Abstract
Purpose :
Previous evidence suggests that the time for visual recovery after exposure to glare is commonly slowed in age-related macular degeneration (AMD), even among patients with normal visual acuity, varying by age and extent of disease. However, systematic data from epidemiological studies is lacking. We thus set out to assess photoreceptor function and recovery following photostress in a population-based study of individuals aged 70+ (AugUR), to investigate the association of photostress recovery time (PRT) with age and AMD status.
Methods :
Presence and severity of AMD was assessed via manual grading of color fundus images applying the Three Continent AMD Consortium Severity Scale. After assessing visual acuity via ETDRS charts in 4m distance, the full macular region was bleached tor 30 seconds via a bright direct ophthalmoscope and PRT was measured as the seconds of the participants’ recovery to regain their visual acuity. The participant’s AMD status was derived as their most severe eye-specific AMD status (worse eye), PRT was then analyzed for this worse eye, or a random eye if both had the same AMD stage. As cataract can potentially influence PRT, status after cataract surgery was determined via interview-based questionnaire.
Results :
Baseline data on AMD status as well as PRT was available for 1391 AugUR participants, aged 70-95 years (mean age 78.3±4.9), 42.5% male. A total of 289 individuals had early (moderate, mild, severe) and 49 had late AMD. PRT ranged from 2 to 239 seconds (mean 94.6±48.1), increased by age and particularly early AMD (Figure 1A,B). Logistic regression adjusted by age and sex revealed a highly significant association of increasing PRT with any AMD (Odds Ratio [OR]=1.091 per 10 seconds, P-value=3.2*10-11). The same association was found when focussing on early AMD (OR=1.091, P=3.0*10-10), and when only including participants with cataract surgery (n=483; e.g. any AMD: OR=1.088, P=7.7*10-5).
Conclusions :
PRT is easy to assess, thus potentially applicable broadly in epidemiological studies and worthwhile for further evaluation longitudinally. In addition to providing unique PRT values for an older population, we demonstrate a significant association with particularly early AMD cross-sectionally, indicating the potential of PRT as a functional biomarker.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.