Novel computer-based assessments of everyday visual function in people with age-related macular degeneration

Abstract

Purpose To test the hypothesis that the performance in novel computer-based tasks of everyday visual function worsens with disease severity in people with non-neovascular age-related macular degeneration. Methods Participants with and without non-neovascular age-related macular degeneration (≥60 years, minimum logMAR binocular visual acuity 0.7) performed a series of standard visual function tests and two novel computer-based tasks. In a visual search task, participants had to locate an image of a single real-world object within an array of 49 distractor images. Next, in a series of simulated dynamic driving scenes, participants were asked to identify one or two approaching real-world road signs and then select these road signs from four options. Outcome measures were median response times and total correct responses. Results Forty-nine participants had no macular disease (n = 11), early/intermediate age-related macular degeneration (n = 16) or geographic atrophy (n = 22). Groups were age-similar with median (interquartile range) logMAR visual acuity of 0.00 (-0.08,0.12), 0.13 (-0.08,0.70) and 0.32 (0.12,0.70) respectively. Median (interquartile range) visual search response times were 1.9 (1.0,2.4), 1.8 (1.1,3.7) and 2.4 (1.2,6.0) seconds respectively. Median (interquartile range) road sign response times (single road signs) were 1.2 (0.4,1.7), 1.5 (0.9,2.8) and 1.8 (1.0,5.5) seconds respectively. Median (interquartile range) road sign response times (double road signs) were 1.7 (0.7,2.4), 2.3 (1.2,3.1) and 2.5 (1.7,6) seconds respectively. Participants with geographic atrophy recorded slower response times in all tasks and over 50% performed outside the normative limit for task performance. There were no significant differences between groups in total correct responses across all tasks. Conclusions In a novel computer-based assessment, people with increasing severity of age-related macular degeneration take longer to perform visual search of everyday objects and take longer to identify road signs than those with no age-related macular degeneration. These novel assessments could be useful as patient-relevant, secondary outcomes for clinical trials.

Humanistic and Economic Burden of Geographic Atrophy: A Systematic Literature Review

“…Participants with GA recorded slower response times than other groups for performing visual searches for everyday objects and had fewer correct responses; >50% performed outside the normal limit for task performance. 30 However, visual and reading acuity do not necessarily reflect functional reading ability in patients with GA and may depend on the location of atrophy. 31 , 32 Sunness et al 31 conducted a study of 156 US patients with GA who had visual acuity of 20/50 or better (logMAR visual acuity <0.46) in one or both eyes with GA to explore reading difficulties and the progression of reading impairment.…”

Intravitreal treatment for geographic atrophy: coming soon to a patient near you?

“…About one-half of patients develop GA in both eyes within seven years of initial diagnosis [4]. People with GA have worse vision-related quality-of-life even when their visual acuity is preserved; for example, we have shown that they have increased anxiety about mobility, problems with searching for objects and difficulty recognising faces [5][6][7][8][9]. With no current treatment for GA, patients diagnosed in hospital eye service are typically discharged to the community for monitoring [10,11].…”

51.2: Simulating the Visual Impairment Symptoms of Age‐related Macular Degeneration in Virtual Reality

“…Loss of vision due to AMD has been found to have numerous effects on people, such as negatively affecting mental health [9] and making daily activities more difficult, often leading to a decrease in physical activity levels and an overall poorer quality of life [10]. It can also be quite isolating, with many of those with the condition reporting that it prevents them from independently reaching local amenities [3].…”