclear layer (ONL), and in two eyes this appeared to originate from the junction of the IS/OS towards the ONL. EDTs revealed borderline or a reduced EOG in 25 (51%) and a degraded PERG in 41eyes (83.6%) with the P50 component reduced in 23 and N95 in 18. CMT and Arden ratio did not show any significant correlation with VA.

CONCLUSIONS: We observed relatively consistent features between different types of pattern dystrophies. In addition we observed novel findings on 3D-OCT. We also report 3D-OCT features of reticular, multifocal and butterfly pattern dystrophies. The degraded PERG results observed in our study indicate that the disease process in this condition is not limited to the RPE.

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Contributors

Author: A. J. Lotery

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