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Importance of two-dimensional gaze analyses in the assessment of reading performance in patients with retinitis pigmentosa.

ABSTRACT: The causes of reading difficulties in people with peripheral visual field loss are not fully understood. We conducted a two-dimensional gaze analysis on eye movements during reading in patients with retinitis pigmentosa to investigate the causes of reading difficulties in relation to the central visual field using a binocular eye mark recorder (EMR-9). Twenty-seven patients with retinitis pigmentosa whose central visual field narrowed to ≤ 20° using Goldmann kinetic perimetry (I/4 target) and this present study included eight healthy participants. The participants' visual acuities were corrected to better than +0.4 logMAR. Correlations and multivariate regression analyses were investigated between the number of letters read correctly, the I/4 central visual field, V/4 perifoveal and peripheral visual field, and visual acuity. Multivariate regression analysis revealed that all these parameters played almost equal roles in the number of letters read correctly. In the two-dimensional gaze analysis, the task performance time of patients during reading increased as the I/4 central visual field narrowed. The task performance time was more clearly correlated with the rotation saccade (r = 0.428, p <0.05) and the distance of the vertical direction (ΣY) of eye movements (r = 0.624, p < 0.01), but not with regressive saccade and the distance of the horizontal direction (ΣX). Visual acuity was correlated with the task performance time (-0.436, <0.05) but not with eye movement directionality. Reading difficulties in patients with retinitis pigmentosa result from impaired eye movement directionality. Understanding eye measurements for people with tunnel vision required a two-dimensional gaze analysis. The two-dimensional gaze analysis also showed that the involvement of the perifoveal and peripheral visual fields, visual acuity, and I/4 central visual field was important for reading in people with tunnel vision.

SUBMITTER: Yoshida M

PROVIDER: S-EPMC9750004 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Importance of two-dimensional gaze analyses in the assessment of reading performance in patients with retinitis pigmentosa.

Yoshida Masako M Seiyama Akitoshi A

PloS one 20221214 12

The causes of reading difficulties in people with peripheral visual field loss are not fully understood. We conducted a two-dimensional gaze analysis on eye movements during reading in patients with retinitis pigmentosa to investigate the causes of reading difficulties in relation to the central visual field using a binocular eye mark recorder (EMR-9). Twenty-seven patients with retinitis pigmentosa whose central visual field narrowed to ≤ 20° using Goldmann kinetic perimetry (I/4 target) and th ...[more]

PMID: 36516162

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Project description:Retinitis pigmentosa is a group of genetic disorders that involves the breakdown and loss of photoreceptors in the retina, resulting in progressive retinal degeneration and eventual blindness. The Argus II Retinal Prosthesis System is the only currently available surgical implantable device approved by Health Canada. It has been shown to improve visual function in patients with severe visual loss from advanced retinitis pigmentosa. The objective of this analysis was to examine the clinical effectiveness, cost-effectiveness, budget impact, and safety of the Argus II system in improving visual function, as well as exploring patient experiences with the system.We performed a systematic search of the literature for studies examining the effects of the Argus II retinal prosthesis system in patients with advanced retinitis pigmentosa, and appraised the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria, focusing on visual function, functional outcomes, quality of life, and adverse events. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care over a 10-year time horizon. We also conducted a 5-year budget impact analysis. We used a qualitative design and an interview methodology to examine patients' lived experience, and we used a modified grounded theory methodology to analyze information from interviews. Transcripts were coded, and themes were compared against one another.One multicentre international study and one single-centre study were included in the clinical review. In both studies, patients showed improved visual function with the Argus II system. However, the sight-threatening surgical complication rate was substantial. In the base-case analysis, the Argus II system was cost-effective compared with standard care only if willingness-to-pay was more than $207,616 per quality-adjusted life-year. The 5-year budget impact of funding the Argus II system ranged from $800,404 to $837,596. Retinitis pigmentosa significantly affects people's ability to navigate physical and virtual environments. Argus II was described as enabling the fundamental elements of sight. As such, it had a positive impact on quality of life for people with retinitis pigmentosa.Based on evidence of moderate quality, patients with advanced retinitis pigmentosa who were implanted with the Argus II retinal prosthesis system showed significant improvement in visual function, real-life functional outcomes, and quality of life, but there were complications associated with the surgery that could be managed through standard ophthalmologic treatments. The costs for the technology are high.

Project description:The purpose of this study is to determine the factors related to anxiety and depression in patients with retinitis pigmentosa (RP). The status of anxiety and depression was determined in RP patients with the Hospital Anxiety and Depression Scale (HADS) questionnaire which consisted of subscales for HADS-anxiety (HADS-A) and HADS-depression (HADS-D). The vision-specific quality of life (VSQOL) was assessed with the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ25). The correlations between the HADS-A or HADS-D scores and vision-related clinical parameters such as the best-corrected visual acuity (BCVA), Functional Acuity Score, Functional Field Score, Functional Vision Score, the NEI- VFQ25 subscale score were determined. The socioeconomic status, such as the work status and membership in the RP society, was investigated to determine the factors related to the HADS-A and HADS-D scores. One hundred and twelve RP patients (46 men and 66 women) with mean age of 60.7±15.4 (standard deviation) years were studied. The HADS-A score was not significantly correlated with any visual functions but was significantly correlated with the general health condition (r = -0.34, P<0.001) and the role limitation (r = -0.20, P = 0.03) of the NEI-VFQ25 subscale. The HADS-D score was significantly correlated with all the visual functions (r = -0.38 to 0.29, P<0.001), the NEI-VFQ25 subscale score (r = - 0.58 to -0.33, P<0.001) by Spearman's correlations. The HADS-A score was significantly higher in the members of the RP society than in non-members (P = 0.013). The mean HADS-D score of employed individuals was significantly lower than that of unemployed ones (P = 0.001) by the Mann-Whitney U test. The results indicate that visual function impairments and vision-related quality of life are associated with a depressive state, and the general health condition is related to anxiety in RP patients. Being employed may be strongly correlated with the degree of depression in RP patients.

Dataset Information

Importance of two-dimensional gaze analyses in the assessment of reading performance in patients with retinitis pigmentosa.

Publications

Importance of two-dimensional gaze analyses in the assessment of reading performance in patients with retinitis pigmentosa.

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