Association of Vision-related Quality of Life with Visual Function in Age-Related Macular Degeneration

Pondorfer, Susanne G.; Terheyden, Jan Henrik; Heinemann, M.; Wintergerst, Maximilian W. M.; Holz, Frank G.; Finger, Robert P.

doi:10.1038/s41598-019-51769-7

Cited by 47 publications

(43 citation statements)

References 33 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LLVA is hypothesised to be a better marker of everyday visual function under low light conditions than standard VA. And yet studies involving visually healthy, older age groups reported that neither LLVA nor LLD were associated with significant changes in quality of life measures or disability questionnaires 4,35,72 . This contrasts with AMD studies where quality of life measures correlated significantly with LLVA and LLD in all stages of the disease 16,19–21 …”

Section: Discussion and Critical Reviewmentioning

confidence: 98%

Low luminance visual acuity as a clinical measure and clinical trial outcome measure: a scoping review

Wood

Jolly

Buckley

et al. 2021

Ophthalmic Physiologic Optic

View full text Add to dashboard Cite

Purpose The measurement of standard visual acuity (VA) is the most well‐known part of any ophthalmic examination to indicate visual function. Despite this, it is insensitive in detecting early disease changes. Therefore, other visual function tests have been developed including low luminance VA (LLVA) and low luminance deficit (LLD). This scoping literature review aims to summarise the current published applications of LLVA and LLD assessments to evaluate their utility as clinical markers and research outcome measures in a variety of ophthalmic conditions. Recent findings Sixty‐five peer‐reviewed publications were included. LLVA was pioneered for use in geographic atrophy, a subtype of age‐related macular degeneration, which remains the mainstay of its clinical application. However, other studies have reported additional useful applications in inherited retinal diseases including rare maculopathies and rod‐cone dystrophies. Although there are some variations in testing methodology, use of the standard Early Treatment Diabetic Retinopathy Study (ETDRS) chart with a 2.0 log unit neutral density filter is the most popular approach. The optimal testing luminance is still to be defined. Summary Overall, LLVA is an earlier clinical marker of change in central retinal function than standard VA. It has been shown to be a risk factor for disease progression and a better indicator of a patient’s level of everyday visual function. It is inexpensive and simple to implement using readily available standard ophthalmic equipment.

show abstract

Section: Discussion and Critical Reviewmentioning

confidence: 98%

Low luminance visual acuity as a clinical measure and clinical trial outcome measure: a scoping review

Wood

Jolly

Buckley

et al. 2021

Ophthalmic Physiologic Optic

View full text Add to dashboard Cite

show abstract

“…early and intermediate AMD). [1][2][3] In early and intermediate AMD, patients usually perform well in standard high contrast, high luminance best-corrected visual acuity (BCVA) testing. 4 However, the most widely used outcome measure in ophthalmic research is BCVA, 5,6 which appears to be largely insensitive to the specific functional impairment in early and intermediate AMD.…”

Section: Introductionmentioning

confidence: 99%

Development of the Vision Impairment in Low Luminance Questionnaire

Pondorfer

Terheyden

Overhoff

et al. 2021

Trans. Vis. Sci. Tech.

Self Cite

View full text Add to dashboard Cite

The purpose of this study was to design and evaluate an instrument for assessing vision-related quality of life appropriate for the specific visual impairment characteristic for all stages of age-related macular degeneration (AMD), with a focus on the low luminance deficit in early/intermediate stages. Methods:A standardized questionnaire was developed in three steps with participants with early, intermediate, and late AMD: (1) based on in-depth interviews (n = 19) and two focus group discussions (n = 5 each), content was developed followed by 2. (2) The questionnaire development using cognitive debriefing interviews (n = 3) and leading to a preliminary version of the questionnaire. (3) This version was then administered to 127 participants with early, intermediate, and late AMD. Psychometric properties, such as response category functioning (floor and ceiling effects) and targeting of item difficulty to patient ability of the pilot Vision Impairment in Low Luminance (VILL) questionnaire were evaluated using Rasch analysis. Results:The preliminary VILL questionnaire consisted of 68 items with a 5-step response scale. Several items were removed based on floor/ceiling effects or misfit and a final pool of 37 items remained. The response scale was collapsed to four categories as one category was underutilized. The targeting of the instrument was good with minimal difference in person and item means (0.52 logits). Precision was also good with a person separation index of 3.55 and reliability of 0.93. There was evidence of multidimensionality (eigenvalue of the first contrast = 5.95) in the scale, which could be resolved by splitting the items into subscales including a reading, mobility, and emotional well-being subscale.Conclusions: Individuals with AMD report difficulties with vision-related activities and functioning under visually challenging conditions at all stages of the disease. These aspects were considered when developing the 37-item VILL, which demonstrates promising psychometric characteristics. Further assessments of reliability and validity are warranted. Translational Relevance:The VILL questionnaire is a new patient-reported outcome (PRO) measure developed for future use in AMD studies.

show abstract

“…22,23 Various studies found a functional impairment beyond best-corrected central visual acuity, using electroretinography (ERG) testing and fundus-controlled perimetry (FCP) (also termed as microperimetry). [24][25][26][27][28][29][30][31][32] A reduction of multifocal electroretinography (mfERG) function was seen in areas of RPD by Alten and coworkers. 23 In addition increased rodintercept time (RIT) in presence of RPD was observed by Flamendorf et al, 33 whereas within a longitudinal observational period of 12 months RIT was shown to remain stable in eyes with AMD and RPD.…”

mentioning

confidence: 99%

Longitudinal Analysis of Structural and Functional Changes in Presence of Reticular Pseudodrusen Associated With Age-Related Macular Degeneration

Saßmannshausen

Pfau

Thiele

et al. 2020

Invest. Ophthalmol. Vis. Sci.

Self Cite

View full text Add to dashboard Cite

To examine longitudinal changes of retinal thickness and retinal sensitivity in patients with intermediate age-related macular degeneration (iAMD) and predominantly reticular pseudodrusen (RPD). METHODS. At baseline 30 eyes of 25 iAMD patients underwent optical coherence tomography imaging, mesopic and scotopic fundus-controlled perimetry (FCP) with follow-up examinations at month 12 (20 eyes), 24 (12 eyes), and 36 (11 eyes). Thicknesses of different retinal layers and results of FCP testing (n = 56 stimuli) were spatially and longitudinally analyzed using linear mixed-effects models. RESULTS. At baseline, the thickness of the partial outer retinal layer (pORL, 70.21 vs. 77.47 μm) and both mesopic (16.60 vs. 18.72 dB) and scotopic (12.14 vs. 18.67 dB) retinal sensitivity were decreased in areas with RPD compared with unremarkable areas (P < 0.001). Over three years, mean change of pORL was −0.66 normative standard deviation (SD; i.e., z-score, P < 0.001) for regions with existing RPD, −0.40 SD (P < 0.001) for regions with new occurring RPD, and −0.17 SD (P = 0.041) in unremarkable regions. Decrease of scotopic and mesopic sensitivity over three years was more pronounced in areas with existing (−3.51 and −7.76 dB) and new occurring RPD (−2.06 and −5.97 dB). Structure-function analysis revealed that 1 SD decrease of pORL thickness was associated with a sensitivity reduction of 3.47 dB in scotopic and 0.79 dB in mesopic testing. CONCLUSIONS. This study demonstrates progressive outer retinal degeneration and impairment of photoreceptor function in eyes with iAMD and RPD over three years. Preservation of outer retinal thickness and reduction of RPD formation may constitute meaningful surrogate endpoints in interventional trials on eyes with AMD and RPD aiming to slow outer retinal degeneration.

show abstract

Association of Vision-related Quality of Life with Visual Function in Age-Related Macular Degeneration

Cited by 47 publications

References 33 publications

Low luminance visual acuity as a clinical measure and clinical trial outcome measure: a scoping review

Low luminance visual acuity as a clinical measure and clinical trial outcome measure: a scoping review

Development of the Vision Impairment in Low Luminance Questionnaire

Longitudinal Analysis of Structural and Functional Changes in Presence of Reticular Pseudodrusen Associated With Age-Related Macular Degeneration

Contact Info

Product

Resources

About