Reading Speed and Reading Comprehension in Age-related Macular Degeneration

To evaluate the impact of age-related macular degeneration (AMD) on short out-loud and sustained silent reading speeds, and reading comprehension.

Prospective, cross-sectional.

Setting: Wilmer Eye Institute.

Literate, native-English speakers with and without AMD. AMD participants had better-eye visual acuity (VA) <20/32 and >20/100, while controls had binocular VA >20/32.

MNRead was used to assess short-duration out-loud reading speed. Sustained silent reading test was used to evaluate sustained silent reading speeds, while reading comprehension was assessed based on silent reading test text.

MNRead maximum reading speed, sustained-silent reading speed, and comprehension score.

Analyses included 24 AMD patients and 22 controls. In age-adjusted regressions, AMD participants, compared to controls, read 46 words per minute (wpm) slower on MNRead (95% confidence interval [CI]: -66, -26, P < .001), but there was no difference in sustained reading speeds between groups (β = 0.99, 95% CI: -41.8, 43.8, P = .96). In other models, there was a decrement of 12.6 wpm on MNRead per 0.1 worsening logMAR (95% CI: -18.7, -6.6, P < .001), but VA was not associated with a decrement in sustained reading speed (β = -10.1, 95% CI: -22.4, 2.1, P = .10). However, AMD participants had substantially lower comprehension scores than controls (53% vs 85% correct, P < .001), and each 1-line VA decrement was associated with 5.9% lower comprehension score (95% CI: -9.1, -2.7, P = .001).

AMD patients read slower than controls when forced to read out loud. When asked to read silently over a longer duration, both groups read at similar speeds, though AMD patients demonstrated substantially lower comprehension scores, suggesting that they chose to sacrifice comprehension for speed.