Detection of Early Loss of Color Vision in Age-Related Macular Degeneration – With Emphasis on Drusen and Reticular Pseudodrusen

Vemala, Roopa; Sivaprasad, Sobha; Barbur, John L.

doi:10.1167/iovs.17-21771

Cited by 27 publications

(21 citation statements)

References 44 publications

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“…Recent work has indicated cone receptor function in eyes with RPD and intermediate AMD may be impaired through measurement of chromatic sensitivity using the Colour Assessment and Diagnosis test . It was found eyes with RPD and intermediate AMD demonstrated the most loss in red‐green and blue‐yellow channel sensitivity when compared to both individuals with only intermediate AMD and healthy controls.…”

Section: Functional Testingmentioning

confidence: 99%

Reticular pseudodrusen: current understanding

Wightman

Guymer

2019

Clinical and Experimental Optometry

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Reticular pseudodrusen (RPD), also known as subretinal drusenoid deposits, represent a morphological change to the retina distinct from other subtypes of drusen by being located above the level of the retinal pigment epithelium. Although they can infrequently appear in individuals with no other apparent pathology, their highest rates of occurrence are in association with age-related macular degeneration (AMD), for which they hold clinical significance by being highly correlated with end-stage disease sub-types, choroidal neovascularisation and geographic atrophy. Reticular pseudodrusen are also found in other diseases, most notably Sorsby's fundus dystrophy, pseudoxanthoma elasticum and acquired vitelliform lesions. They are found more frequently in females, with increased age and more commonly bilaterally than unilaterally. Increased risk of RPD formation is conveyed by genetic variants known to increase risk of AMD development, including complement factor H, age-related maculopathy susceptibility 2, and high-temperature requirement A serine peptidase 1; however, to date, no genetic factor has been found to predispose to RPD independent of those that carry risks for AMD. They have typical features visible on multimodal imaging, identifiable either as single lesions or more commonly in yellowishwhite net-like patterns on colour fundus photography and are particularly distinguishable using spectral domain optical coherence tomography, fundus auto-fluorescence, and near infrared reflectance imaging. On histological examination, RPD have been shown to have distinct compositions in comparison to typical drusen, suggesting different pathways of pathogenesis. Although their aetiology remains unclear, presence of opsin within lesions, a high topographic association with areas of highest rod-photoreceptor concentration and functional deficits most pronounced within the scotopic range, has implicated rod photoreceptor dysfunction as a component of RPD.

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Section: Functional Testingmentioning

confidence: 99%

Reticular pseudodrusen: current understanding

Wightman

Guymer

2019

Clinical and Experimental Optometry

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“…In low light levels, the rods preferentially consume higher levels of the (limited) available oxygen, which may lead to a further reduction in chromatic sensitivity. 4 Therefore, increasing the luminance of the scene by means of AR enhancement should facilitate an increase in chromatic sensitivity. This hypothesis is supported by our findings of a dramatic improvement in Mrs. M's color perception when using AR (0% / 56%).…”

Section: Discussionmentioning

confidence: 99%

“…1 In particular, patients are often unable to identify facial features or recognize family members, 2 cannot distinguish detail of objects or photographs, 3 and suffer with substantial loss of color vision. 4 Bowers et al 5 report that reading performance in AMD improves as illumination is increased, with up to 2,000 lux being required for optimum performance. However, typical good illumination for domestic living spaces is typically just 2-300 lux.…”

Section: Introductionmentioning

confidence: 99%

The Accessibility of Commercial Off-The-Shelf Virtual Reality for Low Vision Users: A Macular Degeneration Case Study

Powell

Cook

2020

Cyberpsychology, Behavior, and Social Networking

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Virtual reality (VR) is demonstrating increasing potential for therapeutic benefit in elderly care, but it is still generally considered to be the domain of the visually unimpaired. Even where VR and augmented reality (AR) are being explored for use with low vision, it is generally with a focus on creating bespoke software and hardware. However, the properties of commercial off-the-shelf (COTS) headsets, such as high luminance, may render them accessible even to very low vision users. Using a case-study approach, we explored the differences in visual perception from baseline to pass-through AR and commercial VR applications for an elderly female (Mrs. M) with advanced age-related macular degeneration. We found notable improvements in object, face, and color recognition, particularly with higher display brightness. Furthermore, Mrs. M was able to engage fully and enthusiastically with a number of (unmodified) VR applications, providing detailed descriptions of both static and moving elements. We suggest that the high luminance available in COTS VR may support more stable fixation closer to the fovea, improving visual resolution. Furthermore, the improvements we noted in color perception support previous suggestions that increasing luminance may improve photosensitivity by reducing the uptake of limited oxygen by the rod cells. We conclude that low vision should not automatically preclude users from engaging in VR research or entertainment, and that they may be able to use well-illuminated VR applications without any special modifications.

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“…53,54 This is significant as the presence of SDD has been associated with a significantly increased risk of progression to advanced AMD, and is also linked to increased delays in rates of dark adaptation and elevated chromatic thresholds. [55][56][57] However, current software does not allow these drusen and SDD features to be automatically assessed in OCT images. Furthermore, the evaluation of SDD presence/absence is more reliable when multimodal imaging is employed, including infrared imaging.…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of a Battery of Functional and Structural Tests as Predictors of Likely Risk of Progression of Age-Related Macular Degeneration

Robinson

Margrain

Bailey

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To evaluate the ability of visual function and structural tests to identify the likely risk of progression from early/intermediate to advanced AMD, using the Age-Related Eye Disease Study (AREDS) simplified scale as a surrogate for risk of progression. The secondary aim was to determine the relationship between disease severity grade and the observed functional and structural deficits. METHODS.A total of 100 participants whose AMD status varied from early to advanced were recruited. Visual function was assessed using cone dark adaptation, 14 Hz flicker and chromatic threshold tests and retinal structure was assessed by measuring drusen volume and macular thickness. The predictive value of the tests was estimated using ordinal regression analysis. Group comparisons were assessed using analysis of covariance. RESULTS.Change in cone dark adaptation (cone s) and yellow-blue (YB) chromatic sensitivity were independent predictors for AMD progression risk (cone s, pseudo R 2 ¼ 0.35, P < 0.001; YB chromatic threshold, pseudo R 2 ¼ 0.16, P < 0.001). The only structural predictor was foveal thickness (R 2 ¼ 0.05, P ¼ 0.047). Chromatic sensitivity and cone dark adaptation were also the best functional tests at distinguishing between severity groups. Drusen characteristics clearly differentiated between participants with early and advanced disease, but were not able to differentiate between those with early AMD and controls. Mean differences in retinal thickness existed between severity groups at the foveal (P ¼ 0.040) and inner (P ¼ 0.001) subfields.CONCLUSIONS. This study indicates that cone s, YB chromatic threshold and foveal thickness are independent predictors of likely risk of AMD progression.

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Detection of Early Loss of Color Vision in Age-Related Macular Degeneration – With Emphasis on Drusen and Reticular Pseudodrusen

Cited by 27 publications

References 44 publications

Reticular pseudodrusen: current understanding

Reticular pseudodrusen: current understanding

The Accessibility of Commercial Off-The-Shelf Virtual Reality for Low Vision Users: A Macular Degeneration Case Study

An Evaluation of a Battery of Functional and Structural Tests as Predictors of Likely Risk of Progression of Age-Related Macular Degeneration

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