Abstract
Purpose :
Retinitis pigmentosa (RP) is typically characterized by progressive peripheral visual field (pVF) loss. PVF loss is a main source of visual disability in RP patients. Therefore, greater understanding of factors that promote this process is required, so that mitigation or treatment strategies can be rationally developed. Although the factors associated with retained pVF are not fully understood, cataract extraction (CE) might influence the magnitude of pVF loss. Here, we leverage a dataset of RP cases to estimate the effect of the phakic status on pVF preservation.
Methods :
Goldmann visual fields (GVF) of all eyes were included in a cross-sectional dataset, and those with repeated GVFs in a longitudinal dataset. Eyes were classified by phakic status into phakic and pseudophakic/aphakic. Self-reported symptomatic disease duration (SDD) was extracted from the medical records. The remaining area of pVF (cm2) was calculated using segmentation analysis. Mixed-effects regressions estimated the association of the lens status and pVF.
Results :
We included 144 patients and 275 eyes in the cross-sectional dataset. The mean age was 48.6 ± 18 years, and 77.8% (n=214) were phakic. Most eyes (62.8%) had <20 years of SDD. Pseudophakia/aphakia was not associated with a lower baseline pVF (mean difference, -9.33 cm2, SE 14.26; P=0.514), but eyes with SDD >40 years had on average lower retained pVF (mean difference, 56.46 cm2, SE 21.83; P=0.012) than those <20. The longitudinal set included 118 eyes of 59 patients. The follow-up ranged from 1.4 to 6.6 years. Overall, there was a mean loss of 10.64 cm2/year in retained pVF. The retained pVF in pseudophakic/aphakic eyes was significantly lower than in phakic eyes at year 6 of follow-up after adjusting for SDD (mean difference, -75.86 cm2, SE 24.42, P=0.002). There was no effect association between SDD and retained pVF over time.
Conclusions :
Lens status might not affect pVF loss in the short term in patients with RP. However, the effects on the rate pVF decline in pseudophakic/aphakic eyes might increase over time.To more fully understand the environmental and genetic factors associated with progressive pVF loss, future studies should prospectively investigate the change in pVF before and after CE and by RP genotype.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.