Original articleDelayed Rod-Mediated Dark Adaptation Is a Functional Biomarker for Incident Early Age-Related Macular Degeneration
Section snippets
Methods
The Institutional Review Board at the University of Alabama at Birmingham (UAB) approved the study. Participants were recruited from 2 primary eye care practices at the Callahan Eye Hospital at UAB, Birmingham, Alabama. Eligibility criteria at baseline were as follows: (1) Age ≥60 years. (2) Normal macular health in both eyes as determined by 3-field digital stereo-fundus photos (450 Plus camera, Carl Zeiss Meditec, Dublin, CA) graded by an experienced grader masked to study variables. The
Results
At baseline, 390 persons participated in both fundus photography and DA testing. Of the baseline enrollees, 61 persons were lost at follow-up (15.6% of sample); the reasons were illness (22), no longer interested (19), unable to contact (7), deceased (6), worked full-time (4), moved away (3), and incomplete data at follow-up (4). Thus, the final analysis sample was 325 persons who completed both baseline and follow-up visits. Those lost at follow-up were on average 2 years older (P = 0.021) and
Discussion
Older adults with normal macular health were approximately twice as likely to develop early AMD 3 years later if they had abnormal rod-mediated DA at baseline. To our knowledge, this is the first study to demonstrate this relationship. Currently, there are no useful functional end point measures available for trials evaluating strategies for AMD prevention or interventions to arrest its progression at early stages. Visual acuity is the accepted standard end point for preventing or slowing
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Cited by (0)
Financial Disclosure(s): The author(s) have made the following disclosure(s): C.O.: Patent for a method and apparatus for the detection of impaired DA, #20090153802, #20110007276, and #20110141437, with royalties paid.
G.R.J.: Employee and stockholder of MacuLogix, Inc.
Funded by the National Institute on Aging (R01AG04212) and National Eye Institute (R01EY06109), National Institutes of Health (Bethesda, MD); EyeSight Foundation of Alabama (Birmingham, AL); International Retinal Research Foundation (Birmingham, AL); Ludwig von Sallmann Prize (New York, NY); Research to Prevent Blindness Inc (New York, NY); and Alfreda J. Schueler Trust (Chicago, IL).
Author Contributions:
Conception and design: Owsley, McGwin, Jackson, Callahan, Kline
Data collection: Owsley, Clark, Witherspoon
Analysis and interpretation: Owsley, McGwin, Clark, Jackson, Curcio
Obtained funding: Owsley, Curcio
Overall responsibility: Owsley, McGwin, Clark, Jackson, Callahan, Kline, Witherspoon, Curcio