Retinal Hemodynamics in Retinitis Pigmentosa

Purpose

To investigate the retinal hemodynamic changes occurring in patients with retinitis pigmentosa (RP).

Methods

Bidirectional laser Doppler velocimetry and monochromatic fundus photography were used to determine retinal venous diameter (D), maximum erythrocyte velocity (V_max), and volumetric blood flow (Q) in the major retinal veins of eight patients with RP and eight age-matched normal controls. The retinal vascular regulatory responses to hyperoxia, defined as the percent decreases in D (R_D), V_max, and Q (R_Q) at four to six minutes of breathing 100% oxygen, were determined in eight normal subjects and five RP patients.

Results

Average D, V_max, and Q ± S.D. in the largest retinal vein of each subject were 106 ± 14 μm, 1.01 ± 0.20 cm/sec, and 3.5 ±1.3 μl/min, respectively, in RP patients, and 166 ± 12 μm, 1.79 ± 0.14 cm/sec, and 14.7 ± 2.6 μl/min, respectively, in normal subjects. This corresponded to significant decreases from normal of 36% in D, 44% in V_max, and 76% in Q in RP patients (Wilcoxon's rank sum test, P < .001). Average total retinal volumetric blood flow rate was 8.2 ± 2.9 μl/min in RP patients and 37 ± 4.9 μl/min in normal subjects, corresponding to a significant decrease from normal of 78% (Wilcoxon's rank sum test, P < .001). In RP patients, the regulatory responses to hyperoxia were similar to those observed in normal subjects.

Conclusions

Retinal blood flow is significantly decreased in patients with RP, probably as a result of vascular remodeling in response to reduced metabolic demand. The regulatory responses to hyperoxia are similar to those of normal subjects. Measurements of retinal blood flow may help assess the progression of the disease and the effects of treatment.