Abstract
Purpose: To investigate the value of visual acuity and patient-perceived visual function test when subretinal drusenoid deposits (SDD) are incorporated into the classification of age-related macular degeneration (AMD). A total of 50 participants were recruited into the study in these groups: healthy ageing (n = 11), intermediate AMD (iAMD) with no SDD (n = 17), iAMD with SDD (n = 11) and non-foveal atrophic AMD (n = 11) confirmed by two retinal imaging modalities. Best-corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) were measured and low luminance deficit (LLD) was calculated. Participants were also interviewed with the low luminance questionnaire (LLQ). Linear regression was used to assess function–function relations. Compared with healthy participants, BCVA and LLVA scores were significantly reduced in the atrophic AMD group (p < 0.0001 and p = 0.00016, respectively) and in patients with SDD (p = 0.028 and p = 0.045, respectively). Participants with atrophy also had reduced BCVA (p = 0.001) and LLVA (p = 0.009) compared with the iAMD no SDD group. However, there were no differences in visual function tests between healthy aging and iAMD without SDD and between iAMD with SDD and atrophic AMD groups. The LLD score did not differ between groups. BCVA and LLVA correlated well. The LLQ did not correlate with visual function tests. This study shows that LLD is not a marker of disease severity as assessed clinically. Although LLQ is a good marker for disease severity using the current AMD classification, it does not differentiate between eyes with and without SDD. Eyes with non-macular geographic atrophy and SDD had lower function than eyes with no SDD and healthy controls.
Highlights
Visual impairment due to advanced age-related macular degeneration (AMD) is a global public health burden, with an estimated 196 million people being affected world-wide [1]
Unlike drusen, which are located between the retinal pigment epithelium (RPE) and Bruch’s membrane, subretinal drusenoid deposits (SDD) are located internal to the RPE and are in closer proximity to the photoreceptors when compared with drusen [4]
According to the R2 parameter, Best-corrected visual acuity (BCVA) was able to explain 78% (p = 0.0003), 74% (p < 0.0001), 84% (p < 0.0001) and 91% (p < 0.0001) of the variance in low luminance visual acuity (LLVA) for the healthy aging, intermediate AMD (iAMD) no SDD, iAMD with SDD and atrophic AMD groups, respectively
Summary
Visual impairment due to advanced age-related macular degeneration (AMD) is a global public health burden, with an estimated 196 million people being affected world-wide [1]. Subretinal drusenoid deposits (SDD), otherwise termed reticular pseudodrusen (RPD), have been shown to co-exist with drusen in some eyes with early or intermediate AMD and these eyes are at higher risk of progression to advanced AMD [2,3]. Unlike drusen, which are located between the retinal pigment epithelium (RPE) and Bruch’s membrane, SDD are located internal to the RPE and are in closer proximity to the photoreceptors when compared with drusen [4]. These SDDs have not been included in AMD classifications to date, they have been found to have a profound correlation with rod recovery time [5,6]. Not clear whether or not eyes with intermediate AMD should be stratified into those with and without SDD to better define the impact of interventions in this condition
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
