title: Visual function assessment in simulated real-life situations in patients with age-related macular degeneration compared to normal subjects.
abstract: OBJECTIVE
  To evaluate visual function variations in eyes with age-related macular degeneration (AMD) compared to normal eyes under different light/contrast conditions using a time-dependent visual acuity testing instrument, the Central Vision Analyzer (CVA).
  
  
  METHODS
  Overall, 37 AMD eyes and 35 normal eyes were consecutively tested with the CVA after assessing best-corrected visual acuity (BCVA) using ETDRS charts. The CVA established visual thresholds for three mesopic environments (M1 (high contrast), M2 (medium contrast), and M3 (low contrast)) and three backlight-glare environments (G1 (high contrast, equivalent to ETDRS), G2 (medium contrast), and G3 (low contrast)) under timed conditions. Vision drop across environments was calculated, and repeatability of visual scores was determined.
  
  
  RESULTS
  BCVA significantly reduced with decreasing contrast in all eyes. M1 scores for BCVA were greater than M2 and M3 (P<0.001); G1 scores were greater than G2 and G3 (P<0.01). BCVA dropped more in AMD eyes than in normal eyes between M1 and M2 (P=0.002) and between M1 and M3 (P=0.003). In AMD eyes, BCVA was better using ETDRS charts compared to G1 (P<0.001). The drop in visual function between ETDRS and G1 was greater in AMD eyes compared to normal eyes (P=0.004). Standard deviations of test-retest ranged from 0.100 to 0.139 logMAR.
  
  
  CONCLUSIONS
  The CVA allowed analysis of the visual complaints that AMD patients experience with different lighting/contrast time-dependent conditions. BCVA changed significantly under different lighting/contrast conditions in all eyes, however, AMD eyes were more affected by contrast reduction than normal eyes. In AMD eyes, timed conditions using the CVA led to worse BCVA compared to non-timed ETDRS charts.
authors: 1] Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA [2] Ophthalmological Unit, Department of Clinical Sciences and Community Health, Ca' Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors: G
authors: G
authors: Barteselli
authors: Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA.
authors: M L
authors: ML
authors: Gomez
authors: Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA.
authors: A L
authors: AL
authors: Doede
authors: L V Prasad Eye Institute, Hyderabad, India.
authors: J
authors: J
authors: Chhablani
authors: Salus University, Elkins Park, PA, USA.
authors: W
authors: W
authors: Gutstein
authors: Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA.
authors: D-U
authors: DU
authors: Bartsch
authors: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors: L
authors: L
authors: Dustin
authors: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors: S P
authors: SP
authors: Azen
authors: Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA.
authors: W R
authors: WR
authors: Freeman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015350:Contrast Sensitivity / Q000502:physiology*; D005260:Female; D057092:Geographic Atrophy / Q000503:physiopathology*; D019466:Glare; D064368:Healthy Volunteers; D006801:Humans; D008027:Light; D008297:Male; D055255:Mesopic Vision / Q000502:physiology; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014786:Vision Disorders / Q000503:physiopathology*; D014787:Vision Tests; D014792:Visual Acuity / Q000502:physiology*; D057135:Wet Macular Degeneration / Q000503:physiopathology*; D055815:Young Adult