Abstract
Purpose::
Visual acuity has been commonly used as a measure in treatment trials. However, especially parafoveal functions are important, because they are relevant for daily living skills. The main objectives of the AMD-READ project* (a cooperation of Univ. Eye Hospital Tübingen/D, Institute of Ophthalmology London/UK, Univ. Eye Hospital Turku/Fi, INSERM Bron/Fr and SMI, Berlin/D) were 1) to develop tools for assessment of macular functions, which consider the disabilities in everyday life, 2) to provide standardised test procedures, which are compatible across centres and languages and can be used in international studies and 3) to provide a reliable, easy and cheap test battery, which can be everywhere available.
Methods::
334 patients with AMD, 100 age-matched and 100 young controls were included. A set of standardised texts to measure reading speed in English, Finnish, French and German was developed and tested. A method to assess the fixation locus via a modified slit lamp was created. Visual acuity, different charts for testing magnification need, foveal contrast sensitivity by Lea contrast charts, parafoveal contrast sensitivity test (MMtest; Macular Mapping Test) and reading performance were examined and compared to more sophisticated methods, such as eye tracking, SLO and threshold perimetry.
Results::
The combination of visual acuity by ETDRS charts, magnification need by Reading Navigator, reading performance using the new standardized texts, fixation locus by modified slit lamp, foveal and parafoveal contrast sensitivity was found as a reliable test set for low vision patients. The MMtest at 10% contrast allowed the best differentiation between the early AMD and the age-matched control group.
Conclusions::
A test battery can be provided for clinical and scientific examinations. Standardised tests enable comparison of results between centres. New tests for parafoveal function allow early detection and sensitive monitoring of AMD - important for future treatment trials. The test set provides a reliable, easy and cheap tool, which can be used without major technical equipment also in developing countries.*see http://www.amd-read.netSupported by the European Commission QLK6-CT-2002-00214.
Keywords: low vision • age-related macular degeneration • reading