Abstract
Purpose :
Deficits in rod-mediated dark adaptation have been shown to be correlated with increased severity of age-related macular degeneration (AMD). We investigate whether responses on a Low Luminance Questionnaire (LLQ) in patients with a range of AMD severity correlate with their performance on focal dark adaptation testing.
Methods :
A total of 113 participants (mean age, 76.2 ± 9.3 years; 58.4% female) with varying severity of AMD were administered a 32-question LLQ (Owsley et al Invest Ophthalmol Vis Sci. 2006 Feb;47(2):528-35) on the same day (baseline) that they underwent dark adaptation (DA) testing using a prototype of the AdaptDxTM (Maculogix, Hummeltown, PA) measuring rod intercept time (RIT). Each item in the LLQ is designated to one of six subscales describing functional problems in low luminance: driving, emotional distress, mobility, extreme lighting, peripheral vision, and general dim lighting and scores were computed for each subscale. We performed univariate and multivariate analyses of these scores with various study variables (age, RIT, AMD Group, subfoveal choroidal thickness [SFCT], and visual acuity).
Results :
Univariate analysis demonstrated that lower scores on all LLQ subscales were correlated with prolonged DA testing (longer RIT) with the LLQ subscale of driving having the largest parameter estimate (-0.784, p=0.001). All LLQ subscales were also positively correlated with choroidal thickness although the peripheral vision association was not statistically significant. Age, visual acuity and AMD severity group demonstrated statistically significant correlations in some of the subscales. Multivariable analysis for each of the LLQ subfield outcomes, adjusted for age, included both RIT and choroidal thickness, with the exception of “peripheral vision”, which only included RIT. The association with RIT was greater than choroidal thickness in all analyses.
Conclusions :
This cross-sectional (baseline) analysis of evaluation of the Low-Luminance questionnaire, in a population of older adults with varying degree of AMD severity, demonstrates good correlation with measures of dark adaptation and choroidal thickness. The analysis suggests that local functional measurements of DA testing (RIT) and choroidal thickness may be associated with patient reported functional deficits.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.