Clinical investigationsVisual Acuity and 10° Automated Static Perimetry in Eyes with Retinitis Pigmentosa
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.
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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)
- et al.
Optical coherence tomography of cystoid macular edema associated with retinitis pigmentosa
Am J Ophthalmol
(1999) - et al.
Progression of defects in the central 10-degree visual field of patients with retinitis pigmentosa and choroideremia
Am J Ophthalmol
(1999) - et al.
Autosomal-dominant retinitis pigmentosa associated with an Arg-135-Trp point mutation of the rhodopsin gene. Clinical features and longitudinal observations
Ophthalmology
(1996) - et al.
Retinitis pigmentosa and allied diseases
- et al.
The effect of perimetric experience in normal subjects
Arch Ophthalmol
(1989)
Cited by (15)
Factors affecting visual acuity after cataract surgery in patients with retinitis pigmentosa
2015, OphthalmologyCitation Excerpt :In a study by Jackson et al,5 more than 96% of patients reported a functional improvement in visual symptoms despite the acuity being unchanged or worse; therefore, other measures of visual function may be needed when assessing patients with RP for cataract surgery and evaluating its benefit. The MD value on the HFA 10-2 program, which assesses the sensitivity distribution in the macular area, has been used for monitoring the progression of RP.11,17 In previous studies of patients with general RP, most eyes with an MD value of −15 dB or greater had better acuity, whereas eyes with an MD value less than −15 dB had various degrees of acuity loss.
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