Factors Associated With Visual Acuity in Non-arteritic Ischemic Optic Neuropathy Patients: A Five-Year Cross-Sectional Study (original) (raw)
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Ophthalmology, 2009
To evaluate visual acuity outcomes after cataract surgery in patients with varying degrees of age-related macular degeneration (AMD). Design: Cohort study. Participants: A total of 4757 participants enrolled in the Age-Related Eye Disease Study (AREDS), a prospective, multicenter, epidemiological study of the clinical course of cataract and AMD and a randomized controlled trial of antioxidants and minerals. Methods: Standardized lens and fundus photographs, performed at baseline and annual visits, were graded by a centralized reading center using standardized protocols for severity of AMD and lens opacities. History of cataract surgery was obtained every 6 months. Analyses were conducted using multivariate logistic regression. Main Outcome Measure: The change in best-corrected visual acuity (BCVA) after cataract surgery compared with preoperative BCVA. Results: Visual acuity results were analyzed for 1939 eyes that had cataract surgery during AREDS. The mean time from cataract surgery to measurement of postoperative BCVA was 6.9 months. After adjustment for age at surgery, gender, type, and severity of cataract, the mean change in visual acuity at the next study visit after the cataract surgery was as follows: Eyes without AMD gained 8.4 letters of acuity (PϽ0.0001), eyes with mild AMD gained 6.1 letters of visual acuity (PϽ0.0001), eyes with moderate AMD gained 3.9 letters (PϽ0.0001), and eyes with advanced AMD gained 1.9 letters (P ϭ 0.04). The statistically significant gain in visual acuity after cataract surgery was maintained an average of 1.4 years after cataract surgery. Conclusions: On average, participants with varying severity of AMD benefited from cataract surgery with an increase in visual acuity postoperatively. This average gain in visual acuity persisted for at least 18 months.
National Eye Institute Visual Function Questionnaire in the Age-Related Eye Disease Study (AREDS)
Archives of Ophthalmology, 2003
To describe the vision-targeted, healthrelated quality of life, measured with the National Eye Institute Visual Function Questionnaire (NEI-VFQ), in patients with age-related macular degeneration, cataract, or reduced visual acuity; to determine the relationship between the NEI-VFQ subscale scores and clinical measures of visual function; and to assess the internal consistency and reliability of the NEI-VFQ subscales. Design: The 39-item NEI-VFQ was administered at the 5-year clinic visit to 4077 Age-Related Eye Disease Study participants. Results: The subscales of the NEI-VFQ had moderate to high internal consistency (Cronbach's ␣=0.58-0.91). The NEI-VFQ scores for participants with advanced age-related macular degeneration in 1 or both eyes, severe nuclear opacity, reduced visual acuity, or cataract surgery generally were lower than scores for disease-free participants (PϽ.001). Conclusion: These findings support the use of the NEI-VFQ as a measure of vision-targeted, health-related quality of life among patients with age-related macular degeneration, cataract, or reduced visual acuity.
Acta ophthalmologica, 2015
To describe the design of the Montrachet Study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases) and to report visual acuity and refractive errors in this elderly population. Participants were recruited in Dijon (France), from the ongoing population-based 3C Study. In 2009-2011, 1153 participants from the 3 Cities Study, aged 75 years or more, had an initial eye examination and were scheduled for eye examinations. The eye examination comprised visual acuity, refraction, visual field, ocular surface assessment, photographs and OCT of the macula and the optic disc, measurement of intra-ocular pressure, central corneal thickness and macular pigment assessment. Information on cardiovascular and neurologic diseases and a large comprehensive database (blood samples, genetic testing, cognitive tests, MRI) were available from the 3C Study. Presenting visual acuity <20/60 in the better eye was found in 2.3% (95% CI 1.5-3.2) of the participants with no gender differences...
Factors Accounting for the 4-Year Change in Acuity in Patients Between 50 and 80 Years
Optometry and Vision Science, 2013
Purpose-It is well known acuity slowly decreases in later decades of life. We wish to determine the extent 4 year longitudinal acuity changes can be accounted for by changes in optical quality, or combination of optical quality metrics and age between 50 and 80. Methods-High contrast logMAR acuity, 35 image quality metrics, 4 intraocular scatter metrics, and 4 Lens Opacification Classification System-III metrics and entry age were measured on one eye of each of 148 subjects. Acuity change between baseline and the last visit was regressed against change in each metric for all eyes and a faster changing subset of 50 eyes with a gain or loss of 4 or more letters. Results-Average change across 148 subjects was a 1.6 ± 4 letter loss (t 148 = 4.31, p < 0.001) and loss for the faster changing subset was 3.4 ± 6.1 letters (t 50 = 2.73, p = 0.008). The multipleregression model for faster changing eyes included change in point spread function entropy, posterior subcapsular cataract, and trefoil and baseline age (sequential r 2-adj values 0.19, 0.27, 0.32, 0.34 respectively p = 1.48×10 −4 for the full 4 factor model). The same variables entered the multiple-regression model for the full 148 data set where the majority of the acuity measurements were within test re-test error and accounted for less of the variance (r 2-adj = 0.15, p = 2.37×10 −5). Conclusions-Despite being near noise levels for the measurement of acuity, change in optical quality metrics were the most important factors in eyes that lost or gained 4 or more letters of acuity. These findings should be generalizable given our four year acuity change is essentially identical to other studies, and indicate these optical quality markers can be used to help identify those on a faster track to an acuity change.
Normative Scores for the NIH Toolbox Dynamic Visual Acuity Test from 3 to 85 Years
Frontiers in Neurology, 2014
As part of the National Institutes of HealthToolbox initiative, a computerized test of dynamic visual acuity (cDVA) was developed and validated as an easy-to-administer, cost-and timeefficient test of vestibular and visual function. To establish normative reference values, 3,992 individuals, aged 3-85 years, without vestibular pathology underwent cDVA testing at multiple clinical research testing facilities across the United States. Test scores were stratified by sociodemographic characteristics. cDVA was worse in males (p < 0.001) and those subjects 50 years or older, while there was no difference in dynamic visual acuity across age groups binned from 3 to 49 years. Furthermore, we used these normative cDVA data as a criterion reference to compare both the long (validated) and short versions of the test. Both versions can distinguish between those with and without vestibular pathology (p = 0.0002 long; p = 0.0025 short). The intraclass correlation coefficient between longand short-cDVA tests was 0.86.
European Journal of Ophthalmology, 2015
Purpose To assess the difference in best-corrected visual acuity (BCVA) at presentation between the first and second eye in patients with bilateral neovascular age-related macular degeneration (AMD). Methods We reviewed the charts of all patients who had a clinical examination for neovascular AMD at the University Eye Clinic of Creteil in January 2013. We retrospectively analyzed demographic and clinical data for 264 patients. Results In the fellow eye, choroidal neovascularization (CNV) developed in 75/264 patients (28.4%) with a time interval between the 2 events of 30.3 months (range 6-145). Data were available on 65 patients: 14/65 (21.5%) were asymptomatic, 24/65 (36.9%) had BCVA >20/40, whereas at the time of CNV diagnosis in the first eye, no patient was asymptomatic (p<0.0001), and 11/65 (16.9%) eyes had BCVA >20/40 (p<0.0001). The mean BCVA of the first affected eye was 0.68 (±0.41) logarithm of minimum angle of resolution (logMAR) and the mean BCVA for the seco...
Longitudinal Relationships Among Visual Acuity, Daily Functional Status, and Mortality
JAMA Ophthalmology, 2014
IMPORTANCEDetermination of the mechanisms by which visual loss increases mortality risk is important for developing interventional strategies.OBJECTIVETo evaluate the direct and indirect effects of loss of visual acuity (VA) on mortality risk through functional status changes among aging adults.DESIGN, SETTING, AND PARTICIPANTSProspective longitudinal study of a population-based sample of 2520 noninstitutionalized adults aged 65 to 84 years from September 16, 1993, through July 26, 2003, in the greater Salisbury area of Maryland. Participants underwent reassessment 2, 6, and 8 years after baseline. Mortality status was ascertained from linkage with the National Death Index through 2009.EXPOSURESResults of VA testing and self-reported functional status based on activities of daily living (ADL) and instrumental ADL (IADL).MAIN OUTCOMES AND MEASUREMortality.RESULTSWorse VA levels at baseline were associated with an increased the risk for mortality (hazard ratio [HR], 1.16 [95% CI, 1.04–1.28]; P < .01) through their effect on lower IADL levels at baseline. Declines in VA over time were associated with increased mortality risk (HR, 1.78 [95% CI, 1.27–2.51]; P < .001) by way of decreasing IADL levels over time. Participants experiencing the mean linear decline in VA of 1 letter on the Early Treatment Diabetic Retinopathy Study acuity chart per year are expected to have a 16% increase in mortality risk during the 8-year study exclusively through associated declines in IADL levels.CONCLUSIONS AND RELEVANCEIn this longitudinal study of older adults, VA loss adversely affected IADL levels, which subsequently increased the risk for mortality. Prevention of disabling ocular conditions, treatment of correctable visual impairment, and interventions designed to prevent the effect of visual impairment on IADL declines may all reduce mortality risk in aging adults.
Visual Function Versus Visual Acuity in Older People
Ophthalmic Epidemiology, 2009
Purpose: To determine visual function (VF) status in older people, to establish its degree of correlation with visual acuity (VA), and to assess its association with other physical and mental functional limitations. Participants: A sample of 1,160 persons aged 65 years or over were selected by simple randomization. Methods: The participants' VF (The Visual Function Index-VF-14), VA, self-reported vision, mental and physical function (Katz Index, Pfeiffer's test, and Geriatric Depression Scale), and socio-demographic data were determined. Multiple linear regression was used to assess the association between VF and its conditioning factors. Statistical adjustment was made for the possible confounding variables. Results: Of the studied subjects, 6.3% (95% confidence interval (CI) = 4.93-7.82) had VA of less than 6/18 in the better eye and 20.9% (95% CI = 18.6-23.3) had VA of less than 6/12. The best corrected VA of each participant demonstrated moderate correlation with his or her VF-14 score (r = 0.416; p<0.001). Using multiple regression analysis, the variables associated with VF status were: visual impairment, self-reported poor vision, dependence in daily activities, cognitive impairment, depressive symptoms, female gender and older age. These independent variables explain 34.4% (r 2 = 0.344) of the variation in the data. Conclusions: VF impairment is common in older persons and when associated with other limitations, it may be considered a major health problem with important consequences. As a complement to the preventive care guidelines on VA in older persons, assessment of VF impairment in clinical practice, using appropriate visual screening tools, is advisable.