Correlation of Macular Sensitivity Measures and Visual Acuity to Vision-related Quality of Life in Patients with Age-related Macular Degeneration

Abstract

Background: Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant. Methods: Fifty-six consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-eight patients with AMD were included in the study: thirty-three patients with late AMD (exudative AMD and/or geographic atrophy) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity.Results: There was a higher correlation between vision-related quality of life and macular sensitivity (rho=0.371; p=0.034) than between vision-related quality of life and visual acuity (rho=0.334; p=0.058) in patients with late AMD. These correlations were not statistically significant in patients with early AMD. Composite score (rho=0.405; p=0.019) and near-distance activities score (rho=0.469; p=0.006) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated highest with the nasal outer macular sub-region in these patients (rho=0.735; p=0.002). Conclusions: Macular sensitivity as measured using microperimetry correlates significantly better with vision-related quality of life than visual acuity, showing it to be a more patient-relevant outcome measure in patients with late AMD. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD.(330 words)

Microperimetry to predict disease progression in eyes at high risk of age‐related macular degeneration disease: The PREVISION study

“…As such, some patients with unstable fixation or with neurological disorder cannot complete the whole microperimetric examination. This is for this reason that some studies excluded patients with cognitive deficit (Forshaw et al, 2021), as in addition to compliance, it is still debated in the literature how certain neurological disorder can affect the macula or are associated with an increased risk of AMD (Chen et al, 2021; Choi et al, 2020; Keenan et al, 2014; Wen et al, 2021).…”