Skip to main content

Advertisement

SpringerLink
Log in

Relationships between retinal structure and function and vision-related quality of life measures in advanced age-related macular degeneration

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the association between ophthalmic structure/function measures and five standardized quality of life (QoL) instruments, in patients with advanced age-related macular degeneration (AMD).

Methods

We examined 20 AMD patients (ages 66–93 years) recruited from the Canberra Hospital Ophthalmology Department. Visual function measures included low and high contrast visual acuity (LCVA and HCVA) and measures from 10–2 Matrix visual fields (VF). Optical coherence tomography (OCT) quantified central retinal thickness (CRT), average macular thickness (AT), and retinal nerve fibre layer thickness (RNFL). The QoL instruments were the macular degeneration-related quality of life (MacDQoL), the National Eye Institute Visual Functioning Questionnaire (VFQ), its two face-recognition questions (A6 and 11), and the Geriatric Depression Scale (GDS). Pearson correlations, Canonical Correlation Analysis (CCA), and cross-validated stepwise-regression were used to examine the relationships between structure/function measures and the QoL instruments.

Results

The selected models for the five instruments had R2 ranging from 0.65 ± 0.12 to 0.90 ± 0.05 (mean ± SD) and median F-statistics > 188. HCVA was strongly associated with all QoL except the GDS, for which CRT, AT and RNFL figured highly. RNFL was most important for MacDQoL, and 2nd for VFQ question-A6. Centrally weighted VF measures were rarely selected but global VF measures were common, especially for the overall NEI-VFQ questionnaire. CCA revealed that the structure/function measures and QoL instruments contained 2 statistically independent mechanisms.

Conclusions

In patients with advanced AMD, CRT and HCVA were strong determinants of QoL instruments in AMD patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. World Health Organization (2015) Prevention of Blindness and visual impairment. https://apps.who.int/iris/bitstream/handle/10665/103646/9789241500173_eng. Accessed July 2019

  2. Age-Related Eye Disease Study Research G (2001) A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol 119(10):1417–1436

    Article  Google Scholar 

  3. Macular Degeneration Foundation (2011) A Clear Outlook on Age-Related Macular Degeneration. http://www.mdfoundation.com.au/LatestNews/MDFoundationDeloitteAccessEconomicsReport2011. Accessed July 2019

  4. Brown G, Brown M, Sharma S, Stein J, Roth Z, Campanella J, Beauchamp G (2005) The burden of age-related macular degeneration: a value-based medicine analysis. Trans Am Ophthalmol Soc 103:173–184

    PubMed  PubMed Central  Google Scholar 

  5. Mitchell J, Bradley C (2006) Quality of life in age-related macular degeneration: a review of the literature. Health Qual Life Outcomes 4:97

    Article  Google Scholar 

  6. Ouyang Y, Heussen FM, Hariri A, Keane PA, Sadda SR (2013) Optical coherence tomography-based observation of the natural history of drusenoid lesion in eyes with dry age-related macular degeneration. Ophthalmology 120(12):2656–2665

    Article  Google Scholar 

  7. Nassisi M, Lei J, Abdelfattah NS, Karamat A, Balasubramanian S, Fan W, Uji A, Marion KM, Baker K, Huang X, Morgenthien E, Sadda SR (2019) OCT risk factors for development of late age-related macular degeneration in the fellow eyes of patients enrolled in the HARBOR study. Ophthalmology 126:1667–1674

    Article  Google Scholar 

  8. McClure ME, Hart PM, Jackson AJ, Stevenson MR, Chakravarthy U (2000) Macular degeneration: do conventional measurements of impaired visual function equate with visual disability? Br J Ophthalmol 84(3):244–250

    Article  CAS  Google Scholar 

  9. Hazel CA, Petre KL, Armstrong RA, Benson MT, Frost NA (2000) Visual function and subjective quality of life compared in subjects with acquired macular disease. Invest Ophthalmol Vis Sci 41(6):1309–1315

    CAS  PubMed  Google Scholar 

  10. Mitchell J, Bradley C (2004) Design of an individualised measure of the impact of macular disease on quality of life (the MacDQoL). Qual Life Res 13(6):1163–1175

    Article  Google Scholar 

  11. Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD, National Eye Institute Visual Function Questionnaire Field Test I (2001) Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol 119(7):1050–1058

    Article  CAS  Google Scholar 

  12. Sheikh JI, Yesavage JA (1986) Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clin Gerontol 5:165–173

    Article  Google Scholar 

  13. Lane J, Mazlin JL, Irons J, Rohan E, Sabet F, Essex RW, Maddess T, Robbins RA, Gradden T, Dawel A, Smithson M, Barns N, He X, Crookes K, McKone E (2019) Caricaturing can improve facial expression recognition in low-resolution images and age related macular degeneration. J Vis 19(6):18

    Article  Google Scholar 

  14. Lane J, Rohan EMF, Sabeti F, Essex R, Maddess T, Barnes N, He X, Robbins R, Gradden T, McKone E (2018) Improving face identity perception in age-related macular degeneration via caricaturing. Sci Reports 8:15205

    Google Scholar 

  15. Lane J, Rohan EMF, Sabeti F, Essex RW, Maddess T, Dawel A, Robbins RA, Barnes N, He X, McKone E (2018) Impacts of impaired face perception on social interactions and quality of life in age-related macular degeneration: A qualitative study and new community resources. PLoS ONE 13(12):e0209218

    Article  Google Scholar 

  16. Age-Related Eye Disease Study Research G (2001) The Age-Related Eye Disease Study system for classifying age-related macular degeneration from stereoscopic color fundus photographs: the Age-Related Eye Disease Study Report Number 6. Am J Ophthalmol 132(5):668–681

    Article  Google Scholar 

  17. Barbazetto I, Burdan A, Bressler NM, Bressler SB, Haynes L, Kapetanios AD, Lukas J, Olsen K, Potter M, Reaves A, Rosenfeld P, Schachat AP, Strong HA, Wenkstern A, Treatment of Age-Related Macular Degeneration with Photodynamic Therapy Study G, Verteporfin in Photodynamic Therapy Study G (2003) Photodynamic therapy of subfoveal choroidal neovascularization with verteporfin fluorescein angiographic guidelines for evaluation and treatment TAP and VIP report No 2. Arch Ophthalmol 121(9):1253–1268

    Article  CAS  Google Scholar 

  18. Carkeet A (2001) Modeling logMAR visual acuity scores: effects of termination rules and alternative forced-choice options. Optom Vis Sci 78(7):529–538

    Article  CAS  Google Scholar 

  19. Ferris FL 3rd, Freidlin V, Kassoff A, Green SB, Milton RC (1993) Relative letter and position difficulty on visual acuity charts from the Early Treatment Diabetic Retinopathy Study. Am J Ophthalmol 116(6):735–740

    Article  Google Scholar 

  20. Anderson AJ, Johnson CA, Werner JS (2011) Measuring visual function in age-related macular degeneration with frequency-doubling (matrix) perimetry. Optom Vis Sci 88(7):806–815

    Article  Google Scholar 

  21. Owen VM, Crabb DP, White ET, Viswanathan AC, Garway-Heath DF, Hitchings RA (2008) Glaucoma and fitness to drive: using binocular visual fields to predict a milestone to blindness. Invest Ophthalmol Vis Sci 49(6):2449–2455

    Article  Google Scholar 

  22. Asper L, Crewther D, Crewther SG (2000) Strabismic amblyopia. Part 1. Psychophysics. Clin Exp Optom 83(2):49–58

    Article  Google Scholar 

  23. Evans BJ (2007) Monovision: a review. Ophthalmic Physiol Opt 27(5):417–439

    Article  Google Scholar 

  24. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1982) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17(1):37–49

    Article  Google Scholar 

  25. Efron B (1979) Bootstrap methods: Another look at the jackknife. Ann Statist Number 1:1–26

    Google Scholar 

  26. Brown MM, Brown GC, Stein JD, Roth Z, Campanella J, Beauchamp GR (2005) Age-related macular degeneration: economic burden and value-based medicine analysis. Can J Ophthalmol 40(3):277–287

    Article  Google Scholar 

  27. Bennion AE, Shaw RL, Gibson JM (2012) What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research. Soc Sci Med 75(6):976–985

    Article  Google Scholar 

  28. Taylor DJ, Hobby AE, Binns AM, Crabb DP (2016) How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review. BMJ Open 6 (12):e011504.

  29. Bullimore MA, Bailey IL, Wacker RT (1991) Face recognition in age-related maculopathy. Invest Ophthalmol Vis Sci 32(7):2020–2029

    CAS  PubMed  Google Scholar 

  30. Davis JM, McKone E, Dennett H, O'Connor KB, O'Kearney R, Palermo R (2011) Individual differences in the ability to recognise facial identity are associated with social anxiety. PLoS One 6 (12):e28800.

  31. Curcio CA, Allen KA (1990) Topography of ganglion cells in human retina. J Comp Neurol 300(1):5–25

    Article  CAS  Google Scholar 

  32. Gupta N, Ang LC, Noel de Tilly L, Bidaisee L, Yucel YH (2006) Human glaucoma and neural degeneration in intracranial optic nerve, lateral geniculate nucleus, and visual cortex. Br J Ophthalmol 90(6):674–678

    Article  CAS  Google Scholar 

  33. Csaky K, Ferris F 3rd, Chew EY, Nair P, Cheetham JK, Duncan JL (2017) Report From the NEI/FDA Endpoints Workshop on Age-Related Macular Degeneration and Inherited Retinal Diseases. Invest Ophthalmol Vis Sci 58(9):3456–3463

    Article  Google Scholar 

  34. Sabeti F, James AC, Carle CF, Essex RW, Bell A, Maddess T (2017) Comparing multifocal pupillographic objective perimetry (mfPOP) and multifocal visual evoked potentials (mfVEP) in retinal diseases. Sci Reports 7:45847

    CAS  Google Scholar 

  35. Sabeti F, Maddess T, Essex RW, James AC (2012) Multifocal pupillography identifies ranibizumab induced changes in retinal function for exudative age-related macular degeneration. Invest Ophthalmol Vis Sci 53:253–260

    Article  CAS  Google Scholar 

  36. Han Y, Adams AJ, Bearse MA Jr, Schneck ME (2004) Multifocal electroretinogram and short-wavelength automated perimetry measures in diabetic eyes with little or no retinopathy. Arch Ophthalmol 122(12):1809–1815

    Article  Google Scholar 

  37. Xu J, Lu P, Dai M, Huang W, Lin J, Huang J (2019) The Relationship Between Binocular Visual Field Loss and Various Stages of Monocular Visual Field Damage in Glaucoma Patients. J Glaucoma 28(1):42–50

    Article  Google Scholar 

  38. Reilly MA, Villareal A, Maddess T, Sponsel WE (2015) Refined frequency doubling perimetry analysis reaffirms central nervous system control of chronic glaucomatous neurodegeneration. Trans Vis Sci Tech 4. https://doi.org/10.1167/tvst.1164.1163.1167

Download references

Funding

This research was supported by the Australian Research Council through the ARC Centre of Excellence in Cognition and its disorders (CE110001021, DP150100684), NHMRC Project grant (1028560) and Rebecca Cooper Medical Foundation Grant (PG2018040).

Author information

Authors and Affiliations

  1. John Curtin School of Medical Research (JCSMR), The Australian National University, ACT, Canberra, Australia

    Faran Sabeti, Emilie M. F. Rohan & Ted Maddess

  2. Discipline of Optometry, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia

    Faran Sabeti

  3. Research School of Psychology, The Australian National University, Canberra, ACT, Australia

    Jo Lane & Elinor McKone

  4. ARC Centre of Excellence in Cognition and Its Disorders, The Australian National University, Canberra, ACT, Australia

    Jo Lane & Elinor McKone

  5. The Canberra Hospital, Canberra, Australia

    Rohan W. Essex

  6. Academic Unit of Ophthalmology, ANU Medical School, Canberra, ACT, Australia

    Rohan W. Essex

Authors
  1. Faran Sabeti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jo Lane
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emilie M. F. Rohan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rohan W. Essex
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elinor McKone
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ted Maddess
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Faran Sabeti.

Ethics declarations

Ethical approval and informed consent

The study was approved by the Human Research Ethics Committees of the Australian Capital Territory (ACT) Health (Protocol ETH.10.13.291), and the Australian National University (protocol 2013/286), and was conducted according to the Declaration of Helsinki. Written informed consent was obtained from all participants.

Conflict of interest

Authors FS declares that he has no conflict of interest. Author TM declares that he has no conflict of interest. Author JL declares that she has no conflict of interest. Author EMFR declares that she has no conflict of interest. Author EK declares that she has no conflict of interest. Author RWE declares that he has no conflict of interest.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sabeti, F., Lane, J., Rohan, E.M.F. et al. Relationships between retinal structure and function and vision-related quality of life measures in advanced age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 259, 3687–3696 (2021). https://doi.org/10.1007/s00417-021-05296-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-021-05296-9

Keywords

Search

Navigation