Perceived Stress and Biomarkers in Retinitis Pigmentosa

Abstract

Purpose : Patients affected by Retinitis Pigmentosa (RP) lose night vision and peripheral vision. Various degrees of stress and depression may accompany the disease, which progressively leads to legal blindness over time. This project aims to assess emotional (first phase) and biochemical stress (by analyzing biomarkers) as a preliminary step to assess the possibility of using adjuvant treatments

Methods : Patients (age 20-60yrs) with established diagnosis of RP were recruited to participate in this prospective observational study. Thirty patients completed the stress assessments (first phase) using State-Trait Anxiety Inventory (STAI), Epworth Sleepiness Scale (ESS) and Pittsburg Sleep Quality Index (PSQI) questionnaires. The best-corrected visual acuity (BCVA) was also assessed. In addition (second phase, analysis currently on-going), tear and saliva were collected and frozen for ELISA analysis of cortisol, α-amylase, secretory IgA, testosterone, and soluble fraction of receptor II of TNFα. Hair samples were collected for assessing cortisol concentrations. A group (n=34) of age and gender-matched controls has also been recruited to provide normative data. Figure 1

Results : Thirty patients with RP, 20 men (67%) and 10 women (33%) were included. Six groups of patients were established according to visual acuity (Table 1). No correlations were observed between age and BCVA. The sleep quality observed in PSQI was 5.5 [4-8] points, which indicates a poor sleep quality (PSQ), 70% (n=21) obtained pathological values. No significant differences according to sex were seen. The level of sleepiness was 7.43±3.59 points in ESS. 30% of the patients had excessive levels of sleepiness. Significant differences were observed between men and women (p = 0.018). The level of anxiety was 15.85±10.89 points in men and 25.15 ± 7.96 points in women and the level of personal predisposition to stress response was 22.5 [20-30] in men and 21.5 [19.75-25.25] in women. There were no significant differences between both groups

Conclusions : There have been limited studies of the association of chronic stress or sleep quality in RP. The current study assessing chronic stress found PSQ in patients with RP, however the majority of patients did not present excessive daytime sleepiness disorders or pathological anxiety levels. To complete the assessment, biological samples are being analyzed to compare to the healthy controls

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.