Progression of Retinitis Pigmentosa as Measured on Microperimetry: The PREP-1 Study

Mustafa Iftikhar, Saleema Kherani, Ramandeep Kaur, Marili Lemus, April Nefalar, Bushra Usmani, Nadia Junaid, Peter A. Campochiaro, Hendrik Scholl, Syed Mahmood Shah

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate yearly progression of retinitis pigmentosa (RP) using microperimetry (MP) performed on Nidek MP1 (NAVIS Software v1.7; Nidek Technologies, Padova, Italy). Design: Retrospective longitudinal study. Participants: RP patients with consecutive MP tests (using the same test settings). Methods: Data were collected as part of the Photoreceptor Cell Death in Retinitis Pigmentosa Retrospective (PREP-1) study. Visual acuity, fixation stability, mean sensitivity, and regional sensitivity were assessed at baseline and at yearly follow-up appointments. Regional sensitivity was calculated based on 2 methods. Method 1 involved topographical division into central macula (CM) and paracentral macula (PM). Method 2 involved functional division into the edge of scotoma (ES) and the seeing retina (SR). Linear mixed-effects models were used to assess the annual rate of change for each parameter, adjusted for disease duration. Main Outcome Measures: Annual rate of change of visual acuity, fixation stability, and retinal sensitivities (mean sensitivity and regional sensitivities using methods 1 and 2). Results: In total, 75 eyes of 39 patients (median age, 56 y; males, 57%) with a follow-up period ranging from 1 to 4 years were reviewed. Visual acuity at baseline was positively correlated with all retinal sensitivity parameters, most strongly with CM sensitivity (r = 0.545, P < 0.001). There was no change in visual acuity (P = 0.075) or fixation stability (P = 0.371) per year. All retinal sensitivity parameters had a significant decline per year (P < 0.001), with a decline of 0.4 decibel (dB) for mean sensitivity, 0.6 dB for CM, 0.3 dB for PM, 1.3 dB for ES, and 1.1 dB for SR. Method 2 identified the greatest number of cases, with a significant decline in regional sensitivity. Conclusion: MP can detect significant changes in regional sensitivity over a 1-year period in patients with RP, even as visual acuity and fixation remain stable. An individualized approach to analyzing retinal sensitivity derived from MP may offer a useful outcome measure for future clinical trials.

Original languageEnglish (US)
Pages (from-to)502-507
Number of pages6
JournalOphthalmology Retina
Volume2
Issue number5
DOIs
StatePublished - May 1 2018

ASJC Scopus subject areas

  • Ophthalmology

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