Abstract:
We assessed the feasibility of using a touch–screen Amsler Grid (Fink & Sadun, J Biomed Optics 9(1), 149–53, 2004) to evaluate the central visual field (hill of vision) at varying contrasts in subjects with atrophic AMD. Following informed consent, the central 20–degree visual field of 5 male Caucasian patients, 72.8 +/– 9.9 yrs old with atrophic AMD, presenting with metamorphopsia or scotoma on a traditional A Grid test, were examined with a touch sensitive 17" LCD monitor and web based software at fixed 30 cm test distance with best refractive correction. 5 different levels of contrast (5, 10, 20, 40 & 100%) were employed to construct a "hill of vision". In addition to 3D TAG, macular pigment optical density (MPOD), contrast sensitivity (CSF), high contrast acuity (SKILL HC), low contrast acuity (SKILL LC) and glare recovery (GR) were assessed at baseline and approximately 6 and 12 weeks following daily oral intake of 10 mg supplemental lutein. Change from baseline to 12 weeks with negative values representing diminished MPOD or visual function and positive values representing enhanced MPOD or visual function in indicated eye, paired T, 1 tail, equal variance.
The results of this small sample, short–term, non–blinded non–randomized pilot study of central macular function using objective 3D TAG are consistent with subjective glare recovery improvement and subjective Amsler grid scotoma improvement/resolution demonstrated in the Lutein Antioxidant Supplementation clinical trial (LAST study, Optom 2004 75; 4:216–30). The 3D TAG approach appears to be useful for documenting visual recovery in atrophic AMD, in selected patients.
Keywords: carotenoids/carotenoid binding proteins • age-related macular degeneration • macular pigment