Abstract
PurposeThere is a well-established research base surrounding face recognition in patients with age-related macular degeneration (AMD). However, much of this existing research does not differentiate between results obtained for ‘wet’ AMD and ‘dry’ AMD. Here, we test the hypothesis that face recognition performance is worse in patients with dry AMD compared with visually healthy peers.MethodsPatients (>60 years of age, logMAR binocular visual acuity 0.7 or better) with dry AMD of varying severity and visually healthy age-related peers (controls) completed a modified version of the Cambridge Face Memory Test (CFMT). Percentage of correctly identified faces was used as an outcome measure for performance for each participant. A 90% normative reference limit was generated from the distribution of CFMT scores recorded in the visually healthy controls. Scores for AMD participants were then specifically compared to this limit, and comparisons between average scores in the AMD severity groups were investigated.ResultsThirty patients (median [interquartile range] age of 76 [70, 79] years) and 34 controls (median age of 70 [64, 75] years) were examined. Four, seventeen and nine patients were classified as having early, intermediate and late AMD (geographic atrophy) respectively. Five (17%) patients recorded a face recognition performance worse than the 90% limit (Fisher’s exact test, p = 0.46) set by controls; four of these had geographic atrophy. Patients with geographic atrophy identified fewer faces on average (±SD) (61% ± 22%) than those with early and intermediate AMD (75 ± 11%) and controls (74% ± 11%).ConclusionsPeople with dry AMD may not suffer from problems with face recognition until the disease is in its later stages; those with late AMD (geographic atrophy) are likely to have difficulty recognising faces. The results from this study should influence the management and expectations of patients with dry AMD in both community practice and hospital clinics.
Highlights
Face recognition is an important daily activity
We studied computer-based face recognition performance in patients with a range of severities of dry age-related macular degeneration (AMD) compared with visually healthy peers
Our study adds to this knowledge, because it is the first study to document face recognition performance in people with dry AMD
Summary
Face recognition is an important daily activity. We are believed to spend more time looking at faces than any other complex visual stimuli, and this is central to social interactions [1]. People with age-related macular degeneration (AMD) have difficulty with different aspects of face recognition. In a survey of 30 people with bilateral AMD, all but one reported difficulty recognising familiar faces on the street; a third of these felt embarrassment as a result [3]. Over half of respondents reported missing things in conversation because of an inability to make out facial expressions. These patient-reported data are corroborated by performance-based research studies. Viewing distances required for recognising faces were found to be shorter on average for people with AMD than those without [4]; the ability to determine whether or not a face is expressive has been reported to be closely related to near reading acuity [3]. In another study [5], only 26% of 100 people with AMD were able to correctly identify the facial expression in four photographs of people depicting
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