Age-related Maculopathy Patients Research Articles

Эффективность микроимпульсной (577 нм) коагуляции пигментного эпителия сетчатки у больных возрастной макулопатией в зависимости от морфофункциональных особенностей

Эффективность микроимпульсной (577 нм) коагуляции пигментного эпителия сетчатки у больных возрастной макулопатией в зависимости от морфофункциональных особенностей

COMPARISON OF CHOROIDAL THICKNESS AMONG PATIENTS WITH HEALTHY EYES, EARLY AGE-RELATED MACULOPATHY, NEOVASCULAR AGE-RELATED MACULAR DEGENERATION, CENTRAL SEROUS CHORIORETINOPATHY, AND POLYPOIDAL CHOROIDAL VASCULOPATHY

To compare choroidal thicknesses among eyes with early age-related maculopathy (ARM), neovascular age-related macular degeneration, polypoidal choroidal vasculopathy, and central serous chorioretinopathy. Patients with age-related maculopathy (37 eyes), neovascular age-related macular degeneration (24 eyes), polypoidal choroidal vasculopathy (12 eyes), and central serous chorioretinopathy (31 eyes) underwent spectral-domain optical coherence tomography evaluations using a choroid scanning protocol. A horizontal linear section comprising 50 averaged scans was obtained of each macula. The choroidal thickness was measured from the outer border of the retinal pigment epithelium to the inner scleral border. Twenty-nine subjects with healthy eyes served as a control group. Analysis of covariance tests were performed to evaluate the effects of various diagnoses on choroidal thickness after removal of variance (covariates = gender, age, and refractive error). Among the different covariates, age was associated with choroidal thickness (fovea: F = 12.067, P = 0.001). After controlling for age differences, the choroid was thicker in polypoidal choroidal vasculopathy (319.92 ± 68.66 μm) and central serous chorioretinopathy (367.81 ± 105.56 μm) patients than in controls (241.97 ± 66.37 μm) and age-related maculopathy patients (186.62 ± 64.02 μm). However, there were no significant differences in mean choroidal thickness between neovascular age-related macular degeneration (226.46 ± 102.87 μm) and any of the other diagnoses. The choroid was thicker in eyes with polypoidal choroidal vasculopathy or central serous chorioretinopathy than in control or age-related maculopathy groups.

Macular Carotenoid Levels of Normal Subjects and Age-Related Maculopathy Patients in a Japanese Population

Macular carotenoid pigments composed of lutein and zeaxanthin are thought to affect the development of age-related maculopathy (ARM). Macular carotenoid levels were measured in normal Japanese subjects and Japanese patients with ARM. Observational case-control series. One hundred normal eyes of 100 normal subjects and 187 eyes of 97 patients with ARM; all were Japanese. The definitions of early ARM and late ARM (exudative age-related macular degeneration [AMD] and dry AMD) were used according to an accepted international classification system. Macular carotenoid levels were measured using resonance Raman spectroscopy. Raman signal intensity generated from carbon-carbon double bond vibrations of lutein and zeaxanthin. The mean (+/-standard deviation [SD]) macular carotenoid level in normal subjects was 1471+/-540 Raman counts. The macular carotenoid levels in normal subjects declined with age. The mean macular carotenoid level was 620+/-204 (+/-SD) in eyes with early ARM and 427+/-283 (+/-SD) in eyes with late ARM (equal to AMD). The macular carotenoid levels of early ARM and AMD were significantly lower than those in normal subjects older than 60 years (1100+/-340 [+/-SD]). No difference was revealed in carotenoid levels by the severity for ARM, type of AMD (exudative, atrophic, and disciform scar), or types of choroidal neovascularization (classic, minimally classic, occult, polypoidal choroidal vasculopathy), although small numbers in some groups weakened statistical power. Macular carotenoid levels were affected by the severity of macular disease in the opposing eye. The average for normal eyes where AMD was found in the opposite eye was significantly lower than that of normal eyes in the absence of AMD in the opposite eye (i.e., healthy volunteers older than 60 years). Macular carotenoids decreased even in older healthy individuals. The ARM patients showed lower macular carotenoid levels than healthy people. Low macular carotenoid levels may be one of the risk factors of progression in ARM.

Vision-specific health-related quality of life in age-related maculopathy patients presenting for low vision services

Few studies have examined the effectiveness of low vision rehabilitation for age-related maculopathy (ARM) patients and its impact on vision-specific health-related quality of life (HRQoL). However, before a multi-site clinical trial can be conducted, appropriate outcome measures need to be identified for ARM patients who seek out low vision rehabilitation, including a vision-specific HRQoL instrument. The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was developed to assess vision-specific HRQoL for low vision patients, including those with ARM. This study examines the performance of the NEI VFQ-25 among ARM patients who seek out low vision services and examines its relationship with visual acuity and self-reported use of low vision aids. One hundred and twenty-seven patients were recruited from a University-affiliated low vision clinic. During two telephone interviews, subjects completed the NEI VFQ-25 and a short cognitive test and provided information on general health and use of low vision aids. Additional information on visual acuity and eye health were collected from the medical record. Our results indicate that ARM patients who seek out low vision services report significant impairment in their vision-specific HRQoL. Their NEI VFQ-25 scores were lower compared to other ARM and low vision rehabilitation samples previously studied. The VFQ subscales with the largest deficits were near and distance visual acuities and psychosocial issues (near vision, distance vision, role difficulties, dependency, social functioning, mental health). These subscale scores were lower for those with greater visual acuity impairment. The VFQ subscale scores most impacted by the disease had wide variability and were higher for those who used low vision aids, suggesting that the NEI VFQ-25 is suitable for measuring further decline and treatment-related improvements. Thus, it should be strongly considered for a multi-site clinical trial on the effectiveness of low vision rehabilitation.

Contribution of vision variables to mobility in age-related maculopathy patients.

Can mobility performance be predicted from measures of vision function? This study addressed this question by measuring a series of vision variables including visual acuity, visual fields, and differential motion sensitivity in a group of patients with age-related maculopathy (ARM) and a group of age-matched normals. Mobility performance at three adaptation levels was determined objectively on an indoor course. The results indicate that for the patients with ARM, mobility variables can be predicted from measures of vision function, including differential velocity sensitivity, and that simple variables such as time taken to complete the course and average speed are those which relate best to vision.