Association between abnormal autofluorescence and photoreceptor disorganization in retinitis pigmentosa

PURPOSE: To evaluate the association between the third high-reflectance band on high-resolution optical coherence tomography (OCT), fundus autofluorescence (AF), and kinetic perimetry results in patients with typical retinitis pigmentosa (RP). DESIGN: Retrospective, observational case series. METHODS: Thirty-four patients with typical RP who were referred to our institute were examined, with a diagnosis made by full,field electroretinography. We evaluated the fundus AF and the third high-reflectance band by high,resolution OCT, both qualitatively and quantitatively. We investigated whether the vertical length of the AF diameter or the third high,reflectance band correlated with Goldmann kinetic perimetry results. RESULTS: We classified three types of abnormal fundus AF: ring AF, central AF, and the absence of both patterns. In eyes with ring AF, the length of the third high,reflectance band was almost equal to the diameter of the abnormal ring AF with significant correlation (P < .001), whereas the band length did not correlate with the diameter of the visual field (P = .237). Eyes with central AF did not have a continuous third high,reflectance band. In eyes with neither ring nor central AF, the length of the third high,reflectance band correlated with the AF length and the diameter of the visual field (P = .024 and P < .001, respectively). CONCLUSIONS: A novel classification based on the fundus AF and the third high,reflectance band determined by OCT suggests different patterns of pathogenesis in the retinal pigment epithelium and photoreceptor degeneration in the progression of RP.