Jung Suk Hoon, Yi Sang Un, Hwang Bo-Een, Park Young Gun, Park Young-Hoon
Department of Visual Science and Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2025 Jun 25;20(6):e0325654. doi: 10.1371/journal.pone.0325654. eCollection 2025.
This retrospective study analyzed optical coherence tomography (OCT) findings in 130 eyes of 130 patients with retinitis pigmentosa (RP) at initial diagnosis, including 42 with cystoid macular edema (CME) and 88 without, between September 2016 and March 2024. The CME group exhibited increased central macular thickness (CMT) (257.50 ± 104.98 µm vs. 171.40 ± 73.15 µm, p = 0.000), whereas the non-CME group had greater subfoveal choroidal thickness (SCT) (294.52 ± 122.85 µm vs. 246.98 ± 87.31 µm, p = 0.043), total choroidal area (TCA) (4.64 ± 1.98 mm² vs. 3.82 ± 1.34 mm², p = 0.031), stromal area (SA) (1.85 ± 0.76 mm² vs. 1.53 ± 0.54 mm², p = 0.025), luminal area (LA) (2.79 ± 1.22 mm² vs. 2.30 ± 0.81 mm², p = 0.033), and foveal avascular zone in the superficial capillary plexus (FAZ_SCP) (0.42 ± 0.31 mm² vs. 0.27 ± 0.12 mm², p = 0.022). The CME group had more moderate stage cases (47.62% vs. 26.14%, p = 0.015), while the non-CME group had more advanced cases (39.77% vs. 9.52%, p = 0.000). Visual acuity (logMAR) worsened in advanced stages for both groups (CME: 1.62 ± 0.79, p = 0.003; Non-CME: 1.12 ± 0.80, p = 0.000). In the CME group, FAZ in the deep capillary plexus (FAZ_DCP) enlarged from moderate to advanced stages (0.28 ± 0.12 mm² to 0.64 ± 0.09 mm², p = 0.025), and vessel density in the deep capillary plexus (VD_DCP) decreased from early to moderate stages (31.83 ± 3.94% to 28.75 ± 2.71%, p = 0.036), whereas superficial capillary plexus vessel density (VD_SCP) remained stable across stages (early: 32.82 ± 2.59%, moderate: 31.04 ± 2.37%, advanced: 31.52 ± 1.26%, all p > 0.1). The non-CME group exhibited progressive declines in CMT (early: 226.27 ± 38.60 µm, moderate: 195.04 ± 52.56 µm, advanced: 108.83 ± 59.72 µm, all p < 0.01) and choroidal vascularity index (CVI) (early: 0.61 ± 0.02, moderate: 0.60 ± 0.02, advanced: 0.58 ± 0.04, all p < 0.05). In the CME group, visual acuity (logMAR) was positively correlated with cyst area (p = 0.019, rho = 0.361) and FAZ_DCP (p = 0.002, rho = 0.564). These findings suggest that RP-CME may be associated with choroidal atrophy regardless of disease stage and could have a compensatory mechanism to SCP. Cyst area and FAZ_DCP may serve as indicators of visual acuity in RP-CME.
这项回顾性研究分析了2016年9月至2024年3月期间130例初诊视网膜色素变性（RP）患者的130只眼中的光学相干断层扫描（OCT）结果，其中42例患有黄斑囊样水肿（CME），88例未患。CME组的中心黄斑厚度（CMT）增加（257.50±104.98 µm对171.40±73.15 µm，p = 0.000），而非CME组的黄斑下脉络膜厚度（SCT）更大（294.52±122.85 µm对246.98±87.31 µm，p = 0.043）、脉络膜总面积（TCA）（4.64±1.98 mm²对3.82±1.34 mm²，p = 0.031）、基质面积（SA）（1.85±0.76 mm²对1.53±0.54 mm²，p = 0.025）、管腔面积（LA）（2.79±1.22 mm²对2.30±0.81 mm²，p = 0.033）以及浅表毛细血管丛中的黄斑无血管区（FAZ_SCP）（0.42±0.31 mm²对0.27±0.12 mm²，p = 0.022）。CME组中度阶段病例更多（47.62%对26.14%，p = 0.015），而非CME组晚期病例更多（39.77%对9.52%，p = 0.000）。两组在晚期视力（logMAR）均恶化（CME组：1.62±0.79，p = 0.003；非CME组：1.12±0.80，p = 0.000）。在CME组中，深层毛细血管丛中的FAZ（FAZ_DCP）从中度到晚期增大（0.28±0.12 mm²至0.64±0.09 mm²，p = 0.025），深层毛细血管丛中的血管密度（VD_DCP）从早期到中度降低（31.83±3.94%至28.75±2.71%，p = 0.036），而浅表毛细血管丛血管密度（VD_SCP）在各阶段保持稳定（早期：32.82±2.59%，中度：31.04±2.37%，晚期：31.52±1.26%，所有p>0.1）。非CME组的CMT（早期：226.27±38.60 µm，中度：195.04±52.56 µm，晚期：108.83±59.72 µm，所有p<0.01）和脉络膜血管指数（CVI）（早期：0.61±0.02，中度：0.60±0.02，晚期：0.58±0.04，所有p<0.05）呈进行性下降。在CME组中，视力（logMAR）与囊肿面积（p = 0.019，rho = 0.361）和FAZ_DCP（p = 0.002，rho = 0.564）呈正相关。这些发现表明，无论疾病阶段如何，RP-CME可能与脉络膜萎缩有关，并且可能对SCP有代偿机制。囊肿面积和FAZ_DCP可作为RP-CME视力的指标。
