Peterson Claire L, Yap Chun Lin, Tan Ting Fang, Tan Lynn L Y, Sim Kai Ting, Ong Lisa, Tan Zhen Kiat, Tan Yan Wen, Man Ryan, Fenwick Eva, Cheung Gemmy, Lamoureux Ecosse, Tan Anna C S
Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Eye-ACP, Duke-NUS Medical School, Singapore.
Singapore Eye Research Institute, Singapore.
Ophthalmol Retina. 2024 Jan;8(1):32-41. doi: 10.1016/j.oret.2023.08.013. Epub 2023 Aug 28.
To evaluate the relationship between specific monocular and binocular visual function (VF) assessments with binocularly performed activities of daily living task tests (ADLTTs) in patients with age-related macular degeneration (AMD) and healthy controls.
Prospective case-control cohort study.
Thirty-six AMD patients and 36 controls.
Visual field assessments included monocular and binocular best-corrected visual acuity (BCVA), contrast sensitivity (CS), and monocular microperimetry testing for mean macula sensitivity, mean retina sensitivity (MRS), fixation area, and fixation distance from fovea (FDF). Age-related macular degeneration lesion area and sensitivity were measured on OCT and microperimetry, respectively. Participants performed 4 validated ADLTTs with binocular BCVA: (1) reading; (2) item-search; (3) money-counting; and (4) multi-step drink-making tasks.
Spearman correlations and multivariate regression analysis, adjusted for age, sex, and potential correlation between the 2 eyes, were used to assess the relationship between monocular and binocular VF assessments, and ADLTT performance in both groups.
Age-related macular degeneration patients had poorer VF (BCVA, CS, mean macula sensitivity, and MRS) compared with healthy controls. Monocular BCVA in both better- and worse-vision eyes was moderately correlated with the binocular reading speed and money-counting tasks in participants with AMD. In AMD, monocular worse eye CS, MRS, AMD lesion area on OCT, and lesion sensitivity on microperimetry showed moderate correlations to various ADLTTs, such as reading, money-counting, and drink-making. Similar findings were found in our AMD cohort on multivariate regression analysis. Fewer significant correlations were observed for the better-vision eye, whereas no correlations were observed for healthy controls between VF parameters and ADLTTs. In contrast, significant associations were observed between binocular BCVA and CS with binocular ADLTTs (reading and item-search tasks) but not in AMD patients.
Although monocular BCVA remains the most common measure of VF, CS and microperimetry testing also show significant correlations with ADLTTs performance in AMD patients, and should be considered as complimentary VF-outcome measures in both clinical and research settings. Unlike healthy subjects, AMD patients do not rely on binocular VF for ADLTT function, with the worse-vision eye impacting binocular ADLTT function more than the better-vision eye. Therefore, the worse-vision eye should not be neglected during the management of AMD.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
评估年龄相关性黄斑变性（AMD）患者及健康对照者单眼和双眼视觉功能（VF）的特定评估与双眼进行的日常生活任务测试（ADLTTs）之间的关系。
前瞻性病例对照队列研究。
36例AMD患者和36例对照者。
视野评估包括单眼和双眼最佳矫正视力（BCVA）、对比敏感度（CS），以及单眼微视野检查以测量黄斑平均敏感度、视网膜平均敏感度（MRS）、注视区域和注视点距中央凹的距离（FDF）。分别在光学相干断层扫描（OCT）和微视野检查中测量年龄相关性黄斑变性的病变面积和敏感度。参与者使用双眼BCVA进行4项经过验证的ADLTTs：（1）阅读；（2）物品搜索；（3）点钞；（4）多步骤饮品制作任务。
采用Spearman相关性分析和多因素回归分析，并对年龄、性别以及双眼之间的潜在相关性进行校正，以评估两组中单眼和双眼VF评估与ADLTTs表现之间的关系。
与健康对照者相比，年龄相关性黄斑变性患者的VF（BCVA、CS、黄斑平均敏感度和MRS）较差。在AMD患者中，较好眼和较差眼的单眼BCVA与双眼阅读速度和点钞任务均呈中度相关。在AMD患者中，较差眼的单眼CS、MRS、OCT上的AMD病变面积以及微视野检查中的病变敏感度与各种ADLTTs（如阅读、点钞和饮品制作）呈中度相关。在我们的AMD队列中，多因素回归分析也发现了类似的结果。较好眼观察到的显著相关性较少，而健康对照者的VF参数与ADLTTs之间未观察到相关性。相比之下，双眼BCVA和CS与双眼ADLTTs（阅读和物品搜索任务）之间存在显著关联，但在AMD患者中并非如此。
尽管单眼BCVA仍然是最常用的VF测量指标，但CS和微视野检查在AMD患者中也与ADLTTs表现显著相关，在临床和研究环境中均应被视为补充性的VF结果测量指标。与健康受试者不同，AMD患者在进行ADLTT功能时并不依赖双眼VF，较差眼对双眼ADLTT功能的影响大于较好眼。因此，在AMD的治疗过程中，较差眼不应被忽视。
在本文末尾的脚注和披露中可能会发现专有或商业披露信息。
