Purchase this article with an account.
Ronald E P Frenkel, Howard Shapiro, Ivo Stoilov; Low Luminance Visual Acuity and Treatment Response in Patients with wet Age-Related Macular Degeneration Enrolled in the HARBOR Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3963.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Explore the effect of baseline low luminance visual acuity (LLVA) score on best corrected visual acuity (BCVA) response to ranibizumab treatment in patients with subfoveal wet AMD (n = 1097).
Subanalysis of the HARBOR study (NCT00891735). LLVA was measured by placing a 2.0-log-unit neutral density filter and having the participant read the normally illuminated ETDRS chart. The relationship of LLVA with BCVA at baseline and over 24 months of treatment (months 3, 6, 9, 12, 15, 18, 21, and 24) was explored using Pearson correlation.
Mean baseline LLVA was similar across treatment groups (28.2 to 29.3 letters) and was significantly correlated with baseline BCVA (P<.0001). On average for all treatment groups pooled, LLVA increased by 15.4 letters from baseline to month 24, compared with 8.7 letters gain in BCVA. Therefore, the effect of treatment under low luminance conditions was underestimated by BCVA measurements, but it is likely meaningful to patients. The magnitude of the difference (gap) between BCVA and LLVA at baseline (but not the absolute baseline value of LLVA) was negatively correlated with BCVA gain at month 24 (P<.0001). Patients with ≤17 letters difference between BCVA and LLVA at baseline gained on average 13.4 letters BCVA at month 24 while patients with ≥33 letters difference gained only 2.4 letters BCVA (Figure).
LLVA was correlated with BCVA and showed a robust response to treatment. While baseline LLVA itself was not associated with a differential treatment effect, patients with a wider gap between the BCVA and LLVA scores at baseline gained less BCVA during the 24 month treatment period than those whose baseline LLVA and BCVA were more similar. Therefore a small BCVA-LLVA differential may be a manifestation of a milder retinal impairment and a predictor of greater capacity for visual function improvement with ranibizumab therapy.
This PDF is available to Subscribers Only