Visual acuity and structural findings in old age-related macular degeneration.
BACKGROUND
Although exudative age-related macular degeneration (AMD) leads to a substantial visual loss in most patients there is still significant variation in the end- stage visual acuity level. We analysed lesions in eyes with long-standing AMD in order to find contributing factors for this variation.


METHODS
Sixty-one out of 121 patients examined for exudative AMD and still alive 4.8-9.2 (mean 6.8) years after the acute phase were re-examined. The lesion size, area of subretinal fibrosis, geographic atrophy, presence of a persistent exudative process, and shortest distance to normal looking retina were measured from digital fundus photographs taken at the re-examination and correlated with visual acuity.


RESULTS
Lesion size, the presence of a continuing exudative process, or subretinal fibrosis were independent predictors for poor vision. Better vision in the other eye was connected with poor vision in the affected study eye.


CONCLUSIONS
In addition to lesion size, the presence of a continuing exudative process and subretinal fibrosis also have deleterious effects on long-term visual acuity after exudative AMD.
Riusala
Aila
A
Department of Ophthalmology, Helsinki University Hospital, Haartmaninkatu 4 C, FIN-00029 JP 220 Helsinki, Finland.
Sarna
Seppo
S
Immonen
Ilkka
I
D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D005122:Exudates and Transudates; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology; D012160:Retina / Q000473:pathology*; D014792:Visual Acuity