Visual Field Estimation in X-Linked Retinitis Pigmentosa Associated with Retinitis Pigmentosa GTPase Regulator (RPGR) from Image Analysis Using Artificial Intelligence.

PURPOSE: To develop an efficient approach to estimating visual field (VF) in patients with X-linked retinitis pigmentosa (RP) based on macular OCT scans.

DESIGN

Retrospective analysis of patients who were enrolled in a natural history study at Moorfields Eye Hospital (London, United Kingdom).

SUBJECTS: Male patients with genetically confirmed retinitis pigmentosa GTPase regulator (RPGR)-associated RP.

METHODS

Visual field raw data were exported and analyzed including Visual Field Modeling and Analysis software. Retinal imaging consisted of OCT macular scans. Paired imaging and VF data acquired within a 1-month range were jointly analyzed. Artificial intelligence (AI) was used to automatically segment and quantify macular ellipsoid zone width (EZW), and ellipsoid zone area (EZA).

MAIN OUTCOME MEASURES: Functional parameters from static VF testing such as mean sensitivity (MS) and Hill of Vision analysis that included total volume (VTOT), volume of central 20° (V20), and volume of central 30° (V30) were predicted from EZW and EZA.

RESULTS

Patient age ranged from 5 to 55 years old at baseline. A total of 332 OCT-VF pairs were analyzed. Ellipsoid zone area had the highest conditional R2 (R2c) and most significant associations with MS and V20. There were significant associations between MS and EZW (P = 0.00176), and MS with EZA (P = 0.0009).

CONCLUSIONS

This study showed that AI enables efficient acquiring of large amounts of structural OCT parameters, facilitating research and structure-function predictions. The cohort included patients with a wide range of disease severity and statistical significance was achieved with parameters representing a wide range of VF, proving that this method can be applied for patients with milder disease.

FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.