Purchase this article with an account.
Sunita Saigal, Michael J. Byrnes, Jennifer Keating, Patrick Johnston, Gregory R. Blaha, Jeffrey L. Marx, Avner Ingerman; Assessment Of Self-Reported Visual Function History In Patients With Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5575.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Although visual acuity is typically not affected in eyes with early-to-intermediate AMD, several psychophysical techniques have shown reduced visual function. Individuals with dry AMD and good visual acuity have also been shown to score significantly lower on vision-related quality of life questionnaires such as the VFQ25. In this study, we interviewed 39 subjects with advanced AMD to determine their earliest reported AMD-related visual changes.
Each interview was conducted in three stages according to a defined protocol: first, subjects were asked open-ended questions about their visual history; second, subjects were asked to describe any visual changes they noticed in specified aspects of visual function (e.g. near/reading, distance, night, etc.); third, probing questions related to any visual changes noted in stages 1 and 2 were asked. Patients with other ophthalmic conditions affecting vision were excluded. Of the 39 patients interviewed, 15 had bilateral wet AMD (including 2 who also had unilateral GA), 22 had unilateral wet AMD with dry AMD in the fellow eye, and 2 had geographic atrophy (1 bilateral, 1 unilateral GA). The mean age of all subjects was 76.7 (range 54 - 94) and 74% of all subjects were female.
Only 62% (24 of 37) of the wet AMD patients reported metamorphopsia, a hallmark of wet AMD onset. Of these, 30% (7 of 23) reported occurrence of other visual symptoms at least 1 year earlier. Initial symptoms reported included metamorphopsia (41%) as well as difficulties with night vision (31%), near vision/reading (23%), vision while driving (21%), motion tracking (8%) and peripheral vision (3%). Additional symptoms reported frequently included visual difficulties while driving (90% of subjects), near vision/reading (77%), distance vision (64%) and night vision (62%). Less frequently reported symptoms included peripheral vision (21%) and motion tracking (23%).
More than half of AMD patients reported visual symptoms prior to the onset of wet AMD despite maintaining VA prior to conversion. Initial symptoms prior to wet AMD onset involved a variety of visual tasks, the most frequent of which was night vision difficulty. The frequency of initial symptoms is higher than one would expect in healthy age-matched eyes based quality of life assessments in AMD patients and age-matched controls (AREDS Report #10, 2003). Further investigation of these symptoms as potential risk factors for progression of AMD may be warranted.
This PDF is available to Subscribers Only