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J. Feher, B. Kovacs, I. Kovacs, M. Schvoller, G. Mannino, A. Papale, C. Balacco Gabrieli, Ophthalmic Neuroscience Program; Correlation Between Fundus Alterations and Visual Functions in Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2005;46(13):198.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: An International Classification and Grading System (ICGS) for AMD is a widely applied method for clinical studies of this disease. However, this system is based on the evaluation of fundus alterations neglecting any changes in visual functions. The aim of our studies was to determine the correlations between fundus alterations and visual functions. Methods: 352 eyes of 176 patients affected by early and intermediate AMD (Grade 1, 2, 3 by the criteria of the ICGS) were evaluated and the drusen covered area was correlated with the visual functions (visual acuity with Snellen and ETDRS charts, as well as visual field mean defect and foveal sensitivity as measured with automatic visual field analyzer). Data were also compared after 1 year of treatment with a food supplementary combination (Phototrop®). Results: The sum of drusen covered area was in Grade AMD 1 <0.1mm², in Grade 2 AMD varied between 0.1 and 1.0mm², and in Grade 3 AMD it was >1.0mm². Statistical analyses of data showed significant correlation between drusen covered area and visual acuity with both Snellen chart (p<0.05) and ETDRS chart (p<0.05). Weak correlation was found between the drusen covered area and the visual mean defect, as well as between drusen covered area and foveal sensitivity. Treatment efficacy was revealed by the evaluation of these correlations. Conclusions: These data strongly suggest that the ICGS may be improved with the addition of the corresponding functional data permitting a more suitable evaluation of AMD: i.e. to reveal slight changes in the natural course of AMD and to detect a treatment efficacy. To our knowledge, this is the first clinical study which revealed the correlation between fundus alterations and changes in visual function in AMD. Further studies on a larger population and in various ethnic groups are certainly needed to confirm these data.
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