Classification of disease severity in retinitis pigmentosa

Br J Ophthalmol. 2019 Nov;103(11):1595-1599. doi: 10.1136/bjophthalmol-2018-313669. Epub 2019 Jan 31.

Abstract

Aim: To develop a simple and easily applicable classification of disease severity in retinitis pigmentosa (RP).

Methods: This is a retrospective cross-sectional study. Visual acuity (VA), visual field width (VF) and ellipsoid zone width (EZ) were obtained from medical records of patients with RP. A scoring criterion was developed wherein each variable was assigned a score from 0 to 5 depending on its distribution. The cumulative score (from 0 to 15) was used to classify disease severity from grade 0 to 5. The scores were correlated with each other and the final grade. The grades were then correlated with age and disease duration.

Results: The median age (range) of patients (n=93) was 55 (12-87) years, 51% were female, 70% had been diagnosed within 10 years, and 50% had autosomal recessive disease. Most eyes (n=181) at least had a VA of 20/40 (67%), a VF of 20° (75%) and an EZ of 5° (76%). All scores were correlated with each other (r=0.509-0.613; p<0.001 for all) and with the final grade (r=0.790-0.869; p<0.001 for all). Except for grade 0 (5%), all grades were evenly distributed: 21% for grade 1, 23% for grade 2, 22% for grade 3, 17% for grade 4 and 12% for grade 5. Grades were correlated with both age (r=0.252; p<0.001) and disease duration (r=0.383; p<0.001).

Conclusions: We present a simple, objective and easy to use disease severity classification for RP which can be used to categorise and compare patients.

Keywords: classification; retinitis pigmentosa; severity.

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retinitis Pigmentosa / classification*
  • Retinitis Pigmentosa / diagnosis*
  • Retinitis Pigmentosa / physiopathology
  • Retrospective Studies
  • Severity of Illness Index
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Visual Fields / physiology
  • Young Adult