Measuring dynamic levels of self-perceived anxiety and concern during simulated mobility tasks in people with non-neovascular age-related macular degeneration

Abstract

Background/aimsTo assess response to real-world mobility scenarios in people with dry age-related macular degeneration (AMD) using a computer-based test.MethodsParticipants were shown 18 point-of-view computer-based movies simulating walking through real-world scenarios, and pressed a button during scenes which would cause them self-perceived anxiety or concern in their day-to-day life. Button pressure was recorded throughout. Pressure traces were generated, which aligned with each movie time point. Group averages based on AMD severity were generated. Bootstrapped confidence intervals (CIs) for responses by group were generated around traces. Traces were examined to discover events causing the greatest differences between groups.ResultsParticipants had early/no AMD (n=8), intermediate AMD (n=7) or geographic atrophy (n=15 (GA)). Median (IQR) logMAR visual acuity was 0.04 (−0.04, 0.18), 0.26 (0.10, 0.40) and 0.32 (0.20, 0.56), respectively. Participants with intermediate AMD or GA recorded greater pressure than those with early and no AMD (Kruskal-Wallis, p=0.04). Four events involving navigating stairs and three under low luminance elicited greatest differences between groups (p<0.001).ConclusionPeople with intermediate AMD or GA likely experience higher levels of concern associated with mobility. The test highlights areas of specific concern. Results should be useful in patient management and educating the public about the everyday effects of AMD.

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“…Moreover, we did not find a single study looking at how measures of DA could be associated with people with AMD performing real-world visually guided tasks, or surrogates of them (sometimes referred to as performance-based tasks). Such tasks could measure face recognition, search performance, visuomotor control or mobility [75][76][77]. For example, DA would be expected to impact mobility in low lighting, and this could be a promising area of research.…”

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“…Additionally, simulated environments may aid in capturing visual disability measures that are difficult to capture in multipronged questionnaires, such as feelings of fear and anxiety when a person is walking in poor lighting conditions. [29][30][31]…”