Abstract
Purpose. To assess the long-term effects of nilvadipine on the progression of central visual field defect in retinitis pigmentosa (RP). Methods. Patients with RP were randomly divided into a treated group receiving oral nilvadipine and a control group. Progression of RP was evaluated with MD slope and the average sensitivity of the central 2° (ΔCENT4). Results. The mean MD slopes were −0.55/−0.39 (right/left eyes, n = 19) dB/year in the treated group and −1.37/−1.15 (right/left eyes, n = 22) dB/year in the control group (P = 0.016/0.050, resp.). In both eyes, however, no statistical difference was observed between the two groups for the ΔCENT4 values. Conclusion. Although we confirmed that nilvadipine significantly retarded the progression of the average of MD value defects in the central 10°, it was not specific for the central 2° of the visual field in RP.
Highlights
Retinitis pigmentosa (RP) denotes a heterogeneous group of hereditary retinal degenerations and comprises one of leading causes of visual handicaps
Irrespective of the involvement of the calcium channelblocking actions, the increased blood flow, or both, the present study does indicate that nilvadipine can slow the progression of the central visual field defect in RP for a longterm period
Assessment by the 10-2 program in Analysis 1 estimated that the annual protection induced by 4 mg/day of oral nilvadipine was, on average, 0.82 to 0.77 dB/year over that found in the control patients, both of which were statistically significant (P = 0.016 and 0.050, resp.)
Summary
Retinitis pigmentosa (RP) denotes a heterogeneous group of hereditary retinal degenerations and comprises one of leading causes of visual handicaps. Serially monitoring the central visual field is important for patients with RP so that clinicians can both determine the level of the visual handicaps and be able to speculate on the actual progression of the disease. Iijima’s study found that the average sensitivity for the central 4 points (CENT4) was correlated with the central visual acuity and proved better than the MD value for monitoring the advanced stages of RP. This previous study demonstrated the CENT4 values are more correlated to the visual progression of RP than the central visual acuity
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