Study on the correlation between rate of visual field loss and gene abnormality in retinitis pigmentosa

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Retinitis pigmentosa is caused by various gene abnormality. Because the fundamental treatment for the disease has not been established, the information on the disease progression and visual prognosis may be important for the patients. In the present study, we proposed the method of quantitative evaluation for the disease progression using the automated static perimetry.We studied the perimetry results of patients with RP and analyzed the progression rate of the mean deviation (MD) of Humphrey perimetry program 30-2 and 10-2 using HFA files ver. 5 (BeeLine Office Co. Tokyo). Out of 126 eyes of 65 patients with RP who had been examined using Humphrey perimetry for 5 years or more, 68 eyes (54%) demonstrated statistically significant reduction of MD during the follow-up period. The progression rate of MD in 30-2 program ranged between 0.11 and 3.1 dB/year with the average of 0.93 dB/year in 26 eyes. That for 10-2 program ranged between 0.19 and 2.05 with the average of 0.64 dB/year in 51 eyes.Then we studied the relationship between visual loss and the perimetric progression. Most eyes maintain good visual acuity until the MD of Humphrey perimetry central 10-2 program is -15dB, while after that, some cases start to show decreased visual acuity. Eyes with MD of -15 dB of worse, the visual acuity and corrected pattern standard deviation (CPSD) showed good correlation. Eyes with high value of CPSD, which means unevenly damaged visual field showing almost normal sensitivity at the canter of the field and absolute scotoma in the periphery of the 10-degree central field.