Elsevier

Japanese Journal of Ophthalmology

Volume 46, Issue 5, September–October 2002, Pages 581-585
Japanese Journal of Ophthalmology

Clinical investigations
Visual Acuity and 10° Automated Static Perimetry in Eyes with Retinitis Pigmentosa

https://doi.org/10.1016/S0021-5155(02)00548-8Get rights and content

Abstract

Purpose: In a previous study we demonstrated that the progression of the disease retinitis pigmentosa (RP) can be readily monitored by the mean deviation (MD) measured by Humphrey central 10-2 perimetry, which assesses the sensitivity distribution in the macular area in eyes affected by RP. In the present study, we investigated whether the 10° perimetric results could predict the time of declining visual acuity in eyes with RP in a cross-sectional study.

Methods: Humphrey 10-2 perimetry results and visual acuity were studied in the right eyes of 69 patients with typical RP. Patients whose eyes had cataract, glaucoma, cystoid macular edema, or other complications affecting vision were excluded.

Results: Eyes with an MD of −15 dB or greater had almost normal visual acuity. Various degrees of visual acuity loss were observed in eyes with an MD of less than −15 dB. In the 35 eyes with an MD of less than −15 dB, visual acuity correlated well with the corrected pattern standard deviation (CPSD), which is the measure of the degree to which the shape of the measured field departs from the age-corrected normal reference field.

Conclusion: In the absence of complications, many eyes with RP may experience acuity loss after the field constriction reaches an MD of less than −15 dB. The CPSD may be used as an indicator of acuity because eyes showing a lower CPSD tend to have greater loss of acuity among eyes with an equivalent MD value.

Introduction

Retinitis pigmentosa (RP) is a hereditary retinal disease characterized by progressive visual field defects. In the typical form of the disease, visual acuity tends to be preserved for many years.1 Acuity may, however, start to decline at a certain point in the progression of the disease, even without such complications as cataract, glaucoma, or macular edema.2 Therefore, a major concern for patients with RP is knowing when their acuity will start to decline and how great a reduction of visual acuity to expect. It has been demonstrated that the rate of progression of the disease can be readily assessed in many patients through the annual loss of mean deviation (MD) in the central 10° field.3 If the visual acuity is closely related to MD or other parameters of static perimetry, we could then more accurately predict the time when the RP patients' central visual acuity will start to decline and advise them more precisely on their visual prognosis.

In the present study we investigated the relationship between perimetric parameters and visual acuity loss in a cross-sectional study.

Section snippets

Materials and Methods

The right eyes of 69 patients (36 men and 33 women, ranging in age from 7 to 88 years with a mean of 50) with the typical form of RP1 were selected from a database of 194 RP patients registered at the Yamanashi Medical University Hospital. Clinical records were reviewed to determine inheritance patterns and to exclude those patients with other diseases that could cause visual field loss. Excluded were patients with cataract, pseudophakia with posterior capsular opacity, glaucoma, cystoid

Results

While logMAR was correlated with MD (r = 0.5, P < .001), which ranged from −33.1 to 0.9 dB (Figure 1), most eyes with an MD of −15 dB or higher showed a logMAR value of 0.3 or less (corresponding to vision of 20/40 or better). In contrast, eyes with an MD of less than −15 dB showed vision loss of various degrees. Figure 2 shows the relationship between CPSD and MD for eyes assigned to one of three groups according to logMAR. Although the highest value of CPSD depends on MD values, better visual

Discussion

In a previous study,3 MD measured by Humphrey central 10-2 perimetry decreased linearly in a follow-up period of longer than 3.5 years in eyes with RP. Therefore, MD can be used as a parameter for disease progression, especially in eyes with relatively advanced RP.

The negative correlation between MD and logMAR demonstrated in the present cross-sectional study suggests that visual acuity also decreases with field defect progression in the central 10° visual field. Because eyes with lens

Acknowledgements

This study was supported by a grant from the Research Committee on Chorioretinal Degeneration and Optic Atrophy provided by the Ministry of Health and Welfare of the Japanese Government.

References (10)

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