Modified images reflecting effects of age‐related macular degeneration on perception of everyday scenes

Abstract

Background

Depictions of vision with age‐related macular degeneration (AMD) in public information material typically show a central region of absolute vision loss. Patients with early and moderate disease frequently do not report this. We aimed to measure how a group of people with AMD perceive everyday scenes in order to produce accurate depictions.

Methods

We report on six people aged 65–82 years with monocular AMD (visual acuity +0.04 to +1.64 logMAR) and normal vision in the fellow eye. Participants viewed four images monocularly, alternating between eyes. The image was digitally altered to approximate participants’ descriptions of their perception with the affected eye. The altered image was viewed with the unaffected eye, and compared with the original image viewed with the affected eye. This was repeated iteratively until a perceptual match was achieved between the modified image/unaffected eye and the original image/affected eye.

Results

For five AMD participants with visual acuity +0.04 to +0.50 logMAR the modified images did not resemble those in current public information material. Image modifications required to achieve perceptual similarity with the affected eyes included localised distortion, contrast reduction and blur. Widespread colour desaturation was also required in some cases. One participant with advanced geographic atrophy reported an absolute positive scotoma, similar to existing depictions.

Conclusions

Vision in people with AMD may not conform to the common depiction of a central region of absolute vision loss. The accurate representations of AMD patients’ vision produced in this study will enable better understanding of the visual consequences of AMD.

Key words:

• age‐related macular degeneration vision
• AMD vision
• central vision loss
• natural scene perception
• scotoma perception

ACKNOWLEDGEMENTS

This work was supported by a College of Optometrists Postdoctoral Award (Jonathan Denniss and Andrew Astle). Andrew Astle is supported by a National Institute for Health Research (NIHR) Postdoctoral Fellowship. This report presents independent research funded by the NIHR. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health. The sponsor or funding organisation had no role in the design or conduct of this research.

The authors thank members of the patient and public involvement groups for their useful comments that helped with the study design, Haag‐Streit UK for equipment loan and Curve Digital Ltd. for professional image editing.

Additional information

Funding

College of Optometrists Postdoctoral Award

National Institute for Health Research (NIHR)