Grewal Manjot K, Chandra Shruti, Gurudas Sarega, Bird Alan, Jeffery Glen, Sivaprasad Sobha
Institute of Ophthalmology, University College London, London EC1V9EL, UK.
NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK.
J Clin Med. 2020 Sep 1;9(9):2832. doi: 10.3390/jcm9092832.
To investigate the value of visual acuity and patient-perceived visual function test when subretinal drusenoid deposits (SDD) are incorporated into the classification of age-related macular degeneration (AMD). A total of 50 participants were recruited into the study in these groups: healthy ageing (n = 11), intermediate AMD (iAMD) with no SDD (n = 17), iAMD with SDD (n = 11) and non-foveal atrophic AMD (n = 11) confirmed by two retinal imaging modalities. Best-corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) were measured and low luminance deficit (LLD) was calculated. Participants were also interviewed with the low luminance questionnaire (LLQ). Linear regression was used to assess function-function relations. Compared with healthy participants, BCVA and LLVA scores were significantly reduced in the atrophic AMD group ( < 0.0001 and = 0.00016, respectively) and in patients with SDD ( = 0.028 and = 0.045, respectively). Participants with atrophy also had reduced BCVA ( = 0.001) and LLVA ( = 0.009) compared with the iAMD no SDD group. However, there were no differences in visual function tests between healthy aging and iAMD without SDD and between iAMD with SDD and atrophic AMD groups. The LLD score did not differ between groups. BCVA and LLVA correlated well. The LLQ did not correlate with visual function tests. This study shows that LLD is not a marker of disease severity as assessed clinically. Although LLQ is a good marker for disease severity using the current AMD classification, it does not differentiate between eyes with and without SDD. Eyes with non-macular geographic atrophy and SDD had lower function than eyes with no SDD and healthy controls.
为了研究当视网膜下类玻璃膜疣沉积物（SDD）被纳入年龄相关性黄斑变性（AMD）分类时，视力和患者主观视觉功能测试的价值。通过两种视网膜成像方式确诊了以下几组共50名参与者纳入研究：健康老龄组（n = 11）、无SDD的中度AMD（iAMD）组（n = 17）、有SDD的iAMD组（n = 11）和非黄斑区萎缩性AMD组（n = 11）。测量了最佳矫正视力（BCVA）和低亮度视力（LLVA），并计算了低亮度缺陷（LLD）。还使用低亮度问卷（LLQ）对参与者进行了访谈。采用线性回归评估功能-功能关系。与健康参与者相比，萎缩性AMD组的BCVA和LLVA评分显著降低（分别为<0.0001和 = 0.00016），SDD患者的BCVA和LLVA评分也显著降低（分别为 = 0.028和 = 0.045）。与无SDD的iAMD组相比，萎缩性AMD组的参与者BCVA（ = 0.001）和LLVA（ = 0.009）也降低。然而，健康老龄组与无SDD的iAMD组之间以及有SDD的iAMD组与萎缩性AMD组之间的视觉功能测试没有差异。各组之间LLD评分没有差异。BCVA和LLVA相关性良好。LLQ与视觉功能测试不相关。本研究表明，LLD并非临床评估的疾病严重程度的标志物。虽然LLQ对于使用当前AMD分类的疾病严重程度是一个良好的标志物，但它无法区分有无SDD的眼睛。有非黄斑区地图样萎缩和SDD的眼睛比无SDD的眼睛及健康对照的眼睛功能更低。
