Department of Ophthalmology, Zealand University Hospital, Vestermarksvej 23, DK-4000, Roskilde, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
BMC Ophthalmol. 2021 Mar 23;21(1):149. doi: 10.1186/s12886-021-01901-x.
Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant.
Fifty-one consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity.
There was a higher correlation between vision-related quality of life and macular sensitivity (r = 0.458; p = 0.014) than between vision-related quality of life and visual acuity (r = 0.446; p = 0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r = 0.542; p = 0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r = 0.469; p = 0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r = 0.652; p < 0.001) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated with the nasal outer macular sub-region in these patients (r = 0.469; p = 0.012).
Macular sensitivity as measured using microperimetry correlates with vision-related quality of life in early AMD and in late AMD, showing it to be a patient-relevant outcome measure. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD. (338 words).
尽管视力与自我感知的视觉生活质量相关性较弱，但在年龄相关性黄斑变性（AMD）患者中，视力通常被用作功能结果测量。微视野检查是一种检测黄斑功能丧失的有用方法。我们想研究这两种客观视觉结果测量与主观视觉相关生活质量之间的关系，以确定哪种客观测量更能反映患者的情况。
本研究纳入了 51 例连续的 AMD 患者。要求参与者完成视觉功能问卷 39 项、早期治疗糖尿病视网膜病变研究视力检查和使用微视野计 3 进行微视野评估。有 1 名患者撤回同意，7 名患者因微视野下的合作困难而退出。共有 43 例 AMD 患者纳入研究：28 例晚期 AMD（渗出性 AMD）和 15 例早期（非渗出性）AMD。右眼为标准眼，最佳矫正视力眼也为标准眼。
晚期 AMD 患者的生活质量与黄斑敏感性的相关性（r=0.458；p=0.014）高于生活质量与视力的相关性（r=0.446；p=0.018）。早期 AMD 患者的生活质量与黄斑敏感性呈正相关（r=0.542；p=0.037），而这些患者的生活质量与视力之间的相关性没有统计学意义。在晚期 AMD 患者中，综合评分（r=0.469；p=0.012）与鼻外侧黄斑子区和近距活动评分（r=0.652；p<0.001）相关性最高，而在早期 AMD 患者中，综合评分与黄斑子区之间的相关性不显著，但近距活动评分与这些患者的鼻外侧黄斑子区呈正相关（r=0.469；p=0.012）。
使用微视野计测量的黄斑敏感性与早期和晚期 AMD 的视觉相关生活质量相关，表明其是一种与患者相关的结果测量。此外，AMD 患者的鼻侧黄斑子区似乎是更优选的视网膜位置。（338 个单词）
