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The effect of pre-adapting light intensity on dark adaptation in early age-related macular degeneration

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Abstract

Background

This study aimed to identify the pre-adapting light intensity that generated the maximum separation in the parameters of dark adaptation between participants with early age-related macular degeneration (AMD) and healthy control participants in the minimum recording time.

Methods

Cone dark adaptation was monitored in 10 participants with early AMD and 10 age-matched controls after exposure to three pre-adapting light intensities, using an achromatic annulus (12° radius) centred on the fovea. Threshold recovery data were modelled, and the time constant of cone recovery (τ), final cone threshold, and time to rod-cone-break (RCB) were determined. The diagnostic potential of these parameters at all pre-adapting intensities was evaluated by constructing receiver operating characteristic (ROC) curves.

Results

There were significant differences between those with early AMD and healthy controls in cone τ and time to RCB (p < 0.05) at all pre-adapting ‘bleaching’ intensities. ROC curves showed that the diagnostic potential of dark adaptometry was high following exposure to all three pre-adapting intensities, generating an area under the curve in excess of 0.87 ± 0.08 for cone τ and time to RCB for all conditions.

Conclusions

Dark adaptation was shown to be highly diagnostic for early AMD across a range of pre-adapting light intensities, and therefore, the lower pre-adapting intensities evaluated in this study may be used to expedite dark adaptation measurement in the clinic without compromising the integrity of the data obtained. This study reinforces the suggestion that cone and rod dark adaptation are good candidate biomarkers for early AMD.

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References

  1. Resnikoff S, Pascolini D, Etya’ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP (2004) Global data on visual impairment in the year 2002. Bull World Health Organ 82:844–851

    PubMed  Google Scholar 

  2. Minassian DC, Reidy A, Lightstone A, Desai P (2011) Modelling the prevalence of age-related macular degeneration (2010-2020) in the UK: expected impact of anti-vascular endothelial growth factor (VEGF) therapy. Br J Ophthalmol 95:1433–1436

    Article  PubMed  Google Scholar 

  3. Owen CG, Jarrar Z, Wormald R, Cook DG, Fletcher AE, Rudnicka AR (2012) The estimated prevalence and incidence of late stage age related macular degeneration in the UK. Br J Ophthalmol 96:752–756

    Article  PubMed  Google Scholar 

  4. Pascolini D, Mariotti SP (2012) Global estimates of visual impairment: 2010. Br J Ophthalmol 96:614–618

    Article  PubMed  Google Scholar 

  5. Brown DM, Michels M, Kaiser PK, Heier JS, Sy JP, Ianchulev T (2009) Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: Two-year results of the ANCHOR study. Ophthalmology 116:57.e55–65.e55

    Google Scholar 

  6. Mitchell P, Korobelnik JF, Lanzetta P, Holz FG, Prunte C, Schmidt-Erfurth U, Tano Y, Wolf S (2010) Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials. Br J Ophthalmol 94:2–13

    Article  CAS  PubMed  Google Scholar 

  7. UN (2009) Population prospects: 2008 revision [online]. Available at: http://www.un.org/esa/population/publications/wpp2008/wpp2008_highlights.pdf. Accessed 18 July 2011

  8. Bird AC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD, de Jong PT, Klaver CC, Klein BEK, Klein R, Mitchell P, Sarks JP, Sarks SH, Soubrane G, Taylor HR, Vingerling JR (1995) An international classification and grading system for age-related maculopathy and age-related macular degeneration. The International ARM Epidemiological Study Group. Surv Ophthalmol 39:367–374

    Article  CAS  PubMed  Google Scholar 

  9. Mei M, Leat SJ (2007) Suprathreshold contrast matching in maculopathy. Invest Ophthalmol Vis Sci 48:3419–3424

    Article  PubMed  Google Scholar 

  10. Hahn GA, Messias A, MacKeben M, Dietz K, Horwath K, Hyvarinen L, Leinonen M, Trauzettel-Klosinski S (2009) Parafoveal letter recognition at reduced contrast in normal aging and in patients with risk factors for AMD. Graefes Arch Clin Exp Ophthalmol 247:43–51

    Article  PubMed  Google Scholar 

  11. Sabour-Pickett S, Loughman J, Nolan JM, Stack J, Pesudovs K, Meagher KA, Beatty S (2013) Visual performance in patients with neovascular age-related macular degeneration undergoing treatment with intravitreal ranibizumab. J Ophthal 2013:268438

    Google Scholar 

  12. Eisner A, Stoumbos VD, Klein ML, Fleming SA (1991) Relations between fundus appearance and function—eyes whose fellow eye has exudative age-related macular degeneration. Invest Ophthalmol Vis Sci 32:8–20

    CAS  PubMed  Google Scholar 

  13. Dimitrov PN, Robman LD, Varsamidis M, Aung KZ, Makeyeva GA, Guymer RH, Vingrys AJ (2011) Visual function tests as potential biomarkers in age-related macular degeneration. Invest Ophthalmol Vis Sci 52:9457–9469

    Article  PubMed  Google Scholar 

  14. Phipps JA, Guymer RH, Vingrys AJ (2003) Loss of cone function in age-related maculopathy. Invest Ophthalmol Vis Sci 44:2277–2283

    Article  PubMed  Google Scholar 

  15. Mayer MJ, Spiegler SJ, Ward B, Glucs A, Kim CB (1992) Mid-frequency loss of foveal flicker sensitivity in early stages of age-related maculopathy. Invest Ophthalmol Vis Sci 33:3136–3142

    CAS  PubMed  Google Scholar 

  16. Mayer MJ, Spiegler SJ, Ward B, Glucs A, Kim CB (1992) Foveal flicker sensitivity discriminates ARM-risk from healthy eyes. Invest Ophthalmol Vis Sci 33:3143–3149

    CAS  PubMed  Google Scholar 

  17. Mayer MJ, Spiegler SJ, Ward B, Glucs A, Kim CB (1992) Preliminary evaluation of flicker sensitivity as a predictive test for exudative age-related maculopathy. Invest Ophthalmol Vis Sci 33:3150–3155

    CAS  PubMed  Google Scholar 

  18. Rohrschneider K, Bultmann S, Springer C (2008) Use of fundus perimetry (microperimetry) to quantify macular sensitivity. Prog Retin Eye Res 27:536–548

    Article  PubMed  Google Scholar 

  19. Meleth AD, Mettu P, Agron E, Chew EY, Sadda SR, Ferris FL, Wong WT (2011) Changes in retinal sensitivity in geographic atrophy progression as measured by microperimetry. Invest Ophthalmol Vis Sci 52:1119–1126

    Article  PubMed  Google Scholar 

  20. Sandberg MA, Gaudio AR (1995) Slow photostress recovery and disease severity in age-related macular degeneration. Retina 15:407–412

    Article  CAS  PubMed  Google Scholar 

  21. Midena E, Angeli CD, Blarzino MC, Valenti M, Segato T (1997) Macular function impairment in eyes with early age-related macular degeneration. Invest Ophthalmol Vis Sci 38:469–477

    CAS  PubMed  Google Scholar 

  22. Newsome DA, Negreiro M (2009) Reproducible measurement of macular light flash recovery time using a novel device can indicate the presence and worsening of macular diseases. Curr Eye Res 34:162–170

    Article  PubMed  Google Scholar 

  23. Owsley C, Jackson GR, White M, Feist R, Edwards D (2001) Delays in rod-mediated dark adaptation in early age-related maculopathy. Ophthalmology 108:1196–1202

    Article  CAS  PubMed  Google Scholar 

  24. Owsley C, McGwin G Jr, Jackson GR, Kallies K, Clark M (2007) Cone- and rod-mediated dark adaptation impairment in age-related maculopathy. Ophthalmology 114:1728–1735

    Article  PubMed  Google Scholar 

  25. Dimitrov PN, Guymer RH, Zele AJ, Anderson AJ, Vingrys AJ (2008) Measuring rod and cone dynamics in age-related maculopathy. Invest Ophthalmol Vis Sci 49:55–65

    Article  PubMed  Google Scholar 

  26. Gaffney AJ, Binns AM, Margrain TH (2011) The topography of cone dark adaptation deficits in age-related maculopathy. Optom Vis Sci 88:1080–1087

    Article  PubMed  Google Scholar 

  27. Winsor CP, Clark AB (1936) Dark adaptation after varying degrees of light adaptation. Proc Natl Acad Sci USA 22:400–404

    Article  CAS  PubMed  Google Scholar 

  28. Hecht S, Haig C, Chase AM (1937) The influence of light adaptation on subsequent dark adaptation of the eye. J Gen Physiol 20:831–850

    Article  CAS  PubMed  Google Scholar 

  29. Wald G, Clark AB (1937) Visual adaptation and chemistry of the rods. J Gen Physiol 21:93–105

    Article  CAS  PubMed  Google Scholar 

  30. Haig C (1941) The course of rod dark adaptation as influenced by the intensity and duration of pre-adaptation to light. J Gen Physiol 24:735–751

    Article  CAS  PubMed  Google Scholar 

  31. Mote FA, Riopelle AJ (1951) The effect of varying the intensity and duration of pre-exposure upon foveal dark adaptation in the human eye. J Gen Physiol 34:657–674

    Article  CAS  PubMed  Google Scholar 

  32. Wolf E, Zigler MJ (1954) Location of the break in the dark adaptation curve in relation to pre-exposure brightness and pre-exposure time. J Opt Soc Am 44:875–879

    Article  CAS  PubMed  Google Scholar 

  33. Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, Friend J, McCarthy D, Wu SY (1993) The lens opacities classification system III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol 111:831–836

    Article  PubMed  Google Scholar 

  34. Metha AB, Vingrys AJ, Badcock DR (1993) Calibration of a color monitor for visual psychophysics. Behav Res Methods Instrum Comput 25:371–383

    Article  Google Scholar 

  35. Brainard DH, Pelli DG, Robson T (2001) Display characterization. In: Hornak J (ed) The encyclopaedia of imaging science and technology, vol 18. Wiley, Hoboken, NJ, pp 172–188

    Google Scholar 

  36. Hollins M, Alpern M (1973) Dark adaptation and visual pigment regeneration in human cones. J Gen Physiol 62:430–447

    Article  CAS  PubMed  Google Scholar 

  37. Thomas MM, Lamb TD (1999) Light adaptation and dark adaptation of human rod photoreceptors measured from the a-wave of the electroretinogram. J Physiol Lond 518(Pt 2):479–496

    Article  CAS  PubMed  Google Scholar 

  38. Jackson GR, Owsley C, McGwin G (1999) Aging and dark adaptation. Vis Res 39:3975–3982

    Article  CAS  PubMed  Google Scholar 

  39. McGwin G Jr, Jackson GR, Owsley C (1999) Using nonlinear regression to estimate parameters of dark adaptation. Behav Res Methods Instrum Comput 31:712–717

    Article  PubMed  Google Scholar 

  40. Paupoo AA, Mahroo OA, Friedburg C, Lamb TD (2000) Human cone photoreceptor responses measured by the electroretinogram [correction of electroretinogram] a-wave during and after exposure to intense illumination. J Physiol Lond 529(Pt 2):469–482

    Article  CAS  PubMed  Google Scholar 

  41. Hanley JA, McNeil BJ (1982) The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143:29–36

    CAS  PubMed  Google Scholar 

  42. Hanley JA, McNeil BJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 148:839–843

    CAS  PubMed  Google Scholar 

  43. McMurdo MET, Gaskell A (1991) Dark adaptation and falls in the elderly. Gerontology 37:221–224

    Article  CAS  PubMed  Google Scholar 

  44. Gaffney AJ, Binns AM, Margrain TH (2012) Aging and cone dark adaptation. Optom Vis Sci 89:1219–1224

    Article  PubMed  Google Scholar 

  45. Mahroo OA, Lamb TD (2004) Recovery of the human photopic electroretinogram after bleaching exposures: estimation of pigment regeneration kinetics. J Physiol Lond 554:417–437

    Article  CAS  PubMed  Google Scholar 

  46. Mahroo OAR, Lamb TD (2012) Slowed recovery of human photopic ERG a-wave amplitude following intense bleaches: a slowing of cone pigment regeneration? Doc Ophthalmol 125:137–147

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by a research grant from the College of Optometrists, UK.

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Correspondence to Allannah J. Gaffney.

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Gaffney, A.J., Binns, A.M. & Margrain, T.H. The effect of pre-adapting light intensity on dark adaptation in early age-related macular degeneration. Doc Ophthalmol 127, 191–199 (2013). https://doi.org/10.1007/s10633-013-9400-3

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  • DOI: https://doi.org/10.1007/s10633-013-9400-3

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