title: Diminished foveal sensitivity may predict the development of advanced age-related macular degeneration.
abstract: Visual function testing was performed on one eye with drusen from each of 18 elderly patients in 1984. Eleven patients had advanced age-related macular degeneration (AMD) in the fellow eye, and seven had only bilateral drusen. These patients were all followed prospectively (median, 45 months), at which time one eye had a new vessel membrane, three eyes had pigment epithelial detachments, and one eye had geographic atrophy. Only two of these five eyes had AMD-related visual loss in the fellow eye in 1984. The degree of loss of foveal dark-adapted sensitivity in 1984 predicted which patients developed advanced AMD with 100% sensitivity and 92% specificity. The presence of high-risk drusen characteristics in 1984 predicted the development of advanced AMD with 100% sensitivity but only 55% specificity. For this small group of patients, foveal dark-adapted sensitivity loss was an excellent predictor of the subsequent development of advanced AMD in eyes with drusen. A prospective study of a large group of patients with drusen is being undertaken to validate this finding.
authors.affiliation: Laboratory of Physiological Optics, Wilmer Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
authors.forename: J S
authors.initials: JS
authors.lastname: Sunness
authors.forename: R W
authors.initials: RW
authors.lastname: Massof
authors.forename: M A
authors.initials: MA
authors.lastname: Johnson
authors.forename: N M
authors.initials: NM
authors.lastname: Bressler
authors.forename: S B
authors.initials: SB
authors.lastname: Bressler
authors.forename: S L
authors.initials: SL
authors.lastname: Fine
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000503:physiopathology; D003623:Dark Adaptation; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000503:physiopathology*; D006801:Humans; D008266:Macula Lutea / Q000503:physiopathology*; D008268:Macular Degeneration / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011305:Presbyopia / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D014792:Visual Acuity