Purchase this article with an account.
G. H. Portnoy, M. E. Schneck, L. A. Lott, S. Hewlett, J. A. Brabyn; Relation Between Vision Function and Retinal Characteristics Associated With AMD in Elders With Good Acuity. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4456. doi: https://doi.org/.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To examine the association between vision measures and risk factors for AMD in older people with high contrast acuity of 20/40 or better.
Participants were a sub-sample of elderly participants from the fourth round of testing in the the Smith Kettlewell Institute (SKI) Study. High contrast visual acuity and several non-standard low contrast vision measures and subjective refraction were administered to 228 older adults. Participants with high contrast visual acuity correctable to 20/40 or better in at least one eye were asked to return for a clinical exam including fundus photos. The AREDS simplified severity scale (Arch Ophthalmol. 2005; 123:1570-1574) was used to grade the risk of advanced AMD in the person within 5 years. AREDS defined advanced AMD as the presence of 1 or more neovascular abnormalities, photocoagulation for AMD or geographic atrophy involving the center of the macula. The corrected best eye vision measures were used for the analysis.
Of the 221 participants who met the 20/40 criterion, 193 (87%) returned for the clinical exam. One person was excluded due to hereditary retinal disease. The mean age of included participants was 80.9 years (SD=5.1, range=71.8-94.8), and 54% were female. N=22 (11.5%) had fundus grades of =>3 corresponding to a 25% or greater risk of advanced AMD in 5 years according to the AREDS report. Logistic regression analysis controlling for age and sex revealed that contrast sensitivity (p=0.006) and low contrast/low luminance acuity (p=0.001) were significantly associated with =>3 retinal grade. Odds ratios (0.15 log units) ranged from 1.6 to 2.2. In those whose low contrast/low luminance acuity was worse than 20/225, 44% had fundus grades =>3 while only 5% of those with 20/110 or better low contrast/low luminance acuity had a fundus grade =>3. In those with log contrast sensitivity worse than 1.35, 44% had fundus grades =>3 while only 7% with log contrast sensitivity of 1.65 or better had this grade. High contrast visual acuity was not associated with retinal status.
In older people who maintain relatively good high contrast visual acuity, simple low contrast vision tests can identify those who are at high risk for developing advanced AMD in the near future. Such tests may thus be used for screening purposes
This PDF is available to Subscribers Only