The Relationship Between Visual Disability and Visual Scores in Patients With Retinitis Pigmentosa
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)
- et al.
- et al.
Quality of life in patients with retinitis pigmentosa
Rinsho Ganka (Jpn J Clin Ophthalmol)
(1996) - et al.
Relationship between difficulty in performing daily activity and clinical measures of visual function in patients with retinitis pigmentosa
Arch Ophthalmol
(1997) - et al.
Assessment of driving performance in patients with retinitis pigmentosa
Arch Ophthalmol
(1992) - et al.
Patients' responses to retinitis pigmentosa
Optom Vis Sci
(1992) - et al.
Visual disability, stage of invalidity, visual acuity and visual field in glaucoma patients
Atarashii Ganka (J Eye)
(1995)
Cited by (25)
Assessment of patient-reported outcomes in retinal diseases: a systematic review
2017, Survey of OphthalmologyVisual functions and disability in diabetic retinopathy patients
2014, Journal of OptometryContrast sensitivity evaluation with filter contact lenses in patients with retinitis pigmentosa: A pilot study
2011, Journal of OptometryCitation Excerpt :Two thirds of the patients were more comfortable with the contact lens than the glasses filter for indoor use. This could be due by the fact that retinitis pigmentosa patients have difficulty adapting to even small changes in light levels24 and probably wearing contact lens filter provides a constant dark adaptation, diminishing symptoms of light sensitivity in the retina. Before patients could benefit from this contact lens filter we would need to overcome two lens limitations.
Review and update: Current treatment trends for patients with retinitis pigmentosa
2009, OptometryCitation Excerpt :Treatment modalities, such as low vision rehabilitation, are more successful once the patient is properly motivated to succeed. Low vision rehabilitation for RP patients has progressed from an optical/medical model to a functional disability model.52 A careful history (which may include the Activities of Daily Vision Scale109 or the National Eye Institute Visual Function Questionnaire110) can help identify specific functional problems that patients may experience during daily activities.52