Association of Patient-Reported Outcomes with Objective Visual Function Measures in Retinitis Pigmentosa

Abstract

Purpose : As patients with retinitis pigmentosa (RP) retain good central visual acuity (VA) while experiencing notable peripheral vision loss, we administered three validated patient reported outcome (PRO) questionnaires to patients with RP and investigated their association with objective visual measures.

Methods : We performed a single-center, observational, cross-sectional study of patients with RP and healthy volunteers (HVs) with VA 20/63 or better in at least one eye. Participants were administered the National Eye Institute Visual Function Questionnaire (NEI VFQ) and the Vision QOL questionnaire (VisQoL). Six (±4) weeks later they completed the Independent Mobility Questionnaire (IMQ). At each visit, best-corrected VA (BCVA) and visual field (VF) measures of mean deviation (MD) (Compass 24-2) were collected. We compared PRO responses of RP and HV groups and examined the associations between individual question scores to VA and VF. Significance was set as p<0.05.

Results : Twenty-six RP patients (49.4 ± 14.0 years, MD -16.9 ± 7.8 dB, BCVA 81.0 ± 8.4 letters) and 15 HVs (33.1 ±10.5 years, MD 0.3 ± 0.6 dB, BCVA 91.0 ± 3.7 letters) were included in the analysis. All participants completed the NEI VFQ and VisQol while 88.5% (n=23) of RP patients and 53.3% (n=8) of HVs completed the IMQ. We found higher NEI-VFQ and lower VisQoL, IMQ scores for HVs than RP patients for nearly all PROs (figure 1). VF was not significantly related to any VisQoL questions. The strongest associations of PRO scores and VF were for IMQ questions on mobility in public places (R²=0.2995-0.3926), bumping into things (R²=0.2764-0.3032), and NEI VFQ questions on driving status (R²=0.3979), ability to note objects in peripheral vision (R²=0.2615). Two NEI VFQ questions were associated with VF and VA: finding objects on crowded shelves (VF R²=0.3415, VA R²=0.2004) and reading street signs (VF R²=0.2393, VA R²=0.2225). We observed no significant associations of VA with other NEI VFQ questions, or any IMQ, VisQoL responses.

Conclusions : In RP participants with VA 20/63 or better, we observed that nearly every NEI VFQ, VisQoL, and IMQ response significantly differed from HV and worse MD values were associated with IMQ and NEI VFQ scores, suggesting that these PROs may capture QOL aspects related to peripheral vision loss.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

RP and HV were significantly different for almost every question of the PROs (*p<0.05, **p<0.01, ***p<0.001).