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Purpose  To investigate flow area changes measured using optical coherence tomography angiography ( OCTA ;  RTV ue  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 ( IS e) 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  IS e (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.

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