Contributed Session I: Correlating cone structure and function in retinitis pigmentosa using coarse-scale optoretinography (CoORG).

Optoretinography (ORG) has the potential to serve as a powerful diagnostic biomarker, owing to its sensitive and objective localization of function and dysfunction. Majority of ORG implementations employ adaptive optics (AO) for imaging activity at a cellular scale. Coarse-scale Optoretinography (CoORG), an ORG paradigm without AO, offers rapid, extended-field recordings and wider applicability in patients with retinal disease, by compromising cellular resolution. This study investigates the feasibility of CoORG in assessing cone dysfunction in patients diagnosed with retinitis pigmentosa (RP). Five RP patients aged 26 - 60 were recruited, alongside age-similar controls. The stimulus for evoking cone activity had a photon density between 15.5x10e6 - 19.7x10e6 photons/μm2, and was centered at 532 ± 5nm. Eight imaging trials per bleach were performed, allowing for 1 min. between successive trials for dark adaptation. The total experimental time for each bleach was 10-20 mins. In RP, cone function, estimated as the change in optical path length in the outer segment in response to a stimulus, was diminished and generally lower than normal controls. This deficit was observed in areas of seemingly normal outer retinal structure. Contrary to normals, no correlation was observed between outer segment length and cone function in RP. This highlights CoORG's potential for early, sensitive detection of retinal dysfunction prior to apparent structural degradation.