title: The effect of pre-adapting light intensity on dark adaptation in early age-related macular degeneration.
abstract: BACKGROUND
  This study aimed to identify the pre-adapting light intensity that generated the maximum separation in the parameters of dark adaptation between participants with early age-related macular degeneration (AMD) and healthy control participants in the minimum recording time.
  
  
  METHODS
  Cone dark adaptation was monitored in 10 participants with early AMD and 10 age-matched controls after exposure to three pre-adapting light intensities, using an achromatic annulus (12° radius) centred on the fovea. Threshold recovery data were modelled, and the time constant of cone recovery (τ), final cone threshold, and time to rod-cone-break (RCB) were determined. The diagnostic potential of these parameters at all pre-adapting intensities was evaluated by constructing receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  There were significant differences between those with early AMD and healthy controls in cone τ and time to RCB (p < 0.05) at all pre-adapting 'bleaching' intensities. ROC curves showed that the diagnostic potential of dark adaptometry was high following exposure to all three pre-adapting intensities, generating an area under the curve in excess of 0.87 ± 0.08 for cone τ and time to RCB for all conditions.
  
  
  CONCLUSIONS
  Dark adaptation was shown to be highly diagnostic for early AMD across a range of pre-adapting light intensities, and therefore, the lower pre-adapting intensities evaluated in this study may be used to expedite dark adaptation measurement in the clinic without compromising the integrity of the data obtained. This study reinforces the suggestion that cone and rod dark adaptation are good candidate biomarkers for early AMD.
authors.affiliation: School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cathays, Cardiff, CF24 4LU, UK, gaffneyaj1@cf.ac.uk.
authors.forename: Allannah J
authors.initials: AJ
authors.lastname: Gaffney
authors.forename: Alison M
authors.initials: AM
authors.lastname: Binns
authors.forename: Tom H
authors.initials: TH
authors.lastname: Margrain
mesh_terms: D000221:Adaptation, Ocular / Q000502:physiology; D000368:Aged; D019540:Area Under Curve; D003623:Dark Adaptation / Q000502:physiology*; D005260:Female; D006801:Humans; D008027:Light; D008268:Macular Degeneration / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D011601:Psychophysics; D012372:ROC Curve; D017949:Retinal Cone Photoreceptor Cells / Q000502:physiology; D017948:Retinal Rod Photoreceptor Cells / Q000502:physiology; D014792:Visual Acuity