Simple Vision Function Tests that Distinguish Eyes with Early to Intermediate Age-related Macular Degeneration

Figures & data

Figure 1. Cumulative proportion distributions for SKL (panel A), SKD (panel B), CS (panel C), and CS_low lumin (panel D) for eyes categorized as No-AMD (thin black line), E-AMD (thick grey line) and I-AMD (thick black line). Data are plotted with poorer performance to the right along the abscissa. All scales are in log units and x-axes span 1.6 log units. Abbreviations: SKL = SKILL Light: high contrast near acuity; SKD = SKILL Dark: low contrast, low luminance near acuity; CS = contrast sensitivity at high luminance; CS_low lumin = contrast sensitivity at low photopic luminance

Table 1. Fundus Characteristics of the 237 Eyes of 125 People Included in the Baseline (BL) Sample

AMD Category	Fundus Characteristics	Number of Eyes	% Eyes Total	% Eyes by AMD Category
No-AMD				% No-AMD
(56 eyes of	No drusen	20	8.4%	35.7%
33 people)	<7 small central drusen	10	4.2%	17.9%
	Many (7+) small central drusen	26	11.0%	46.4%
E-AMD				% E-AMD
(57 eyes of	Medium non-central drusen plus multiple small drusen	10	4.2%	17.5%
40 people)	1 medium central druse plus multiple small drusen	32	13.5%	56.1%
	Multiple medium central drusen	15	6.3%	26.3%
I-AMD				% I-AMD
(124 eyes of	Large non-central drusen plus multiple small drusen	8	3.4%	6.5%
75 people)	1 large central druse plus multiple small drusen	10	4.2%	8.1%
	Multiple large central drusen, no pigmentary changes	53	22.4%	42.7%
	Medium drusen with pigmentary changes	10	4.2%	8.1%
	Large drusen with pigmentary changes	43	18.1%	34.7%

Table 2. Baseline Demographic and Vision Measure Summary for AMD Categories

			No-AMD	E-AMD	I-AMD
Demographics		n ppts =	33	40	75
Age (years)			73.6 (10.5)[56–90]	74.1 (12.1) [55–94]	76.7 (10.3) [55–95]
Sex (% female)			69.7%	80.0%	64.0%
MMSE Score			28.2 (1.5) [26–30]	28.3 (1.6) [25–30]	28.4 (1.6) [25–30]
Education Level (years)			16.0 (2.4) [12–23]	15.4 (3.1) [10–22]	16.5 (3.0) [10–24]
Vision Measures	n eyes =		56	57	124
SKL (logMAR)			0.05 (0.10) [−0.20–0.26]	0.03 (0.09) [−0.14–0.30]	0.09 (0.11) [−0.12 − 0.3]
SKD (logMAR)			0.59 (0.16) [0.30–0.92]	0.56 (0.16) [0.18–1.08]	0.70 (0.22) [0.24–1.4]
CS (log units)			1.72 (0.09) [1.40–1.80]	1.73 (0.08) [1.40–1.80]	1.62 (0.14) [1.20 − 1.80]
CS_low lumin (log)			1.47 (0.16) [1.04 − 1.68]	1.43 (0.18) [0.96–1.76]	1.32 (0.24) [0.40–1.80]
SDH (logMAR)			−0.69 (0.14) [−0.94 – −0.33]	−0.66 (0.17) [−1.06 – −0.23]	−0.54 (0.22) [−0.99–0.17]
DesatCCS (log CCS)			1.06 (0.29) [0.70–1.79]	1.08 (0.37) [0.70–2.03]	1.43 (0.46) [0.70–2.19]
IReST (log words per minute)			2.27 (0.07) [2.15–2.49]	2.23 (0.07) [2.03–2.35]	2.22 (0.10) [1.84–2.40]
Glare Recovery (log seconds)			0.98 (0.24) [0.48–1.36]	1.01 (0.26) [0.52–1.56]	1.05 (0.26) [0.58–1.71]

Abbreviations: MMSE = Mini Mental State Exam Score; n = number; ppts = participants; SKL = SKILL Light: high contrast near acuity; SKD = SKILL Dark: low contrast, low luminance near acuity; CS = contrast sensitivity at high luminance; CS_low lumin = contrast sensitivity at low photopic luminance; SDH = shape discrimination hyperacuity; DesatCCS = desaturated D-15 color confusion score; IReST = International Reading Speed Test. Except where noted, values indicate means, standard deviations in parentheses, and ranges in square brackets.

Figure 2. Cumulative proportion distributions for SDH (panel A), DesatCCS (panel B), IReST (panel C), and Glare Recovery (panel D) for No-AMD (thin black line), E-AMD (thick grey line), and I-AMD (thick black line). Data are plotted with poorer performance to the right along the abscissa. All scales are in log units and x-axes span 1.6 log units. For DesatCCS, IReST, and Glare Recovery, the displayed range of non-log values is noted in the lower right corner of each panel. Abbreviations: SDH = shape discrimination hyperacuity; DesatCCS = desaturated D-15 color confusion score; IReST = International Reading Speed Test

Table 3. Multinomial Logistic Regression with General Estimating Equation (GEE) Analysis of the Association between Vision Variables for I-AMD vs. E-AMD

	A. Univariate Unadjusted		B. Adjusted for Age and Sex		C. Multivariable Model
I-AMD vs. E-AMD	RRR	95% CI	RRR	95% CI	RRR	95% CI
Age (per decade)	1.06	(0.70–1.60)	–	–	0.76	(0.50–1.15)
Sex (categ, Female)	2.10	(0.87–5.22)	–	–	1.69	(0.67–4.27)
Cat Surg (categ, No)	1.33	(0.57–3.11)	1.17	(0.42–3.32)	–	–
SKL (0.3 logMAR)	3.52	(1.44–8.58)**	3.87	(1.37–11.0)*	1.56	(0.43–5.64)
SKD (0.3 logMAR)	2.53	(1.54–4.15)***	2.56	(1.45–4.51)**	–	–
CS (0.3 log)	9.25	(3.83–22.4)**	9.62	(3.79–24.4)***	5.61	(1.78–17.7)**
CS_low lum (0.3 log)	1.84	(1.24–2.72)**	1.78	(1.12–2.82)*	–	–
SDH (0.3 logMAR)	2.21	(1.31–3.71)**	2.13	(1.27–3.57)**	1.82	(1.04–3.21)*
DesatCCS (0.3 log)	2.81	(1.10–7.20)***	1.49	(1.19–1.87)**	1.45	(1.12–1.88)**
IReST (0.3 logCRR)	1.51	(0.53–4.30)	1.26	(0.42–3.76)	0.75	(0.20–2.76)
GlareRec (0.3 logsec)	0.98	(0.67–1.42)	0.93	(0.64–1.36)	–	–

RRR = relative risk ratio, CI = confidence interval. Significance Values: * p < .05, ** p < .01, ***p < .001I-AMD is the reference category. Model A: Individual variables (unadjusted); Model B: Individual variables adjusted only for age and sex; Model C: Includes SKL, CS, SDH, DesatCCS, IReST, Age and Sex.

Table 4. Multinomial Logistic Regression with General Estimating Equation (GEE) Analysis of the Association between Vision Variables for I-AMD vs. No-AMD

	A. Univariate Unadjusted		B. Adjusted for Age and Sex		C. Multivariable Model
I-AMD vs. No-AMD	RRR	95% CI	RRR	95% CI	RRR	95% CI
Age (per decade)	0.82	(0.57–1.18)	–	–	0.72	(0.46–1.13)
Sex (categ, Female)	1.14	(0.47–2.79)	–	–	1.01	(0.38–2.67)
Cat Surg (categ, No)	2.79	(0.94–8.22)	2.80	(0.86–9.15)	–	–
SKL (0.3 logMAR)	0.80	(0.34–1.80)	0.82	(0.40–1.69)	0.35	(0.15–0.85)*
SKD (0.3 logMAR)	1.52	(0.99–2.33)	1.44	(0.96–2.18)	–	–
CS (0.3 log)	5.77	(2.32–14.4)***	6.31	(2.47–16.1)***	6.48	(1.91–22.0)**
CS_low lum (0.3 log)	1.90	(1.28–2.84)**	1.94	(1.31–2.87)**	–	–
SDH (0.3 logMAR)	2.25	(1.29–3.92)**	2.21	(1.25–3.93)**	2.34	(1.24–4.44)***
DesatCCS (0.3 log)	1.45	(1.25–1.69)***	1.44	(1.24–1.67)***	1.43	(1.22–1.68)***
IReST (0.3 log)	9.01	(2.70–30.1)***	8.48	(2.67–27.2)***	4.64	(1.25–17.2)*
GlareRec (0.3 log)	1.05	(0.77–1.44)	1.02	(0.76–1.37)	–	–

RRR = relative risk ratio, CI = confidence interval. Significance Values: * p < .05, ** p < .01, ***p < .001I-AMD is the reference category. Model A: Individual variables (unadjusted); Model B: Individual variables adjusted only for age and sex; Model C: Includes SKL, CS, SDH, DesatCCS, IReST, Age and Sex.