Visual Function Tests as Potential Biomarkers in Age-Related Macular Degeneration

Dimitrov, Peter; Robman, Liubov; Varsamidis, Mary; Aung, Khin Zaw; Makeyeva, Galina; Guymer, Robyn H.; Vingrys, Algis J.

doi:10.1167/iovs.10-7043

Cited by 111 publications

(152 citation statements)

References 64 publications

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“…This model is on par with other medical assays. For example, photostress recovery evaluation was used to predict AMD with a 71% success rate (24), and optical coherence tomography was shown to detect the presence of AMD based on the presence of a prominent hyper-reflective haze present in the photoreceptor nuclear layer over drusen in 67% of patients with AMD (65). Small molecule biomarkers from the protein adduct class of compounds such as carboxyethylpyrrole were shown to discriminate between AMD and control plasma donors with ;76% accuracy (66).…”

Section: Discussionmentioning

confidence: 99%

“…Because an optimal therapeutic intervention would target early stages of disease, there is a great need for safe and effective ways to detect AMD early and safely monitor its progression. Decline in visual functions, particularly dark adaptation, becomes yet another potential biomarker in monitoring/predicting pathologies leading to AMD (22)(23)(24). Although development of a large number of animal models has helped to advance our understanding of retinal pathobiology and identify specific genetic factors that contribute to photoreceptor degeneration, inflammation, and the biochemistry of many retinal processes, these models all have limitations (25)(26)(27)(28).…”

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confidence: 99%

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Serum levels of lipid metabolites in age‐related macular degeneration

et al. 2015

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Age-related macular degeneration (AMD) is a neurodegenerative disease that causes adult-onset blindness. There are 2 forms of this progressive disease: wet and dry. Currently there is no cure for AMD, but several treatment options have started to emerge making early detection critical for therapeutic success. Analysis of the eyes of Abca4 2/2 Rdh8 2/2 mice that display light-induced retinal degeneration indicates that 11-cis-retinal and docosahexaenoic acid (DHA) levels were significantly decreased as compared with the eyes of control dark-adapted C57BL/6J mice. In addition, exposure to intense light correlated with higher levels of prostaglandin G2 in the eyes of Abca4 2/2 Rdh8 2/2 mice. Intense light exposure also lowered DHA levels in the eyes of wild-type C57BL/6J mice without discernible retinal degeneration. Analysis of human serum from patients with AMD recapitulated these dysregulated DHA levels and revealed dysregulation of arachidonic acid (AA) levels as well (∼32% increase in patients with AMD compared with average levels in healthy individuals). From these observations, we then built a statistical model that included levels of DHA and AA from human serum. This model had a 74% probability of correctly identifying patients with AMD from controls. Addition of a genetic analysis for one of the most prevalent amino acid substitutions in the age-related maculopathy susceptibility 2 gene linked to AMD, Ala 69 →Ser, did not improve the statistical model. Thus, we have characterized a reliable method with the potential to detect AMD without a genetic component, paving the way for a larger-scale clinical evaluation. Our studies on mouse models along with the analysis of human serum suggest that our small molecule-based model may serve as an effective tool to estimate the risk of developing AMD.-Orban, T., Johnson, W. M., Dong, Z., Maeda, T., Maeda, A., Sakai, T., Tsuneoka, H., Mieyal, J. J., Palczewski, K. Serum levels of lipid metabolites in age-related macular degeneration. FASEB J. 29, 4579-4588 (2015). www.fasebj.org

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Serum levels of lipid metabolites in age‐related macular degeneration

et al. 2015

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“…54,55 More recently, Dimitrov and colleagues showed that while rod dark-adaptation rate had a better sensitivity (87%), a more clinically deployable combination of 14 Hz flicker threshold and photo-stress dynamic could detect 71% of early AMD cases and took 10-28 minutes. 56 De Kinkelder and colleagues found that early AMD subjects had a significantly lower hit rate than healthy controls in a rarebit test (detecting one or two very small light spots). 57 Wang and colleagues demonstrated that the ability to detect small bumps on an otherwise circular stimulus (shape discrimination) was significantly reduced in eyes with early AMD.…”

Section: Visual Function Testsmentioning

confidence: 99%

Improving patient outcomes: role of the primary care optometrist in the early diagnosis and management of age-related macular degeneration

Лю¹,

Swanson²

2013

OPTO

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Not long ago, the management of age-related macular degeneration (AMD) was confined to rehabilitating whatever vision had not been damaged by the disease. The recent successes of the anti-vascular endothelial growth factor agents and the antioxidant clinical trials have revolutionized AMD treatment. For the first time, there is realistic hope that the progression of AMD can be slowed down or stopped and near normal vision can be preserved. Developments in new vision tests, imaging modalities, and genetic testing have greatly improved the chance of detecting the onset of AMD and choroidal neovascularization. However, because the current treatments still cannot revive degenerated retinal cells, the best patient outcome that can be achieved is early detection of the disease and application of the appropriate treatment before too much retinal damage has occurred. The opportunities and challenges offered by the new treatment options and disease detection methods have redefined the role of primary care optometrists in AMD management. This review of literature and practice guidelines demonstrates that, in addition to the traditional roles of refraction and visual rehabilitation, the unique position of optometrists as the first-line eye-care providers has allowed them to play an important role in the early detection of AMD, patient education, lifestyle-change counseling, disease monitoring and referral, and nutrition supplement counseling. The active participation of primary care optometrists in the shared care of AMD management is likely to result in great improvement in patient outcomes. Optometrists also need to improve their competence in these areas to meet the new challenges. Although primary care optometrists have always managed patients with AMD, their role in managing this sight-threatening disease has not been adequately documented. In light of the recent game-changing developments in AMD treatment, it is important to review what primary care optometrists are doing, what they can do, and what they should do to improve patient outcomes in the new era of AMD management. Keywords: detection, patient education, lifestyle-change counseling, disease monitoring, disease referral, nutrition supplement counseling Age-related macular degenerationAge-related macular degeneration (AMD) is an acquired degenerative disease of the macular area of the retina that, in its final stage, can cause severe visual impairment. AMD affects mainly older people and its prevalence increases with age. The prevalence of any AMD and late AMD (geographic atrophy [GA] or choroidal neovascularization [CNV]) in persons aged 40 years and older is between 5.2% and 14.3%, and between 0.3% and 2.6%, respectively, depending on race and ethnicity.1 AMD results in centrally located scotomas; reduced visual acuity, contrast sensitivity, color vision, and depth perception; and poor control of eye movements. AMD is one of the leading causes of severe visual impairment in Dovepress submit your manuscript | www.dovepress.com

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“…These include changes to contrast sensitivity [9][10][11], colour vision [12][13], flicker sensitivity [13][14], temporal thresholds [15][16][17], microperimetry [11,[18][19], photostress or glare recovery [11,[20][21][22] and dark adaptation [12][13][14][23][24][25][26]. When measured alongside these other visual functions, dark adaptation abnormalities have emerged as the most sensitive markers for early AMD [12][13][14]23].…”

Section: Introductionmentioning

confidence: 99%