Quantification of Visual Field Loss in Age-Related Macular Degeneration

Abstract

BackgroundAn evaluation of standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP) for the central 10–2 visual field test procedure in patients with age-related macular degeneration (AMD) is presented in order to determine methods of quantifying the central sensitivity loss in patients at various stages of AMD.Methods10–2 SAP and SWAP Humphrey visual fields and stereoscopic fundus photographs were collected in 27 eyes of 27 patients with AMD and 22 eyes of 22 normal subjects.ResultsMean Deviation and Pattern Standard Deviation (PSD) varied significantly with stage of disease in SAP (both p<0.001) and SWAP (both p<0.001), but post hoc analysis revealed overlap of functional values among stages. In SWAP, indices of focal loss were more sensitive to detecting differences in AMD from normal. SWAP defects were greater in depth and area than those in SAP. Central sensitivity (within 1°) changed by −3.9 and −4.9 dB per stage in SAP and SWAP, respectively. Based on defect maps, an AMD Severity Index was derived.ConclusionsGlobal indices of focal loss were more sensitive to detecting early stage AMD from normal. The SWAP sensitivity decline with advancing stage of AMD was greater than in SAP. A new AMD Severity Index quantifies visual field defects on a continuous scale. Although not all patients are suitable for SWAP examinations, it is of value as a tool in research studies of visual loss in AMD.

Self‐reported optometric practise patterns in age‐related macular degeneration

“…The assessment of functional loss in AMD is possible using various methods and the clinical utility of these methods for the detection of damage before clinically detectable fundus signs has been reviewed elsewhere . In clinical practice, it is not usual or practical to perform tests such as dark adaptation despite drastic abnormalities characteristic of early AMD .…”

Impact of age‐related macular degeneration in patients with glaucoma: understanding the patients' perspective

“…Both the GAL‐9, assessing vision‐related activity limitation, and the VFQUI, a preference‐based index reflecting near vision, distance vision, vision‐specific role difficulties, vision‐specific social functioning, vision‐specific dependency and vision‐specific mental health, are negatively influenced by AMD and glaucoma severity among glaucoma patients. On multivariate analysis, higher GAL‐9 score (reflecting greater activity limitation) was influenced independently by the presence of AMD and lower better eye MD; the latter is influenced by both AMD and glaucoma . Similarly, VFQUI utility value was independently negatively influenced by the worse eye VA, the presence of high‐risk AMD and severe glaucoma.…”

“…On multivariate analysis, higher GAL-9 score (reflecting greater activity limitation) was influenced independently by the presence of AMD and lower better eye MD; the latter is influenced by both AMD and glaucoma. 50 Similarly, VFQUI utility value was independently negatively influenced by the worse eye VA, the presence of high-risk AMD and severe glaucoma. Both glaucoma and AMD can affect vision profoundly; hence, the combination is a substantial impact on a patient's daily function, especially in the late stages of either disease.…”

Correlation between peripapillary retinal nerve fiber layer thickness and fundus autofluorescence in primary open-angle glaucoma

“…Therefore, FAF has become a valuable tool in monitoring the development and progression of atrophic RPE dysfunction and consecutive neurosensory degeneration, such as in age-related macula degeneration (AMD) 18,19. A close correlation between RPE damage measured with FAF intensity and visual deterioration has been de scribed 33–36. In reverse, RNFL damage may be associated with RPE dysfunction.…”