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The authors present a study of 228 consecutive patients with a clinical or genetic diagnosis of retinitis pigmentosa. Data was collected prospectively between January 2012 and October 2022 in Perth, Australia. The study aimed to determine the proportion of patients with retinitis pigmentosa who reach the Australian fitness to drive standards in terms of visual acuity and binocular Esterman visual field. Overall, 39% of the cohort met the driving standards. The proportion of patients meeting the driving standards declined with age from 55% aged 16-25 to 14% aged 56-65. Overall, 55% of the cohort reported driving, but only 52% of these patients actually met the driving standards for a conditional or unconditional licence. None of the cohort failed to meet the visual acuity standard for driving. The only variable acting as a statistically significant predictor of passing the fitness to drive standards was younger age at time of testing. The authors also suggest that retinitis pigmentosa due to mutations in the RHO gene may have slower rate of decline in the visual field. As an Australian study the driving standards used are those set out by the Australian government, but these are broadly similar to those of the UK. This study raises several interesting points; discussion of driving status is vital when seeing patients with retinal dystrophies as a large number of patients in this study still drove, over half of whom did not meet the criteria to do so. Additionally, this study may help inform prognostication when seeing patients with a new diagnosis of retinitis pigmentosa. A similar study based on the UK driving standards would be welcome, and more directly relevant to UK clinical practice.

Driving with retinitis pigmentosa.
Heath Jeffery RC, Lo J, Thompson JA, et al.
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Ian Reekie

Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

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