Higher‐Order Wavefront Aberrations in Retinitis Pigmentosa

ABSTRACT: Purpose. The purpose of this study was to characterize higher‐order wavefront aberrations associated with posterior subcapsular (PSC) cataracts in patients with retinitis pigmentosa (RP). Methods. Wavefront aberrations were measured by Shack‐Hartmann (SH) aberrometry in eight patients with RP who had PSC cataracts, 10 patients with RP who had minimal or no PSC cataracts, and 16 age‐equivalent visually normal control subjects. Higher‐order wavefront aberrations for 3‐mm and 6‐mm pupil diameters were defined as the root mean square (RMS) of the wavefront aberration functions. Results. For a 6‐mm pupil diameter, the mean RMS for total higher‐order wavefront aberrations was significantly larger for the patients with RP than for the control subjects, both for patients with PSC cataract (F = 17.30, p < 0.001) and for those with minimal or no PSC cataract (F = 4.80, p < 0.05). The mean RMS for third‐order aberrations was not significantly different for patients with RP than for the control subjects. However, the mean RMS for fourth‐order aberrations was significantly larger for the patients with RP than for the control subjects, both for patients with PSC cataract (F = 8.85, p < 0.01) and those with minimal or no PSC cataract (F = 5.07, p < 0.05). There were no significant differences in higher‐order aberrations between the patients with RP and the control subjects for a 3‐mm pupil diameter. Conclusions. Increased higher‐order wavefront aberrations were present in patients with RP with and without clinically observable PSC cataracts. The measurement of wavefront aberrations in patients with RP provides an objective and quantitative method for detecting and monitoring disease‐related changes in the optics of the eye.