Abstract
Purpose :
To assess the diagnostic utility of dark adaptometry (DA), specifically the rod intercept time (RIT), to differentiate age-related macular degeneration (AMD) from central serous retinopathy (CSR).
Methods :
The study included patients 50 years of age and older who completed a DA study in at least one eye (AdaptDx, MacuLogix Inc., Harrisburg, PA). Excluded were patients with other retinal conditions, optic neuropathies, or ocular conditions that impaired visual function. Patients were classified based on their rod intercept time (RIT), with RIT >6.50 minutes considered indicative of delayed DA kinetics. Sensitivity and specificity of RIT in classifying patients based on the faster- and slower-adapting eyes, when available, were assessed and compared to the clinical diagnosis for each patient.
Results :
The study included 67 patients with AMD and 25 with CSR. Patients with AMD tended to be older (73.8 ± 8.9 vs. 65.0 ± 7.2, p < 0.001), with a higher proportion of females (53.7% vs. 28.0%, P = 0.049). Additionally, they exhibited poorer vision in both their better-seeing eye (LogMAR 0.14 ± 0.13 vs. 0.09 ± 0.12, p = 0.12) and worse-seeing eye (LogMAR 0.48 ± 0.47 vs. 0.21 ± 0.27, p < 0.001). RITs were notably slower in patients with AMD compared to CSR, both in the faster eye (12.44 ± 6.96 minutes vs. 4.01 ± 1.28 minutes, p < 0.001) and slower eye (13.06 ± 6.67 minutes vs. 4.95 ± 1.78 minutes, p < 0.001). Using a delayed RIT in the faster-adapting eye to differentiate between AMD and CSR patients showed an excellent performance with an accuracy of 97.4% (95% CI, 91.7%-99.6%), sensitivity of 79.1% (95% CI, 67.4%-88.1%), and perfect specificity of 100.0% (95% CI, 86.3%-100.0%). For the slower-adapting eye, comparing AMD and CSR patients revealed an accuracy, sensitivity, and specificity of 78.1% (95% CI, 68.2%-86.0%), 92.5% (95% CI, 83.4%-97.5%), and 76.0% (95% CI, 54.9%-90.6%), respectively. Adjusting for age, sex, and vision, RIT in the faster-adapting eye remained an independent predictor of AMD (adjusted odds ratio [aOR] 1.885, 95% CI 1.138-3.123, p = 0.014).
Conclusions :
Prolonged dark adaptation based on RIT in the faster-adapting eye demonstrates potential in distinguishing AMD from other conditions with similar features, like CSR. Future investigations are warranted to assess the cost-effectiveness of utilizing this noninvasive technique for AMD screening in clinical practice.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.