Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis Pigmentosa

Purpose: Novel therapeutic options, such as regenerative medicine and gene therapy, are now emerging as viable treatment options for patients with severe visual impairments, such as retinitis pigmentosa (RP). Gradable assessment of patients’ visual function is essential to consider treatment options...

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Main Authors: Midori Yamamoto, Take Matsuyama, PhD, Tadao Maeda, MD, PhD, Seiji Takagi, MD, PhD, Naohiro Motozawa, MD, PhD, Daiki Sakai, MD, Yasuhiko Hirami, MD, PhD, Akiko Maeda, MD, PhD, Yasuo Kurimoto, MD, PhD, Masayo Takahashi, MD, PhD, Michiko Mandai, MD, PhD
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Ophthalmology Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S266691452300060X
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author Midori Yamamoto
Take Matsuyama, PhD
Tadao Maeda, MD, PhD
Seiji Takagi, MD, PhD
Naohiro Motozawa, MD, PhD
Daiki Sakai, MD
Yasuhiko Hirami, MD, PhD
Akiko Maeda, MD, PhD
Yasuo Kurimoto, MD, PhD
Masayo Takahashi, MD, PhD
Michiko Mandai, MD, PhD
author_facet Midori Yamamoto
Take Matsuyama, PhD
Tadao Maeda, MD, PhD
Seiji Takagi, MD, PhD
Naohiro Motozawa, MD, PhD
Daiki Sakai, MD
Yasuhiko Hirami, MD, PhD
Akiko Maeda, MD, PhD
Yasuo Kurimoto, MD, PhD
Masayo Takahashi, MD, PhD
Michiko Mandai, MD, PhD
author_sort Midori Yamamoto
collection DOAJ
description Purpose: Novel therapeutic options, such as regenerative medicine and gene therapy, are now emerging as viable treatment options for patients with severe visual impairments, such as retinitis pigmentosa (RP). Gradable assessment of patients’ visual function is essential to consider treatment options and to evaluate treatment outcomes; however, evaluation of visual function in patients with advanced low vision is often challenging because of patients’ poor and sometimes unpredictable responses. In this study, we attempted to accurately assess visual capabilities and disease stage in patients with RP with a visual acuity (VA) of ≤ 0.01. Design: Retrospective analysis of visual function indicators, including VA, retinal thickness, full-field stimulus testing (FST), and chromatic pupillometry. Subjects: Overall, 43 patients (84 eyes) with advanced RP with a VA of ≤ 0.01 visited Kobe City Eye Hospital from 2019 to 2021. Methods: Hierarchical (multilevel) Bayesian modeling was used to estimate individual eye’s pupil response and FST threshold, taking into account the ambiguity and randomness often observed in patients with ultralow vision. Using the estimated ability obtained from each test, the correlation between each test and retinal thickness was further analyzed to make a comprehensive assessment of the data. Main Outcome Measures: Visual acuity, retinal thickness, FST threshold, and pupil diameter change to different light stimuli. Results: Full-field stimulus testing and pupillometry measurements were moderately correlated with VA but exhibited a wide range of values within the same VA groups. Full-field stimulus testing was not correlated with central retinal thickness at counting fingers/hand motion VA range and seemed to reflect overall remaining photoreceptor function, including peripheral retina. Pupillometry may be able to distinguish between different levels of inner retinal function. Conclusions: The combination of pupillometry and FST allowed for graded evaluation of visual function within patients grouped in the same VA groups in patients with advanced RP with ultralow vision. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
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spelling doaj.art-74159ada8eb34b0ba084bd74908d0f392023-12-24T04:47:02ZengElsevierOphthalmology Science2666-91452023-12-0134100328Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis PigmentosaMidori Yamamoto0Take Matsuyama, PhD1Tadao Maeda, MD, PhD2Seiji Takagi, MD, PhD3Naohiro Motozawa, MD, PhD4Daiki Sakai, MD5Yasuhiko Hirami, MD, PhD6Akiko Maeda, MD, PhD7Yasuo Kurimoto, MD, PhD8Masayo Takahashi, MD, PhD9Michiko Mandai, MD, PhD10Department of Ophthalmology, Kobe City Eye Hospital, Kobe, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; Correspondence: Takesi Matsuyama and Michiko Mandai, Kobe City Eye Hospital, 2-1-8 Minamimachi, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047, Japan.Department of Ophthalmology, Kobe City Eye Hospital, Kobe, JapanDepartment of Ophthalmology, Toho University Graduate School of Medicine, Tokyo, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan; Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; Vision Care Inc., Kobe, JapanDepartment of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan; Correspondence: Takesi Matsuyama and Michiko Mandai, Kobe City Eye Hospital, 2-1-8 Minamimachi, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047, Japan.Purpose: Novel therapeutic options, such as regenerative medicine and gene therapy, are now emerging as viable treatment options for patients with severe visual impairments, such as retinitis pigmentosa (RP). Gradable assessment of patients’ visual function is essential to consider treatment options and to evaluate treatment outcomes; however, evaluation of visual function in patients with advanced low vision is often challenging because of patients’ poor and sometimes unpredictable responses. In this study, we attempted to accurately assess visual capabilities and disease stage in patients with RP with a visual acuity (VA) of ≤ 0.01. Design: Retrospective analysis of visual function indicators, including VA, retinal thickness, full-field stimulus testing (FST), and chromatic pupillometry. Subjects: Overall, 43 patients (84 eyes) with advanced RP with a VA of ≤ 0.01 visited Kobe City Eye Hospital from 2019 to 2021. Methods: Hierarchical (multilevel) Bayesian modeling was used to estimate individual eye’s pupil response and FST threshold, taking into account the ambiguity and randomness often observed in patients with ultralow vision. Using the estimated ability obtained from each test, the correlation between each test and retinal thickness was further analyzed to make a comprehensive assessment of the data. Main Outcome Measures: Visual acuity, retinal thickness, FST threshold, and pupil diameter change to different light stimuli. Results: Full-field stimulus testing and pupillometry measurements were moderately correlated with VA but exhibited a wide range of values within the same VA groups. Full-field stimulus testing was not correlated with central retinal thickness at counting fingers/hand motion VA range and seemed to reflect overall remaining photoreceptor function, including peripheral retina. Pupillometry may be able to distinguish between different levels of inner retinal function. Conclusions: The combination of pupillometry and FST allowed for graded evaluation of visual function within patients grouped in the same VA groups in patients with advanced RP with ultralow vision. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.http://www.sciencedirect.com/science/article/pii/S266691452300060XChromatic pupillometryFSTRetinitis pigmentosa
spellingShingle Midori Yamamoto
Take Matsuyama, PhD
Tadao Maeda, MD, PhD
Seiji Takagi, MD, PhD
Naohiro Motozawa, MD, PhD
Daiki Sakai, MD
Yasuhiko Hirami, MD, PhD
Akiko Maeda, MD, PhD
Yasuo Kurimoto, MD, PhD
Masayo Takahashi, MD, PhD
Michiko Mandai, MD, PhD
Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis Pigmentosa
Ophthalmology Science
Chromatic pupillometry
FST
Retinitis pigmentosa
title Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis Pigmentosa
title_full Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis Pigmentosa
title_fullStr Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis Pigmentosa
title_full_unstemmed Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis Pigmentosa
title_short Detailed Evaluation of Chromatic Pupillometry and Full-Field Stimulus Testing to Assess Ultralow Vision in Retinitis Pigmentosa
title_sort detailed evaluation of chromatic pupillometry and full field stimulus testing to assess ultralow vision in retinitis pigmentosa
topic Chromatic pupillometry
FST
Retinitis pigmentosa
url http://www.sciencedirect.com/science/article/pii/S266691452300060X
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