Abstract
The purpose of this study was to assess which visual function measures are most strongly associated with vision-related quality of life (VRQoL) in age-related macular degeneration (AMD). A cross-sectional study of subjects with early AMD (n = 10), intermediate AMD (n = 42) and late AMD (n = 38) was conducted. Subjects were interviewed with the Impact of Vision Impairment (IVI) questionnaire. Functional tests performed included best-corrected visual acuity (BCVA), low luminance visual acuity (LLVA), visual acuity measured with the Moorfields Acuity Charts (MAC), contrast sensitivity, reading speed, mesopic and dark-adapted microperimetry. The relationship between VRQoL and visual function was assessed with multiple regressions controlling for confounders. Rasch analysis demonstrated the validity of the IVI to assess VRQoL through three subscales: reading and accessing information, mobility and independence, and emotional well-being. Subjects with late AMD had significant lower IVI scores on all subscales compared with intermediate and early AMD (p < 0.011). In the overall cohort, IVI subscales were associated with BCVA, LLVA, MAC-VA and contrast sensitivity (all p < 0.001). Among the subgroup of early and intermediate AMD subjects, reading and mobility subscales were significantly associated with MAC-VA (p < 0.013). These results suggest that MAC-VA is a useful, patient-relevant measure of visual impairment in AMD.
Highlights
To date we do not know which visual tests or combination of tests with or without structural data might best allow for this
All functional tests were significantly decreased in intermediate and late age-related macular degeneration (AMD) compared to the early AMD group
There was no significant difference in best-corrected visual acuity (BCVA) between early and intermediate AMD (p = 0.553), as well as in reading speed (p = 0.617) and mesopic and dark-adapted microperimetry (p = 0.274 and p = 0.141)
Summary
To date we do not know which visual tests or combination of tests with or without structural data might best allow for this. An important pre-requisite of any functional test is its patient-relevance which can be approximated by VRQoL9. A validated and commonly used VRQoL instrument is the Impact of Vision Impairment (IVI) questionnaire which is reliable[10] and has been validated psychometrically for different ocular conditions and different levels of visual acuity[9,11,12]. In this study, we used the IVI to investigate the relationship between VRQoL and several visual functional tests under low luminance and low contrast in patients with different stages of AMD. The aim of our study was to identify which functional tests are able to discriminate between different stages of AMD and to investigate whether these tests are correlated with VRQoL in order to assess patient-relevance of the tests
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