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Vision testing in atrophic macular degeneration

R Littlewood, G Johnson, P House

    Australian and New Zealand Journal of Ophthalmology
    |February 1, 1996
    PubMed
    Summary
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    The Amsler grid and blue/yellow anomaloscopy show low correlation with Snellen acuity in atrophic macular degeneration (AMD). The Amsler grid is most useful for assessing AMD progression alongside Snellen acuity.

    Area of Science:

    • Ophthalmology
    • Vision Science

    Background:

    • Atrophic macular degeneration (AMD) is a leading cause of vision loss.
    • Assessing AMD progression typically involves Snellen acuity and other vision tests.

    Purpose of the Study:

    • To determine the correlation between various vision tests and Snellen acuity in patients with atrophic macular degeneration (AMD).
    • To evaluate the utility of different vision tests in an office setting for AMD assessment.

    Main Methods:

    • Patients with atrophic AMD underwent six vision tests, including modified contrast sensitivity, blue/yellow anomaloscopy, flicker fusion frequency, Amsler grid, and photostress recovery time.
    • Pearson correlation coefficient was used to correlate test results with Snellen acuity.
    • General linear model was used to analyze the regression of Snellen acuity on age, sex, and disciform macular degeneration.

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    Main Results:

    • All tested vision tests showed low correlation with Snellen acuity.
    • Amsler grid abnormality (r = -0.33345) and blue/yellow anomaloscopy matching range (r = -0.20742) had the highest correlations.
    • Patient age was strongly correlated with Snellen acuity (P = 0.0001).

    Conclusions:

    • The Amsler grid is the most useful additional test for assessing atrophic AMD progression at all stages.
    • Blue/yellow anomaloscopy is useful only in mild AMD with Snellen acuity of 6/12 or better.
    • Clinicians should consider the relative utility of different tests when assessing AMD.