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Richard Jay Kolker, Andrew Kolker, Carmel L. Mercado, Aazim A. Siddiqui, Pavle Doroslovački, Jiangxia Wang; Comparison of Distance-Near Visual Acuity Disparity in Cataract and Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):514.
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© ARVO (1962-2015); The Authors (2016-present)
To assess whether comparison of distance and near best corrected visual acuities (BCVA) can be used as a quick, basic screening tool for differentiating between cataract and ARMD in the clinical setting.
Retrospective chart review of 102 patients with cataract (N=121 eyes) or ARMD (N=27 eyes) who were seen for follow-up between January - November 2013.
A greater proportion of cataract eyes (88%) compared to AMD eyes (52%) had one Snellen line better near than distance BCVA (p<0.001). When BCVA was 20/30, or worse than 20/30, cataract eyes were 5.5 times (p=0.027) and 32.4 times (p=0.002) more likely than ARMD eyes, respectively, to have a one line near-distance BCVA difference. When distance BCVA was worse than 20/30, cataract eyes were 4.6 times (p=0.011) more likely to have two lines better near VA compared to ARMD eyes. There were 16 cataract eyes and no ARMD eyes with a three line or greater near-distance BCVA disparity, a statistically significant difference between the groups (p=0.001).
Comparison of distance and near BCVA can serve as a simple and quick screening tool to help differentiate between cataract and ARMD. Better near than distance BCVA makes the patient’s diagnosis more likely to be cataract; if no disparity, it is more likely to be ARMD. This comparison method may provide clinicians with a screening tool that can be used in resource-poor settings, where a potential acuity meter or other diagnostic modalities may be unavailable.
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