Elsevier

Japanese Journal of Ophthalmology

Volume 44, Issue 1, January–February 2000, Pages 82-87
Japanese Journal of Ophthalmology

The Relationship Between Visual Disability and Visual Scores in Patients With Retinitis Pigmentosa

https://doi.org/10.1016/S0021-5155(99)00171-9Get rights and content

Abstract

Purpose: To evaluate the relationship between visual disability and visual scores in patients with retinitis pigmentosa.

Methods: The relationship between visual disability and visual scores (visual acuity and visual field) was investigated in 93 patients with retinitis pigmentosa. The visual disability of each patient was evaluated using a questionnaire (a total of 35 questions, in 7 sections, regarding daily life). The reproducibility and validity of the data obtained by the questionnaire had been established by a similar investigation in glaucoma patients. Mean (±SD) age of patients was 52.6 ± 15.1 years, the mean visual acuity of the logarithm of the minimum angle of resolution (log10MAR) was 0.5 ± 0.4, and the mean deviation of visual field with the Humphrey Field Analyzer program 30-2 was −22.0 ± 10.9 dB.

Results: The visual acuity of log10MAR in the better eye (r = 0.66 to 0.81) and the mean sensitivity within the central 10° of the visual field (r = −0.76 to −0.62) had a definite relationship to the visual disability index of each section and their sum (P < .0001). This relationship was also confirmed in multiple regression analysis, which showed a high correlation coefficient (R2 = 0.57 to 0.77, P < .0001).

Conclusions: The retinal sensitivity within the central 10° and the visual acuity of log10MAR in the better eye had a significant influence on a patient's daily life. We suggest that in patients with retinitis pigmentosa, visual disability in daily life can be precisely evaluated with the retinal sensitivity within the central 10° and the visual acuity in the logarithm of the minimum angle of resolution in the better eye.

Introduction

Retinitis pigmentosa (RP) is characterized by progressive photoreceptor and retinal pigment epithelium degeneration.1 As the disease progresses, the degree of patients' subjective symptoms, such as visual field loss and central vision loss, increases and causes severe visual disability in their daily life. The relationship between visual disability and clinical assessment of visual functions, including visual field, visual acuity, or electroretinographic data in RP patients already has been reported2, 3, 4, 5; however, only the visual field has been assessed by Szlyk et al.3, 4 Because they used the Goldmann perimeter for visual field testing, the central visual field that seems to have a great influence on daily visual function has not been assessed in their study. We have previously evaluated the relationship between visual disability and the central visual field with program 30-2 of the Humphrey Field Analyzer (HFA 30-2; Carl Zeiss, Dublin, CA, USA) in patients with glaucoma, which is regarded as one of the representative diseases, such as RP, which cause visual field impairment. We reported that the mean sensitivity within the central 10° (especially the lower hemifield within the central 5°) showed the strongest correlation with the visual disability in glaucoma patients.6, 7 In the present study, we evaluated the relationship between visual disability and the central visual field assessment by HFA 30-2 in patients with RP, whose pattern of visual field defect differs from glaucoma.

Section snippets

Subjects

The degree of visual disability in daily life was determined in 93 patients (50 men and 43 women) with RP. The genetic type of RP was either autosomal recessive or isolated. The mean (± SD) age of patients was 52.6 ± 15.1 years. The mean best corrected visual acuity in the logarithm of the minimum angle of resolution (log10MAR) was 0.4 ± 0.4 in the eye with better vision (better eye) and 0.6 ± 0.4 in the eye with worse vision (worse eye) (Figure 1). The mean deviation of HFA 30-2 data was −21.0

Results

As shown in Table 2, visual acuity in the better eye, the worse eye, and the mean of both eyes correlated strongly with the DIs. Especially, the visual acuity in the better eye showed the strongest correlation with all the DIs (r = 0.66 to 0.81, P < .0001).

As shown in Table 3, regardless of which method was used for calculating the representative sensitivity within the central 30° in the HFA 30-2 assessment, there was a significant correlation with the DIs. However, when we adopted the higher

Discussion

The relationship between visual disability in daily life and the clinical assessment of visual acuity and visual field with the HFA 30-2 were evaluated in RP patients. The visual acuity of log10MAR in the better eye and the mean sensitivity within the central 10° of the visual field had a definite relationship to the visual DIs.

In Japan, visual disability in patients with RP has already been reported by Hayakawa et al2 in what they called a “Quality of Life Questionnaire,” based on a

References (12)

  • T. William et al.
  • M. Hayakawa et al.

    Quality of life in patients with retinitis pigmentosa

    Rinsho Ganka (Jpn J Clin Ophthalmol)

    (1996)
  • J.P. Szlyk et al.

    Relationship between difficulty in performing daily activity and clinical measures of visual function in patients with retinitis pigmentosa

    Arch Ophthalmol

    (1997)
  • J.P. Szlyk et al.

    Assessment of driving performance in patients with retinitis pigmentosa

    Arch Ophthalmol

    (1992)
  • J. Lowe et al.

    Patients' responses to retinitis pigmentosa

    Optom Vis Sci

    (1992)
  • I. Sumi et al.

    Visual disability, stage of invalidity, visual acuity and visual field in glaucoma patients

    Atarashii Ganka (J Eye)

    (1995)
There are more references available in the full text version of this article.

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