Visual losses in early age-related maculopathy

Age-related maculopathy (ARM) can be considered a transition from normal retinal changes to pathological processes. It is important to recognize patients who have progressed beyond a normal state in order to provide appropriate clinical management. This pilot study considers the clinical dilemma of diagnosing and monitoring early ARM. We carried out a controlled study and tested the visual functions of 11 pre-ARM (PARM) and 11 early ARM subjects. Apart from compromised visual acuity, losses in central visual field, color vision, and visual adaptation were also recorded in our ARM subjects. We found a low contrast (LC) Amsler grid to be most sensitive to central field defects and that the desaturated panel D-15 gave too many false positives among normal elderly subjects. Our results indicate foveal sparing in early ARM and question the capacity of acuity assessment to reflect early functional changes adequately. A clinical battery is recommended to detect and monitor ARM.