Photoreceptor Loss Overlying Congenital Hypertrophy of the Retinal Pigment Epithelium by Optical Coherence Tomography
Received 26 April 2005; accepted 8 October 2005.
Objective
To describe the cross-sectional retinal anatomy overlying congenital hypertrophy of the retinal pigment epithelium (CHRPE) using optical coherence tomography (OCT).
Design
Retrospective, observational, noncomparative case series.
Participants
Ten consecutive patients with CHRPE.
Main Outcome Measures
The main outcome measures were retinal and retinal pigment epithelium (RPE) thickness relative to normal tissue and the status of the retinal layers, in particular the photoreceptor layer.
Results
The median patient age was 36 years (mean, 34 years; range, 7–56 years). The CHRPE was within 6 mm of the optic disc or foveola in all patients. All patients showed retinal thinning and complete photoreceptor loss overlying the CHRPE. The sensory retina measured a mean of 68% of normal thickness (range, 47%–87%). Of the 8 patients with pigmented CHRPE, the CHRPE was 52% thicker than adjacent RPE. All 8 patients with pigmented CHRPE showed moderate relative shadowing of the underlying choroid. The 2 patients with nonpigmented CHRPE, presumed to represent large lacunae with thin CHRPE rim, showed absent RPE and increased transmission of light, not shadowing, into the choroid by OCT. Both patients with visual field testing showed a visual field defect corresponding to the photoreceptor loss.
Conclusions
Using OCT, overlying retinal thinning and photoreceptor loss directly over CHRPE was found in 10 consecutive patients. These findings likely account for related visual field loss.
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Correspondence to Carol L. Shields, MD, Ocular Oncology Service, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA 19107.
Manuscript no. 2005-360.
Supported by a donation from Michael, Bruce, and Ellen Ratner, New York, New York (JAS, CLS); the Paul Kayser International Award of Merit in Retina Research, Houston, Texas (JAS); Mellon Charitable Giving from the Martha W. Rogers Charitable Trust, Philadelphia, Pennsylvania (CLS); Rosenthal Award of the Macula Society, Barcelona, Spain (CLS); Macula Foundation, New York, New York (CLS); and Eye Tumor Research Foundation, Philadelphia, Pennsylvania (CLS, JAS).
ABSTRACT