June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
The impact of luminance and disease stage on navigation performance in age related macular degeneration (AMD) - a MACUSTAR study report
Author Affiliations & Notes
  • Ariel Zenouda
    Streetlab, Institut de la vision, Paris, Île-de-France, France
  • Alina Schenk
    Institute of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
  • Amina Abdirahman
    Institute of Ophthalmology, University College London, London, London, United Kingdom
  • Charlotte Behning
    Institute of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
  • José-Alain Sahel
    INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
  • Adnan Tufail
    Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Nadia Zakaria
    Novartis Institutes for BioMedical Research Inc, Cambridge, Massachusetts, United States
  • Nick Tyler
    Pedestrian Accessibility Movement Environment Laboratory, University College London, London, London, United Kingdom
  • Saddek Mohand-Said
    INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
  • Michel Paques
    INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, Île-de-France, France
  • Ulrich F O Luhmann
    Research and Early Development, Translational Medicine Ophthalmology, Roche Innovation Center, Roche Pharma Schweiz AG, Basel, Basel-Stadt, Switzerland
  • Hannah M P Dunbar
    Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Ariel Zenouda None; Alina Schenk None; Amina Abdirahman None; Charlotte Behning None; José-Alain Sahel None; Adnan Tufail None; Nadia Zakaria Novartis, Code E (Employment); Nick Tyler None; Saddek Mohand-Said None; Michel Paques None; Ulrich Luhmann Roche, Code E (Employment); Hannah Dunbar None
  • Footnotes
    Support  grant agreement No 116076 ; European Union’s Horizon 2020 research and innovation program and EFPIA and Carl Zeiss Meditec AG
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2456 – F0033. doi:
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      Ariel Zenouda, Alina Schenk, Amina Abdirahman, Charlotte Behning, José-Alain Sahel, Adnan Tufail, Nadia Zakaria, Nick Tyler, Saddek Mohand-Said, Michel Paques, Ulrich F O Luhmann, Hannah M P Dunbar; The impact of luminance and disease stage on navigation performance in age related macular degeneration (AMD) - a MACUSTAR study report. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2456 – F0033.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : A navigation task was developed to study the impact of illumination and disease stage on navigation performance in people with AMD.

Methods : 64 subjects with AMD and 10 similarly aged healthy controls recruited to the MACUSTAR study at 2 sites; Quinze-Vingts CHNO (n=35, mean age: 72, AMD stage: 3 controls/27 early or intermediate[e/i]/5 late) and Moorfields Eye Hospital (n=39, mean age: 74, AMD state: 7/26/6) undertook a navigation task at Streetlab (S) and Pedestrian Accessibility Movement Environment Laboratory (P) respectively. 4 obstacle seeded mazes were developed at each site. Due to different platform sizes (S:9x5m, P:11x7m) and availability of obstacles maze configurations varied. Subjects navigated 1 of 4 randomly selected mazes under 1 transition (256 reducing to 1lux) and 3 static (256, 4, 1 lux) light conditions. Preferred walking speed (PWS) for an unobstructed path was measured under 256lux and %PWS calculated for each trial. A linear mixed model was constructed using %PWS as the outcome measure, adjusted for age and site. Disease stage, light condition and their interaction term were also included.

Results : A site effect was present with %PWS being 9 percentage points higher (p < 0.001) at S compared to P. Subsequent findings are adjusted for this effect. There were no direct effects of AMD stage or light level on %PWS, however their interaction term indicates %PWS is differentially affected by luminance depending on AMD stage. Specifically, e/i AMD had a significant interaction with the transition condition (b = -5.87, p = 0.047), whereas late AMD had significant interactions with 4 lux (b = -7.68, p=0.04) and transition condition (b = -11.37, p = 0.003).

Conclusions : Results indicate that whilst those with late AMD have poorer navigation performance under low and transient light conditions, people with e/i AMD do not experience a deleterious effect of static low light, but are negatively impacted by a sudden reduction in luminance. This may be a real-world manifestation of delayed dark adaptation and impaired vision in low luminance. These findings support the exploration of the utility of navigation-based endpoints for future novel treatment trials in both e/i and late AMD.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

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