Photopic temporal processing in retinitis pigmentosa.

PURPOSE: The relation between early changes in the photopic flicker electroretinogram (ERG) and photopic psychophysical changes in retinitis pigmentosa (RP) is poorly understood. Here, abnormalities in foveal and extrafoveal temporal contrast sensitivity functions (TCSFs) were studied in a group of carefully selected patients with RP who had relatively preserved macular function. The psychophysical results were compared with changes in the timing of the multifocal ERG.

METHODS

Subjects were patients with RP who had acuity > or =20/32 and no visual field defects within 6 degrees from the fovea. Maxwellian-view and direct-view optical systems were used to obtain foveal and extrafoveal TCSFs under a range of test conditions, including high retinal illuminances that yielded temporal contrast sensitivity independent of mean retinal illuminance. TCSFs were described using log sensitivity and corner frequency parameters.

RESULTS

Foveal TCSFs in these patients showed overall reductions in sensitivity but no frequency-dependent defects. Also, no macular defects were found in the timing of the multifocal ERG. TCSFs from extrafoveal locations in moderate field defects, obtained at retinal illuminances that were sufficient to render flicker sensitivity independent of effective mean luminance, showed reductions in overall sensitivity as well as changes in temporal tuning. The multifocal ERGs from these extrafoveal locations showed signs of temporal slowing.

CONCLUSIONS

Changes in temporal tuning (both psychophysical and electroretinographic) were found only within visual field scotomas, whereas changes of the log sensitivity parameter were found also in the relatively preserved foveas of this group of patients with early stage RP.