Discrepancy between Visual Acuity and Microperimetry in AMD Patients: Visual Acuity Appears as an Inadequate Parameter to Test Macular Function

Tran, Bao Khanh; Herbort, Carl P.

doi:10.1055/s-0035-1545779

Cited by 10 publications

(13 citation statements)

References 7 publications

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“…MAC-VA and contrast sensitivity both showed a stronger relationship with the subscales of the IVI in the overall cohort than BCVA. This is of special relevance because poor contrast sensitivity has been shown to be sensitive in discriminating early stages of AMD 34,37 . Furthermore, in previous studies contrast sensitivity was a factor impacting VRQoL of AMD patients: Roh and colleagues 38 demonstrated that contrast sensitivity was an important factor affecting VRQoL in patients with vision impairment due to bilateral advanced AMD.…”

Section: Discussionmentioning

confidence: 99%

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

Pondorfer

Terheyden

Heinemann

et al. 2019

Sci Rep

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The purpose of this study was to assess which visual function measures are most strongly associated with vision-related quality of life (VRQoL) in age-related macular degeneration (AMD). A cross-sectional study of subjects with early AMD (n = 10), intermediate AMD (n = 42) and late AMD (n = 38) was conducted. Subjects were interviewed with the Impact of Vision Impairment (IVI) questionnaire. Functional tests performed included best-corrected visual acuity (BCVA), low luminance visual acuity (LLVA), visual acuity measured with the Moorfields Acuity Charts (MAC), contrast sensitivity, reading speed, mesopic and dark-adapted microperimetry. The relationship between VRQoL and visual function was assessed with multiple regressions controlling for confounders. Rasch analysis demonstrated the validity of the IVI to assess VRQoL through three subscales: reading and accessing information, mobility and independence, and emotional well-being. Subjects with late AMD had significant lower IVI scores on all subscales compared with intermediate and early AMD (p < 0.011). In the overall cohort, IVI subscales were associated with BCVA, LLVA, MAC-VA and contrast sensitivity (all p < 0.001). Among the subgroup of early and intermediate AMD subjects, reading and mobility subscales were significantly associated with MAC-VA (p < 0.013). These results suggest that MAC-VA is a useful, patient-relevant measure of visual impairment in AMD.

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Section: Discussionmentioning

confidence: 99%

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

Pondorfer

Terheyden

Heinemann

et al. 2019

Sci Rep

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“…Despite the well-known limitations of using VA to characterize early functional deficits or quantify disease progression, VA remains the most widely accepted and used metric in evaluating visual function in AMD. To better assess visual function in AMD, various alternative metrics of functional outcome have been investigated, including dark adaptation [11], microperimetry [12][13][14], multifocal ERG [15], photo-stress recovery time [16], cone-mediated flicker sensitivity [17], photopic or scotopic light sensitivity [18,19], the Moorfields Acuity Charts [20] and contrast sensitivity [21][22][23]. Among these, contrast sensitivity (1) seems to correlate better with subjective visual impairment and visionrelated quality of life compared to VA [24][25][26][27], (2) may be affected earlier in the course of neurodegenerative disorders [28][29][30] and (3) may detect more subtle changes in visual function [24,31,32].…”

Section: The Value Of Contrast Sensitivity Testing In Amdmentioning

confidence: 99%

Measuring the Contrast Sensitivity Function in Non-Neovascular and Neovascular Age-Related Macular Degeneration: The Quantitative Contrast Sensitivity Function Test

Vingopoulos

Wai

Katz

et al. 2021

JCM

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Age-related macular degeneration (AMD) affects various aspects of visual function compromising patients’ functional vision and quality of life. Compared to visual acuity, contrast sensitivity correlates better with vision-related quality of life and subjectively perceived visual impairment. It may also be affected earlier in the course of AMD than visual acuity. However, lengthy testing times, coarse sampling and resolution, and poor test–retest reliability of the existing contrast testing methods have limited its widespread adoption into routine clinical practice. Using active learning principles, the qCSF can efficiently measure contrast sensitivity across multiple spatial frequencies with both high sensitivity in detecting subtle changes in visual function and robust test–retest reliability, emerging as a promising visual function endpoint in AMD both in clinical practice and future clinical trials.

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“…The functional deficit under reduced luminance and/or contrast has been well documented in patients with early and intermediate AMD [14,15] using a number of different functional assessments such as low luminance visual acuity (LLVA) [8,14,[16][17][18], visual acuity (VA) measurements with the Moorfields Vanishing Optotypes Acuity Chart (MAC), which employs high-pass filtered letters [19], contrast sensitivity tests [20][21][22][23]15,24,16,25], and fundus-controlled perimetry [12,[26][27][28]9,9,29]. Combinations of any of these visual function tests might further increase sensitivity to detect changes in visual function in particular in early stages of AMD.…”

Section: Introductionmentioning

confidence: 99%

Detecting vision loss in intermediate age-related macular degeneration: A comparison of visual function tests

et al. 2020

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The purpose of the study was to evaluate the diagnostic accuracy of visual function tests in intermediate age-related macular degeneration (iAMD). A total of 62 subjects (38 patients with iAMD and 24 controls) were included and underwent several functional assessments: Best-corrected visual acuity (BCVA), low luminance visual acuity (LLVA), visual acuity (VA) measured with the Moorfields Vanishing Optotypes Acuity Charts (MAC), contrast sensitivity with the Pelli-Robson test, reading speed using the International Reading Speed texts (IReST) and mesopic and dark-adapted microperimetry (S-MAIA, CenterVue, Padova, Italy). Groups were compared using non-parametric Wilcoxon rank sum tests and ROC analyses. Linear regression was used to control for confounding. Results showed that all visual function test performances except the IReST were significantly reduced in iAMD patients compared to controls (p < 0.05). These effects did not alter after controlling for age and sex. Best discrimination between iAMD and controls yield the combination of LLVA and contrast sensitivity as well as MAC-VA and contrast sensitivity (ROC area under the curve 0.95 and 0.93, respectively). Our results suggest that LLVA, MAC-VA, contrast sensitivity and mesopic and dark-adapted microperimetry can capture visual impairment characteristic for iAMD. Best discrimination against iAMD is achieved with a combination of two tests.

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Discrepancy between Visual Acuity and Microperimetry in AMD Patients: Visual Acuity Appears as an Inadequate Parameter to Test Macular Function

Abstract: More than a third of the AMD patients had a bad or very bad microperimetry performance in parallel with a good visual acuity. Microperimetry is a valuable tool to assess and follow real macular function in AMD patients when visual acuity alone can be misleading.

Cited by 10 publications

References 7 publications

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

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

Measuring the Contrast Sensitivity Function in Non-Neovascular and Neovascular Age-Related Macular Degeneration: The Quantitative Contrast Sensitivity Function Test

Detecting vision loss in intermediate age-related macular degeneration: A comparison of visual function tests

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