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Comparative Study
. 2016;41(2):266-72.
doi: 10.3109/02713683.2015.1011282. Epub 2015 Mar 24.

Comparison of Visual Function in Older Eyes in the Earliest Stages of Age-related Macular Degeneration to Those in Normal Macular Health

Cynthia Owsley  1 , Carrie Huisingh  1 , Mark E Clark  1 , Gregory R Jackson  2 , Gerald McGwin Jr  1   3
Affiliations
Comparative Study

Comparison of Visual Function in Older Eyes in the Earliest Stages of Age-related Macular Degeneration to Those in Normal Macular Health

Cynthia Owsley et al. Curr Eye Res. 2016.

Abstract

Purpose: To compare the ability of several visual functional tests in terms of the strength of their associations with the earliest phases of age-related macular degeneration (AMD), which bears on their potential to serve as functional endpoints in evaluating treatments for early AMD and prevention strategies.

Materials and methods: Eyes from adults ≥60 years old were identified as being in normal macular health or in the earliest stages of AMD (steps 2, 3 or 4) through grading of color stereo-fundus photos by an experienced grader masked to all other study variables who used the 9-step Age-Related Eye Disease Study (AREDS) classification system for AMD severity. Visual function was assessed using the following tests: best-corrected visual acuity, low luminance visual acuity, spatial contrast sensitivity, macular cone-mediated light sensitivity and rod-mediated dark adaptation.

Results: A total of 1260 eyes were tested from 640 participants; 1007 eyes were in normal macular health (defined as step 1 in AREDS system) and 253 eyes had early AMD (defined as steps 2, 3 or 4). Adjusting for age and gender, early AMD eyes had two times the odds of having delayed rod-mediated dark adaptation than eyes in normal macular health (p = 0.0019). Visual acuity, low luminance acuity, spatial contrast sensitivity and macular light sensitivity did not differ between normal eyes and early AMD eyes.

Conclusions: Eyes in the earliest phases of AMD were two times more likely to have delayed rod-mediated dark adaptation, as assessed by the rod-intercept, as compared to older eyes in normal macular health, whereas there was no difference in early AMD versus normal eyes in tests of visual acuity, low luminance acuity, macular light sensitivity and spatial contrast sensitivity.

Keywords: Age-related macular degeneration; aging; dark adaptation; functional endpoints; visual function.

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Conflict of interest statement

DECLARATION OF INTEREST

Cynthia Owsley is a patent holder on the technology used to measure dark adaptation in this study. Gregory Jackson is an employee of and investor in MacuLogix, the manufacturer of the AdaptDx used in this study. The other authors report no conflicts of interest. The authors alone are responsible for the content of this paper.

Figures

Figure 1
Figure 1
Frequency histogram of the rod-intercept as measured by dark adaptation testing for the participants in normal macular health and those with early AMD. Frequency in each group is expressed as a percentage of the group with rod-intercept values in each of the indicated ranges. The p-value comparing the distributions of the two groups is p < 0.0001.
See this image and copyright information in PMC

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