Multimodal Evaluation of Visual Function in Geographic Atrophy versus Normal Eyes
Received 16 January 2020
Accepted for publication 30 April 2020
Published 4 June 2020 Volume 2020:14 Pages 1533—1545
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Noemi Burguera-Giménez,1– 3 Santiago García-Lázaro,2 Enrique España-Gregori,4,5 Roberto Gallego-Pinazo,6 Neus Burguera-Giménez,2 Manuel Rodríguez-Vallejo,3 Gowtham Jonna1
1Ophthalmology Department, Retina Research Center, Austin, Texas, USA; 2Optometry Department, University of Valencia, Valencia, Spain; 3Ophthalmology Department, Qvision, Hospital Vithas Virgen Del Mar, Almeria, Spain; 4Ophthalmology Department, La Fe University Hospital, Valencia, Spain; 5Surgery Department, University of Valencia, Valencia, Spain; 6Ophthalmology Department, Oftalvist, IMED Hospital, Valencia, Spain
Correspondence: Gowtham Jonna Tel +1512 454 – 5851
Purpose: To comprehensively evaluate visual function in eyes with geographic atrophy (GA) as compared to normal eyes.
Patients and Methods: Sixty-three eyes from 63 patients ≥ 50 years old were recruited for this observational study; 31 were identified as normal macular health eyes and 32 with GA. Visual function was tested with best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), low luminance deficit (LLD), reading speed, macular integrity microperimetry, fixation stability, and contrast sensitivity function (CSF). Anatomic function was evaluated with spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF). Quality of life and vision were assessed with the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25).
Results: Visual function and quality of life are reduced in patients with GA. Moderate and strong correlations in the GA group were found between maximum reading speed (r = 0.787) (p˂0.01), CS spatial frequency 3 cpd (r = 0.441) (p˂0.05), CS spatial frequency 6 cpd (r = 0.524) (p˂0.01), fixation P1 (r = 0.379) (p˂0.05), macular sensitivity (r = 0.484) (p˂0.05) and atrophic area (r = − 0.689) (p˂0.01), and the VFQ-25 composite score.
Conclusion: The decreased visual function is reflected in a poor quality of life in patients with GA. Reading speed, contrast sensitivity, fixation, and macular sensitivity are strongly associated with vision-related quality of life. The results suggest the importance of the reading letter size in patients with GA. Microperimetry and reading speed are useful tools to better assess visual impairment in patients with GA.
Keywords: geographic atrophy, age-related macular degeneration, reading speed, visual function, quality of life