<p>Multimodal Evaluation of Visual Function in Geographic Atrophy versus Normal Eyes</p>

Abstract

Purpose: To comprehensively evaluate visual function in eyes with geographic atrophy (GA) as compared to normal eyes. Patients and Methods: Sixty-three eyes from 63 patients ≥50 years old were recruited for this observational study; 31 were identified as normal macular health eyes and 32 with GA. Visual function was tested with best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), low luminance deficit (LLD), reading speed, macular integrity microperimetry, fixation stability, and contrast sensitivity function (CSF). Anatomic function was evaluated with spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF). Quality of life and vision were assessed with the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Results: Visual function and quality of life are reduced in patients with GA. Moderate and strong correlations in the GA group were found between maximum reading speed (r = 0.787) (p˂0.01), CS spatial frequency 3 cpd (r = 0.441) (p˂0.05), CS spatial frequency 6 cpd (r = 0.524) (p˂0.01), fixation P1 (r = 0.379) (p˂0.05), macular sensitivity (r = 0.484) (p˂0.05) and atrophic area (r = −0.689) (p˂0.01), and the VFQ-25 composite score. Conclusion: The decreased visual function is reflected in a poor quality of life in patients with GA. Reading speed, contrast sensitivity, fixation, and macular sensitivity are strongly associated with vision-related quality of life. The results suggest the importance of the reading letter size in patients with GA. Microperimetry and reading speed are useful tools to better assess visual impairment in patients with GA.

Seeing Beyond Anatomy: Quality of Life with Geographic Atrophy

“…Larger areas of GA are associated with decreased visual acuity, hindering the ability to carry out daily tasks [28][29][30][31]. GA also reduces one's ability to recognise faces [32,33], and reading speed decreases as the GA lesion increases in size [31,34]. Critically, GA severely impacts a patient's ability to drive, which limits their freedom to travel, reducing their independence [35].…”

“…GA is associated with a reduction in independence and mental wellbeing. Larger areas of GA are associated with decreased visual acuity, hindering the ability to carry out daily tasks [ 28 – 31 ]. GA also reduces one’s ability to recognise faces [ 32 , 33 ], and reading speed decreases as the GA lesion increases in size [ 31 , 34 ].…”

The Use of Neuroprotective Agents in Treating Geographic Atrophy

“…Close to half of all patients with GA are legally blind, with 42% reported as having 20/200 vision or worse [46]. Larger areas of GA are associated with a decreased visual acuity and function, hindering patients’ ability to carry out daily tasks [47-50]. Reading speed declines as a function of GA lesion size, location, and growth [50, 51], and GA negatively affects patients’ ability to recognize faces [52, 53].…”

“…Larger areas of GA are associated with a decreased visual acuity and function, hindering patients’ ability to carry out daily tasks [47-50]. Reading speed declines as a function of GA lesion size, location, and growth [50, 51], and GA negatively affects patients’ ability to recognize faces [52, 53]. GA also severely impacts patients’ ability to drive, limiting their freedom to travel [54]; 66.7% of patients become ineligible to drive within a median time of 1.6 years from their diagnosis [12].…”

“…AMD and GA also affect other aspects of patients’ quality of life, increasing the risk of depression as well as susceptibility to falls and injuries due to poor visual acuity [55, 56]. As a GA lesion increases in size, skills critical for maintaining quality of life deteriorate, such as reading speed and recognizing faces [50, 51, 57]. Many patients with GA also experience fear related to their condition and the deterioration of their eyesight [48, 49].…”