Ultra-Widefield Fluorescein Angiography Findings in Patients With Retinitis Pigmentosa

Purpose: To describe ultra-widefield fluorescein angiographic (UWF-FA) features of patients with retinitis pigmentosa (RP) and to compare the findings with those of controls without inherited retinal degeneration. Methods: Patients with RP who underwent ultra-widefield FA between 2017 and 2024 at an academic center were included. Age-matched controls without inherited retinal degeneration or vascular disease were also included. Arteriovenous transit times relative to choroidal flush and angiographic features were documented. Central and peripheral retinal vessels were defined based on distance from the fovea. Patients with RP with complete peripheral atrophy were excluded from peripheral analysis. Student t test was used for comparisons. Results: In total, 30 eyes from 15 patients with RP and 28 eyes from 14 control participants were analyzed. The groups were similar in age and sex distribution. Central retinal transit times were comparable between groups; however, patients with RP demonstrated significantly prolonged laminar flow during the arteriovenous phase (8.1 ± 2.4 vs 5.5 ± 1.2 seconds, P = .001) and delayed peripheral venous filling (28.6 ± 2.7 vs 17.7 ± 1.4 seconds, P < .001). Common angiographic features in RP included peripheral vascular dropout (93%), bone-spicule-associated blocking (87%), granular staining or window defects (73%), central hypofluorescence (67%), and ring-like hyperfluorescence (53%). Conclusions: Patients with RP demonstrate significant peripheral vascular dropout and delayed venous filling on ultra-widefield FA, along with distinct angiographic patterns that may aid in interpretation.