Optical coherence tomography angiography in patients with retinitis pigmentosa who have normal visual acuity

PURPOSE: To investigate flow area changes measured using optical coherence tomography angiography (OCTA; RTVue XR Avanti(®)) in patients with retinitis pigmentosa (RP) with preserved visual acuity (VA). METHODS: This was an age‐ and refraction‐matched case–control study. Consecutive patients with a best‐corrected visual acuity (BCVA) of ≥20/20 and normal subjects were recruited. Fifty eyes (32 patients) and 22 eyes (12 controls) were included. The flow area and foveal avascular zone (FAZ) were measured in both superficial and deep layers within a 3 × 3 mm central area of the fovea. Association between OCTA parameters and the length of the inner segment ellipsoid (ISe) and external limiting membrane (ELM), the area without abnormal fluorescence in fundus autofluorescence (normal FAF area ratio) and the area of I‐2e of the Goldmann perimeter were analysed using mixed‐effects regression analysis. RESULTS: Foveal avascular zones were significantly smaller in patients with RP than in controls in superficial (p = 0.004) but not in deep layers (p = 0.25). The flow area in superficial (p = 0.007) and deep layers (p = 0.004) was significantly smaller in patients with RP than in controls. In patients with RP, flow areas in the superficial layers, but not in the deep layers, were significantly associated with the lengths of ISe (p = 0.001) and ELM (p = 0.002) and the I‐2e area (p = 0.036), but not with the normal FAF area ratio (p = 0.399). CONCLUSION: Optical coherence tomography angiography (OCTA)‐measured flow area in superficial layers gradually reduced with RP progression and may be a useful parameter of RP pathogenesis.