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 P N Scholl; Syed M Shah

doi:10.1016/j.oret.2017.09.008

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

Ophthalmol Retina. 2018 May;2(5):502-507. doi: 10.1016/j.oret.2017.09.008. Epub 2017 Nov 9.

Affiliations

¹ The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
² The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Ophthalmology, University of Basel, Basel, Switzerland.
³ The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: qvrc@qvrc.net.

PMID: 31047333
DOI: 10.1016/j.oret.2017.09.008

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.