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-one 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-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) 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 (r = 0.458; p = 0.014) than between vision-related quality of life and visual acuity (r = 0.446; p = 0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r = 0.542; p = 0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r = 0.469; p = 0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r = 0.652; p < 0.001) 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 with the nasal outer macular sub-region in these patients (r = 0.469; p = 0.012). Conclusions Macular sensitivity as measured using microperimetry correlates with vision-related quality of life in early AMD and in late AMD, showing it to be a patient-relevant outcome measure. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD. (338 words)

Design and Validation of a Novel Smartphone-Based Visual Acuity Test: The K-VA Test

“…VA less than 1.0 logMAR can only be measured at 40 cm and the examination is limited to 1.3 logMAR at this distance. Moreover, the accuracy of the VA assessment is often dependent on the competency level of the examiner, leading to inter-observer variability [1,54]. In our study, a single researcher conducted all the measurements with the traditional ETDRS charts [54].…”

“…Moreover, the accuracy of the VA assessment is often dependent on the competency level of the examiner, leading to inter-observer variability [1,54]. In our study, a single researcher conducted all the measurements with the traditional ETDRS charts [54]. Furthermore, the study was conducted using only one type of smartphone and the application is available for devices running Android OS 5.0 or later.…”

Intravitreal ranibizumab improves macular sensitivity in patients with central retinal vein occlusion and macula edema

“…This result suggests that improvement in macular sensitivity is independent of improvement in visual acuity. Some studies indicated that macular sensitivity in patients with age-related macular degeneration and retinitis pigmentosa is associated with vision-related quality of life [ 13 , 14 ]. Our result that macular sensitivity improved even in patients with little improvement in visual acuity may help to explain these earlier findings.…”

Beyond the Visual Acuity: Assessing the Visual Function in mCNV Patients After Anti-VEGF Treatment

“…Three dependent variables were used: the final BCVA after 12 months of treatment, the final composite VR-QoL score, and the improvement of the composite VR-QoL score. According to the reported possible prognostic factors, the independent variables included gender, age, BCVA, macular integrity, average threshold, P1, P2, 63% BCEA area, 95% BCEA area, composite VR-QoL score, and average metamorphopsia score ( 3 , 9 , 10 , 20 ). The level of significance was set at p < 0.05.…”

“…To date, several quantifiable measurements have been developed for a wide recognition of the total visual ability and subjective perception of VR-QoL, including microperimetry, contrast sensitivity, metamorphopsia, and the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). The macular sensitivity measured by microperimetry has been used for the assessment of macular function in several diseases and showed correlation with the VA or VFQ-25 in several diseases ( 9 , 10 ). Some studies in wet age-related macular degeneration (wAMD) demonstrated the discrepancy between VA and other visual functions.…”