Abstract
Purpose:To generate the first published reference database of colour contrast sensitivity in eyes at high risk of neovascular age-related macular degeneration and to explore this important feature in quality of vision.Background:Quality of vision depends on many factors. Changes in chromatic contrast sensitivity remain largely unexplored in eyes at high risk of neovascular age-related macular degeneration; they may however not only be relevant for quality of life but also an early indicator of the onset of the disease, so it is important to have a means to evaluate any variation in colour contrast sensitivity, especially in view of the likely increase in neovascular age-related macular degeneration as the population ages.Methods:This prospective longitudinal study evaluated colour contrast sensitivity along the protan and tritan colour axes in 145 eyes at high risk of neovascular age-related macular degeneration.Results:Colour contrast sensitivity showed statistically significant correlations with age and visual acuity, but not gender nor laterality (i.e. whether the right or left eye was being tested). There was significant variability among individuals, especially for the tritan axis, with some subjects well within normal limits for age and others with very poor colour contrast sensitivity.Conclusion:This study has generated the first published colour contrast sensitivity reference database for eyes at high risk of neovascular age-related macular degeneration. It has also shown a high inter-individual variability of colour contrast sensitivity in eyes at high risk of neovascular age-related macular degeneration, but the significance of this is unclear. Further work is required to establish if eyes with high colour contrast sensitivity thresholds (i.e. poor colour vision) have a higher risk of developing neovascular age-related macular degeneration over time, and this is the subject of ongoing work.
Highlights
This study reveals that colour contrast sensitivity (CCS) in the fellow unaffected eye of patients with unilateral neovascular age-related macular degeneration (nAMD), when compared with a normative database of subjects with no evidence of macular pathology in either eye,[8] tends to be higher than expected, especially on the tritan axis
This study has generated a valuable database of CCS values in the fellow unaffected eye of individuals with unilateral nAMD in the clinical setting, which may serve as a reference for future projects evaluating colour vision in a cohort of subjects with the same disease entity
Cost-effective screening for eyes at risk of developing nAMD is essential if early treatment, before irreversible damage occurs, is to be achieved, avoiding the significant personal suffering and socio-economic burden associated with sight loss from nAMD
Summary
Age-related macular degeneration (AMD) is the leading cause of irreversible sight impairment in people older than 50 years in Western society.[1,2,3] As the population ages, AMD is likely to become a much more significant issue,[2] with estimates suggesting numbers will more than double by 2050.4 It is a complex multifactorial disease, with genetic as well as environmental factors involved in its pathogenesis.[5,6,7] Previous studies[8] have noted function in eyes at high risk of neovascular age-related macular degeneration (nAMD) is frequently impaired, and it has been suggested[9,10,11,12,13] that retinal changes in high-risk eyesEuropean Journal of Ophthalmology 30(6)determine abnormal function in the adjacent photoreceptors/inner retina, with some cone populations affected more than others.[12,13,14] Normal colour vision involves comparison of signals generated in short-wavelength (S), medium-wavelength (M) and long-wavelength (L) sensitive cones. Age-related macular degeneration (AMD) is the leading cause of irreversible sight impairment in people older than 50 years in Western society.[1,2,3] As the population ages, AMD is likely to become a much more significant issue,[2] with estimates suggesting numbers will more than double by 2050.4 It is a complex multifactorial disease, with genetic as well as environmental factors involved in its pathogenesis.[5,6,7] Previous studies[8] have noted function in eyes at high risk of neovascular age-related macular degeneration (nAMD) is frequently impaired, and it has been suggested[9,10,11,12,13] that retinal changes in high-risk eyes. Whilst several vision attributes have been studied in AMD, changes in chromatic sensitivity remain largely unexplored and a colour vision database of eyes at high risk of nAMD, against which tested eyes can be compared, has not been published
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