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Liang Wang, Yingying Shi, Jonathan Russell, Mengxi Shen, Xiaoshuang Jiang, Prashanth G Iyer, Sonia H Yoo, Terri Rose, Rabash Georgia Habash, Guillermo Amescua, William J Feuer, Giovanni Gregori, Philip J Rosenfeld; Impact of Cataract Surgery on Low Luminance Visual Acuity Deficit Measurements. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1045 – F0292.
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The impact of cataract surgery on low luminance visual acuity deficit (LLVAD) measurements was investigated by comparing LLVAD measurements before and after cataract surgery.
Both normal luminance best-corrected visual acuity (NL-BCVA) and low luminance BCVA (LL-BCVA) were obtained using the Early Treatment Diabetic Retinopathy Study (ETDRS) charts. LL-BCVA was measured by using a 2.0-log unit neutral density filter in front of the examined eye (Wratten filter; Kodak, Rochester, NY). LLVAD scores were calculated by subtracting the LL-BCVA letter score from the NL-BCVA letter score. To estimate the test-retest variability of these visual acuity measurements, we used data from a previously published study entitled Complement Inhibition with Eculizumab for the Treatment of Nonexudative Age-Related Macular Degeneration (COMPLETE) Study, where the NL-BCVA, LL-BCVA, and LLVAD measurements were obtained at an interval of three months. In the current study, the impact of cataract surgery on LLVAD measurements was analyzed by comparing the NL-BCVA, LL-BCVA, and LLVAD measurements before and after cataract surgery.
In the COMPLETE study, a total of 37 eyes were included at baseline and at the month-3 follow-up visit. There were no clinically significant differences in the NL-BCVA, LL-BCVA, and LLVAD measurements between baseline and the month-3 follow-up visits with mean differences in ETDRS letter scores of -1.1 (P=0.02), -1.3 (P=0.11), and 0.1 (P=0.88). In the current study, a total of 25 eyes were assessed before and after cataract surgery. Not surprisingly, there were significant increases in the NL-BCVA (+7.3) and LL-BCVA (+10.2) letter score measurements after cataract surgery (both P < 0.001); however, a statistically significant decrease in the average LLVAD measurement (-3.0) was observed after cataract surgery (P = 0.002). This change was due to the greater impact of cataracts on LL-BCVA measurements compared to the NL-BCVA measurements.
A greater effect of cataracts on LL-BCVA than NL-BCVA measurements caused a significant change in LLVAD values after cataract surgery. Caution should be exercised when using LLVAD measurements as a predictor of disease progression in phakic eyes with age-related macular degeneration.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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