Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;104(4):529-534.
doi: 10.1136/bjophthalmol-2019-313864. Epub 2019 Jul 9.

Measuring dynamic levels of self-perceived anxiety and concern during simulated mobility tasks in people with non-neovascular age-related macular degeneration

Deanna J Taylor  1 , Nicholas D Smith  1 , Pete R Jones  1 , Alison M Binns  1 , David P Crabb  2
Affiliations

Measuring dynamic levels of self-perceived anxiety and concern during simulated mobility tasks in people with non-neovascular age-related macular degeneration

Deanna J Taylor et al. Br J Ophthalmol. 2020 Apr.

Abstract

Background/aims: To assess response to real-world mobility scenarios in people with dry age-related macular degeneration (AMD) using a computer-based test.

Methods: Participants were shown 18 point-of-view computer-based movies simulating walking through real-world scenarios, and pressed a button during scenes which would cause them self-perceived anxiety or concern in their day-to-day life. Button pressure was recorded throughout. Pressure traces were generated, which aligned with each movie time point. Group averages based on AMD severity were generated. Bootstrapped confidence intervals (CIs) for responses by group were generated around traces. Traces were examined to discover events causing the greatest differences between groups.

Results: Participants had early/no AMD (n=8), intermediate AMD (n=7) or geographic atrophy (n=15 (GA)). Median (IQR) logMAR visual acuity was 0.04 (-0.04, 0.18), 0.26 (0.10, 0.40) and 0.32 (0.20, 0.56), respectively. Participants with intermediate AMD or GA recorded greater pressure than those with early and no AMD (Kruskal-Wallis, p=0.04). Four events involving navigating stairs and three under low luminance elicited greatest differences between groups (p<0.001).

Conclusion: People with intermediate AMD or GA likely experience higher levels of concern associated with mobility. The test highlights areas of specific concern. Results should be useful in patient management and educating the public about the everyday effects of AMD.

Keywords: degeneration; macula; rehabilitation; vision.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Photographs of big button test setup.
Figure 2
Figure 2
Still screenshots from each of the 18 movies.
Figure 3
Figure 3
Mean big button response across all movies stratified by AMD classification (points have been horizontally jittered to avoid overlap). AMD, age-related macular degeneration; GA, geographic atrophy.
Figure 4
Figure 4
Mean (SE) BB response (dotted line=mean; solid lines=SE) for the entire duration of each of the 18 movies shown. Grey regions on chart indicate time periods at which the difference in BB response between groups was significantly different (p<0.001), that is, situations which caused particular anxiety to individuals with dry AMD compared with controls. AMD, age-related macular degeneration; BB, big button; GA, geographic atrophy.
Figure 5
Figure 5
Example still shots from the movie ‘southbank’ with the corresponding pressure trace. The blue trace represents button pressure from people with no AMD and early AMD, and the red trace represents button pressure from people with intermediate AMD and GA. Example movies can be found in online supplementary files 2–4. AMD, age-related macular degeneration; GA, geographic atrophy.
See this image and copyright information in PMC

References

    1. Collins AL, Goldman N, Rodríguez G. Is positive well-being protective of mobility limitations among older adults? J Gerontol B Psychol Sci Soc Sci 2008;63:P321–P327. 10.1093/geronb/63.6.P321 - DOI - PMC - PubMed
    1. Shimada H, Ishizaki T, Kato M, et al. . How often and how far do frail elderly people need to go outdoors to maintain functional capacity? Arch Gerontol Geriatr 2010;50:140–6. 10.1016/j.archger.2009.02.015 - DOI - PubMed
    1. Wang MY, Rousseau J, Boisjoly H, et al. . Activity limitation due to A fear of falling in older adults with eye disease. Invest Ophthalmol Vis Sci 2012;53:7967–72. 10.1167/iovs.12-10701 - DOI - PubMed
    1. Xue Q-L, Fried LP, Glass TA, et al. . Life-space constriction, development of frailty, and the competing risk of mortality: the women's health and aging study I. Am J Epidemiol 2008;167:240–8. 10.1093/aje/kwm270 - DOI - PubMed
    1. Taylor DJ, Hobby AE, Binns AM, et al. . How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review. BMJ Open 2016;6:e011504 10.1136/bmjopen-2016-011504 - DOI - PMC - PubMed

Publication types