Our results indicated that the average MD progression rate of 45 patients was −0.46 dB/year, (95% CI −0.64 to −0.28) with a P value 3000 mm). We determined the annual progression of visual field sensitivity decrease of the mean deviation (MD) and also the sensitivities of three concentric areas of the HFA 10-2 by a method that was a modification of previous studies 11, 13. We reviewed the serial results of the sensitivities determined by the HFA 10-2 program in RP patients and performed trend analysis with mixed linear models. Thus, the aim of this study was to assess the annual decrease of the visual sensitivity of the central visual field in RP patients. However, earlier studies included only a small number of RP patients 10, 11, and the nature of progression of the visual field in the central 10 degrees was not determined conclusively. Because RP patients have difficulties when the visual field constricts to the central 10 degrees, the HFA 10-2 program is a reasonable option for assessing the disease progression. Several other studies have demonstrated the usefulness of the HFA 10-2 program to evaluate RP patients 9, 10, 11, 12. Two studies have shown a progressive constriction of the visual field in RP patients with the HFA 30-2 program 7, 8. The HFA has been used to assess not only the extent of the central visual field but also to quantify the visual sensitivity of different areas of the central visual field. Dublin, CA, USA) is a reliable method to evaluate the central visual filed, and it is widely used to determine the stage of glaucoma. These findings indicated that an evaluation of the central visual field is essential in the advanced stage of RP, however Goldmann kinetic perimetry is not appropriate for evaluating small areas of the central visual field 3, 5.Īutomated static perimetry with the Humphrey Field Analyzer (HFA Carl Zeiss Meditec, Inc. The time course of the progression of the visual field defects in RP has been extensively studied by Goldmann kinetic perimetry 1, 2, 3, 4, and the results have shown several patterns of visual field progression the basic pattern of concentric visual field loss, changes beginning with scotomas in the mid-peripheral regions, asymmetrical visual field loss, and the end stage when only the central visual field remains 5, 6. The natural history of RP must be known to determine the possible clinical markers of a progression of RP, and these can be used to evaluate the safety and efficacy of new treatments. Several therapeutic options are present for the preclinical or early clinical stages of RP, and the methods used to assess the efficacy of these treatments are being extensively studied. Visual field loss progresses peripheral-to-central but can simultaneously expand peripherally and centrally in patients with ring scotomas. The loss of the cone photoreceptors results in the central visual field loss and visual acuity reduction, which are the most critical problems for RP patients. The signs and symptoms of RP are impaired night vision and slow progressive visual field loss and eventual decline in the visual acuity. The characteristic fundus changes include that of the retinal pigment epithelium (RPE), blood vessel attenuation, disc pallor, and presence of bone-spicule pigmentation, which can be seen at different stages of RP. Retinitis pigmentosa (RP) is a genetically heterogeneous group of inherited retinal disorders characterized by a slow, progressive loss of photoreceptors primarily the rods. These results should be useful in understanding the pathological changes of RP in the central visual field. When the patients were grouped by the average initial MD, the less advanced group had slower progressions than the more advanced group in S4, S12, and S20. The mean change of the MD was −0.46 dB/year (−5.80%/year). The median number of the visual field tests was 3 (range: 3 to 15, IQR: 3 to 4). The median follow-up time was 3.86 years. Linear mixed models were used to follow the changes of the mean deviation and the average sensitivity of 4, 12, and 20 points in three concentric squares, designated as S4, S12, and S20. The medical records of 45 eyes of 45 RP patients who had at least 3 visual field tests were reviewed. The aim of this study is to determine the progress of the visual field defects obtained by the Humphrey Field Analyzer 10-2 program (HFA 10-2) in patients with retinitis pigmentosa (RP).
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