Mottling of the retinal pigment epithelium with black ''bone-spicule'' pigmentation is typically indicative (or pathognomonic) of retinitis pigmentosa. Other ocular features include waxy pallor of the optic nerve head, attenuation (thinning) of the retinal vessels, cellophane maculopathy, cystic macular edema and posterior subcapsular cataract.
As the disease progresses and more rod cells breakdown, patients lose their peripheral vision (tunnel vision). Individuals with RP often experience a ring of vision loss in their periphery, but retain clear central vision. Others report the sensation of tunnel vision, as though they see the world through a straw. Many patients with retinitis pigmentosa retain a small degree of central vision throughout their life.
Other forms of RP, sometimes called cone-rod dystrophy, first affect central vision. Patients first experience a loss of central vision that cannot be corrected with glasses or contact lenses. With the loss of cone cells also comes disturbances in color perception. As the disease progresses, rod cells degenerate causing night blindness and peripheral vision.
Symptoms of RP are most often recognized in children, adolescents and young adults, with progression of the disease continuing throughout the individual's life. The pattern and degree of visual loss are variable.
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