Pregnancy linked to increased risk of central vision loss in women with retinitis pigmentosa

Women with USH2A-associated retinitis pigmentosa (RP) who have children are at a higher risk of experiencing significant central vision loss compared to women without children, according to a study. However, the study also found that pregnancy does not appear to accelerate retinal degeneration as measured by ellipsoid zone (EZ) loss.

The study included 142 women with biallelic rare or likely pathogenic variants in the USH2A gene, including 98 who had given birth (69%) and 44 who had never given birth (31%). Researchers analyzed visual acuity (VA), ellipsoid zone (EZ) width, and registration for sight impairment, adjusting for factors such as age, phenotype, cataracts, and cystoid macular oedema (CMO).

Parous women were 3.04 times more likely to have VA worse than LogMAR 0.7 (equivalent to 6/24 vision) compared to nulliparous women (P = 0.016). However, no significant association was found between pregnancy and EZ loss rate, a marker of retinal degeneration.

Parous women did not show higher rates of CMO or cataracts compared to nulliparous women.

This study is the first of its scale to evaluate pregnancy-related RP progression. Researchers emphasize the need for further studies to confirm these findings and explore underlying mechanisms.

Reference
Varela MD, Rashid M, Lopes A, et al. The effects of pregnancy on disease progression of retinitis pigmentosa. Am J Ophthalmol. 2024;S0002-9394(24)00548-8. doi: 10.1016/j.ajo.2024.11.016. Epub ahead of print. PMID: 39615819.