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Matilda Biba, John Barbur; Colour discriminability and flicker sensitivity measures improve detection rates of early Age-related Macular Degeneration.. Journal of Vision 2014;14(10):241. doi: https://doi.org/10.1167/14.10.241.
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Aim: Age-related Macular Degeneration (AMD) is the leading cause of irreversible blindness in the aged population in developed countries. Despite advances in treatment for early-stage AMD, standard clinical tests to diagnose AMD have poor sensitivity. The aim of this study was to compare the sensitivity of the current standard diagnostic test, i.e., LogMAR visual acuity, to other psychophysical tests of visual function, to determine what combination of tests can improve detection rates of early AMD. Methods: A total of 45 normal and 30 early-stage AMD subjects (with varying degrees of maculopathy) were investigated. Monocular assessment of visual acuity (LogMAR), chromatic discriminability (Colour Assessment and Diagnosis test or CAD test)1 and small field, flicker sensitivity (to 20Hz) tests were conducted under photopic and mesopic viewing conditions. Results: A multilinear regression analysis was conducted. Analysis revealed that photopic yellow-blue (YB) chromatic sensitivity alone, improved early-stage AMD detection rates by 11.3%. When combined with mesopic flicker sensitivity data the detection rate increased by a further 4%. ROC analysis revealed a statistically significant difference (p=0.0001) between photopic yellow- blue chromatic sensitivity and LogMAR visual acuity measurements, indicating that psychophysical assessment of YB chromatic discrimination is a more sensitive diagnostic test than the current standard clinical tool. Conclusions: Comparison of visual acuity, flicker sensitivity and chromatic discriminability suggest that photopic YB chromatic sensitivity is the most sensitive measure in detecting early AMD retinal changes and potentially could be used to support and / or replace current diagnostic tests. 1 Rodriguez-Carmona, M., Harlow, A. J., Walker, G. and Barbur, J. L. (2005). The variability of normal trichromatic vision and the establishment of the 'normal' range. Proceed- ings of 10th Congress of the International Colour Association, Granada (Granada, 2005), pp. 979–982
Meeting abstract presented at VSS 2014
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