Patient-reported vision impairment in low luminance relates to visual function in age-related macular degeneration: A MACUSTAR study report

Scientific Reports, vol. 15, pp. 35223

Abstract

Early stages of age-related macular degeneration (AMD) can lead to a number of visual function deficits, but the patient relevance of these deficits is largely unknown. We therefore investigated how bilateral visual function domains affected by age-related macular degeneration (AMD) are associated with patient-reports. Using data from the cross-sectional part of the MACUSTAR study with 245 individuals with AMD (34 early AMD, 168 intermediate (i) AMD, 43 late AMD), the Vision Impairment in Low Luminance (VILL) questionnaire (subscales: reading, VILL_R; mobility, VILL_M; emotional well-being, VILL_E) and visual function assessments from both eyes (best-corrected and low-luminance visual acuity, BCVA, LLVA; Moorfields acuity, MA; contrast sensitivity, CS) were included. Associations between VILL and visual function data (better and worse eyes defined based on BCVA) were investigated using age- and sex-adjusted regression models. In the overall sample, VILL_R and VILL_M were associated with all functional tests across eyes (p ≤ 0.0389), while VILL_E was associated with MA and CS (p ≤ 0.0302). Regression estimates for BCVA, LLVA, MA and CS in the better-seeing eyes were -2.70, -1.84, -1.83 and 1.08 (VILL_R); -2.71, -1.87, -1.90 and 1.88 (VILL_M), and -0.25, -0.22, -2.15 and 1.57 (VILL_E). In iAMD, CS and MA in the worse-seeing eye were associated with two VILL subscales, respectively (VILL_R and VILL_M; VILL_M and VILL_E, respectively; p ≤ 0.0395), while BCVA and LLVA in the worse-seeing eye were both associated with one VILL subscale (VILL_M; p ≤ 0.0317). CS in the better eye was associated with VILL_M (p = 0.0454). Thus, patient-reported outcomes are associated with visual function assessments in both eyes in people with AMD. Contrast vision seems particularly patient-relevant in iAMD. Our results further support the construct validity of the VILL questionnaire.

Authors 77

1. Jan Henrik Terheyden

   University Hospital Bonn

   Affiliation as printed

   Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

2. Charlotte Behning

   University Hospital Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie

   Affiliation as printed

   Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany

3. Hannah Dunbar

   University College London

   Affiliation as printed

   UCL Institute of Ophthalmology, University College London, London, UK

4. Stephen H. Poor

   Novartis (Switzerland)

   Affiliation as printed

   Novartis Pharma AG, Basel, Switzerland

5. Nadia Zakaria

   Novartis (Switzerland)

   Affiliation as printed

   Novartis Pharma AG, Basel, Switzerland

6. Alison M. Binns

   City, University of London

   Affiliation as printed

   Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK

7. Sergio Leal

   University Hospital Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie · Bayer (Germany)

   Affiliation as printed

   Bayer AG, Berlin, Germany

   Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany

8. Matthias C. Schmid

   University Hospital Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie

   Affiliation as printed

   Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany

9. Frank Gerhard Holz

   Roche (Switzerland) · University Hospital Bonn

   Affiliation as printed

   Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

   Roche Pharmaceutical Research and Early Development, Translational Medicine Ophthalmology, Roche Innovation Center Basel, Basel, Switzerland

10. Ulrich F. O. Luhmann

    Roche (Switzerland) · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    Roche Pharmaceutical Research and Early Development, Translational Medicine Ophthalmology, Roche Innovation Center Basel, Basel, Switzerland

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

11. H. Agostini

    Vita-Salute San Raffaele University · University of Freiburg · University Medical Center Freiburg · IRCCS Ospedale San Raffaele

    Affiliation as printed

    Department of Ophthalmology, Universitaetsklinikum Freiburg (UKLFR), University of Freiburg, Freiburg, Germany

    Department of Ophthalmology, University Vita Salute-Scientific Institute of San Raffael, Milan, Italy

12. Lebriz Altay

    University of Cologne · European Clinical Research Infrastructure Network

    Affiliation as printed

    Universität zu Köln, Zentrum für Augenheilkunde, Cologne, Germany

    European Clinical Research Infrastructure Network (ECRIN), Paris, France

13. Raphaël Atia

    Novartis (Switzerland) · University Hospital Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie

    Affiliation as printed

    Novartis Pharma AG, Basel, Switzerland

    Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany

14. Francesco Maria Bandello

    University of Copenhagen · Vita-Salute San Raffaele University · Rigshospitalet · IRCCS Ospedale San Raffaele

    Affiliation as printed

    Department of Ophthalmology, University Vita Salute-Scientific Institute of San Raffael, Milan, Italy

    Department of Ophthalmology Rigshospitalet-Glostrup, Copenhagen University Glostrup, Copenhagen, Denmark

15. P. G. Basile

    University of Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

    Medical Faculty, Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany

16. J. Batuca

    City, University of London · European Clinical Research Infrastructure Network

    Affiliation as printed

    European Clinical Research Infrastructure Network (ECRIN), Paris, France

    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK

17. M. Belmouhand

    University of Copenhagen · Rigshospitalet · Bayer (Germany)

    Affiliation as printed

    Department of Ophthalmology Rigshospitalet-Glostrup, Copenhagen University Glostrup, Copenhagen, Denmark

    BAYER AG, Leverkusen, Germany

18. Moritz Berger

    University of Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie · University of Sheffield

    Affiliation as printed

    Medical Faculty, Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany

    University of Sheffield, Sheffield, UK

19. A. Binns

    City, University of London · Fondation Voir & Entendre

    Affiliation as printed

    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK

    Fondation Voir et Etendre, Paris, France

20. Camiel J. F. Boon Aachen Department of Ophthalmology, Leiden University Medical Center

    Leiden University Medical Center · University of Sheffield

    Affiliation as printed

    Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands

    University of Sheffield, Sheffield, UK

21. M. Böttger

    Hospital de São João · Bayer (Germany)

    Affiliation as printed

    BAYER AG, Leverkusen, Germany

    Department of Ophthalmology Porto Medical School, Centro Hospitalar de Sao Joao EPE (Hospital Sao Joao) Hospital S. Joao Porto, Porto, Portugal

22. John Brazier

    Novartis (Switzerland) · University of Sheffield

    Affiliation as printed

    University of Sheffield, Sheffield, UK

    Novartis Pharma AG, Basel, Switzerland

23. C. Carapezzi

    Association for Innovation and Biomedical Research on Light and Image · Fondation Voir & Entendre

    Affiliation as printed

    Fondation Voir et Etendre, Paris, France

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

24. Jill Carlton

    University of Sheffield

    Affiliation as printed

    University of Sheffield, Sheffield, UK

    Carl Zeiss Meditec, AG, Jena, Germany

25. Ângela M. Carneiro

    University of Milan · Hospital de São João · Luigi Sacco Hospital

    Affiliation as printed

    Department of Ophthalmology Porto Medical School, Centro Hospitalar de Sao Joao EPE (Hospital Sao Joao) Hospital S. Joao Porto, Porto, Portugal

    Department of Ophthalmology Luigi Sacco Hospital, University of Milan, Milan, Italy

26. A. Charil

    Novartis (Switzerland) · City, University of London

    Affiliation as printed

    Novartis Pharma AG, Basel, Switzerland

    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK

27. Raul Sérgio Martins Coimbra

    Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

28. Deborah Cosette

    University of Cologne

    Affiliation as printed

    Carl Zeiss Meditec, AG, Jena, Germany

    Universität zu Köln, Zentrum für Augenheilkunde, Cologne, Germany

29. Mariano Cozzi

    University of Milan · Luigi Sacco Hospital · University College London

    Affiliation as printed

    Department of Ophthalmology Luigi Sacco Hospital, University of Milan, Milan, Italy

    UCL Institute of Ophthalmology, University College London, London, UK

30. David Paul Crabb

    Moorfields Eye Hospital NHS Foundation Trust · City, University of London · Moorfields Eye Hospital

    Affiliation as printed

    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK

    Moorfields Eye Hospital NHSFoundation Trust (MBRC), London, UK

31. José Guilherme Cunha-Vaz

    University Hospital Bonn · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

32. C. Dahlke

    University of Cologne · Gloucestershire Hospitals NHS Foundation Trust

    Affiliation as printed

    Universität zu Köln, Zentrum für Augenheilkunde, Cologne, Germany

    Clinical Trial Unit, Department of Ophthalmology Gloucestershire Hospitals, NHS Foundation TrustCheltenham, Cheltenham, UK

33. H. Dunbar

    St. Franziskus Hospital · University College London

    Affiliation as printed

    UCL Institute of Ophthalmology, University College London, London, UK

    Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany

34. Simona Degli Esposti

    Moorfields Eye Hospital NHS Foundation Trust · Radboud University Nijmegen · Radboud University Medical Center · Moorfields Eye Hospital

    Affiliation as printed

    Moorfields Eye Hospital NHSFoundation Trust (MBRC), London, UK

    Radboud University Medical Center (RUMC), Radbound University, Nijmegen, The Netherlands

35. E. Fletcher

    Gloucestershire Hospitals NHS Foundation Trust

    Affiliation as printed

    Clinical Trial Unit, Department of Ophthalmology Gloucestershire Hospitals, NHS Foundation TrustCheltenham, Cheltenham, UK

    Carl Zeiss Meditec, AG, Jena, Germany

36. M. Gutfleisch

    Royal Victoria Hospital · St. Franziskus Hospital

    Affiliation as printed

    Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany

    Ophthalmology and Vision SciencesThe Queen's University an Royal Group of Hospitals Trust Belfast, Belfast, Northern Ireland

37. Franca C. Hartgers

    Radboud University Nijmegen · University Hospital Bonn · Radboud University Medical Center

    Affiliation as printed

    Radboud University Medical Center (RUMC), Radbound University, Nijmegen, The Netherlands

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

38. Brian Patrick Higgins

    Radboud University Nijmegen · City, University of London · Radboud University Medical Center

    Affiliation as printed

    Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK

    Radboud University Medical Center (RUMC), Radbound University, Nijmegen, The Netherlands

39. Ruth Esther Hogg

    Universitätsklinikum Tübingen · Royal Victoria Hospital · STZ eyetrial

    Affiliation as printed

    Ophthalmology and Vision SciencesThe Queen’s University an Royal Group of Hospitals Trust Belfast, Belfast, Northern Ireland

    STZ Biomed & STZ Eyetrial at the Center of Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany

40. A. Kilani

    Radboud University Nijmegen · Universität Ulm · Radboud University Medical Center

    Affiliation as printed

    Department of Ophthalmology, Universityof Ulm, Ulm, Germany

    Radboud University Medical Center (RUMC), Radbound University, Nijmegen, The Netherlands

41. J. Krätzschmar

    Roche (Switzerland) · Bayer (Germany)

    Affiliation as printed

    BAYER AG, Leverkusen, Germany

    F. Hoffmann-La Roche Ltd, Basel, Switzerland

42. L. Kühlewein

    University Hospital Bonn · Universitätsklinikum Tübingen · STZ eyetrial

    Affiliation as printed

    STZ Biomed & STZ Eyetrial at the Center of Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

43. Michael Larsen

    University of Copenhagen · Rigshospitalet

    Affiliation as printed

    Department of Ophthalmology Rigshospitalet-Glostrup, Copenhagen University Glostrup, Copenhagen, Denmark

    Carl Zeiss Meditec, AG, Jena, Germany

44. Sérgio Leal

    Association for Innovation and Biomedical Research on Light and Image · Bayer (Germany)

    Affiliation as printed

    Bayer AG, Berlin, Germany

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

45. Yara T. E. Lechanteur

    Radboud University Nijmegen · Radboud University Medical Center · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    Radboud University Medical Center (RUMC), Radbound University, Nijmegen, The Netherlands

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

46. U. F. O. Luhmann

    Roche (Switzerland) · Novartis (Switzerland)

    Affiliation as printed

    Roche Pharmaceutical Research and Early Development, Translational Medicine Ophthalmology, Roche Innovation Center Basel, Basel, Switzerland

    Novartis Pharma AG, Basel, Switzerland

47. A. Lüning

    Novartis (Switzerland) · University Hospital Bonn

    Affiliation as printed

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

    Novartis Pharma AG, Basel, Switzerland

48. Niranchana Manivannan

    Centre hospitalier national d'ophtalmologie des Quinze-Vingts

    Affiliation as printed

    Carl Zeiss Meditec, AG, Jena, Germany

    Centre Hospitalier National d'Opthalmologie des Quinze-Vingts, Paris, France

49. I. Marques

    Vita-Salute San Raffaele University · IRCCS Ospedale San Raffaele · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

    Department of Ophthalmology, University Vita Salute-Scientific Institute of San Raffael, Milan, Italy

50. C. Martinho

    Fondazione G.B. Bietti · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

    G. B.Bietti Eye Foundation-IRCCS, Rome, Italy

51. Klaus-Peter Moll

    Novartis (Switzerland)

    Affiliation as printed

    Novartis Pharma AG, Basel, Switzerland

52. Z. Mulyukov

    Novartis (Switzerland) · Universitätsklinikum Tübingen · STZ eyetrial

    Affiliation as printed

    Novartis Pharma AG, Basel, Switzerland

    STZ Biomed & STZ Eyetrial at the Center of Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany

53. Michel Pâques

    Centre hospitalier national d'ophtalmologie des Quinze-Vingts · Royal Victoria Hospital

    Affiliation as printed

    Centre Hospitalier National d’Opthalmologie des Quinze-Vingts, Paris, France

    Ophthalmology and Vision SciencesThe Queen's University an Royal Group of Hospitals Trust Belfast, Belfast, Northern Ireland

54. Maurízio Battaglia Parodi

    Vita-Salute San Raffaele University · University Hospital Bonn · IRCCS Ospedale San Raffaele

    Affiliation as printed

    Department of Ophthalmology, University Vita Salute-Scientific Institute of San Raffael, Milan, Italy

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

55. M. Parravano

    LMU Klinikum · Fondazione G.B. Bietti · Ludwig-Maximilians-Universität München

    Affiliation as printed

    G. B.Bietti Eye Foundation-IRCCS, Rome, Italy

    Ludwig-Maximilians-Universitaet Muenchen (LMU), University Eye Hospital Munich, Munich, Germany

56. S. Penas

    Novartis (Switzerland) · University College London

    Affiliation as printed

    Novartis Pharma AG, Basel, Switzerland

    University College London (UCL), London, UK

57. Tobias M. Peters

    Universitätsklinikum Tübingen · Association for Innovation and Biomedical Research on Light and Image · STZ eyetrial

    Affiliation as printed

    STZ Biomed & STZ Eyetrial at the Center of Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

58. Tünde Pető

    Royal Victoria Hospital · University of Sheffield

    Affiliation as printed

    Ophthalmology and Vision SciencesThe Queen’s University an Royal Group of Hospitals Trust Belfast, Belfast, Northern Ireland

    University of Sheffield, Sheffield, UK

59. Siegfried Georg Priglinger

    Centre hospitalier national d'ophtalmologie des Quinze-Vingts · LMU Klinikum · Ludwig-Maximilians-Universität München

    Affiliation as printed

    Ludwig-Maximilians-Universitaet Muenchen (LMU), University Eye Hospital Munich, Munich, Germany

    Centre Hospitalier National d'Opthalmologie des Quinze-Vingts, Paris, France

60. Sara Ribeiro

    Novartis (Switzerland) · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

    Novartis Pharma AG, Basel, Switzerland

61. D. Rowen

    University Hospital Bonn · University of Sheffield

    Affiliation as printed

    University of Sheffield, Sheffield, UK

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

62. Gary S. Rubin

    University of Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie · University College London

    Affiliation as printed

    University College London (UCL), London, UK

    Medical Faculty, Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany

63. José‐Alain Sahel

    University Hospital Bonn · Centre hospitalier national d'ophtalmologie des Quinze-Vingts

    Affiliation as printed

    Centre Hospitalier National d’Opthalmologie des Quinze-Vingts, Paris, France

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

64. Clarisa Sánchez

    Radboud University Nijmegen · Radboud University Medical Center · LMU Klinikum · Ludwig-Maximilians-Universität München

    Affiliation as printed

    Radboud University Medical Center (RUMC), Radbound University, Nijmegen, The Netherlands

    Ludwig-Maximilians-Universitaet Muenchen (LMU), University Eye Hospital Munich, Munich, Germany

65. O. Sander

    Novartis (Switzerland) · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    Novartis Pharma AG, Basel, Switzerland

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

66. Marlene Saßmannshausen

    University Hospital Bonn · Hôpital Intercommunal de Créteil

    Affiliation as printed

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

    Centre Hospitalier Intercommunal de Creteil (HIC), University Eye Clinic, CentreHospitalier Creteil, Paris, France

67. Steffen Schmitz-Valckenberg

    University Hospital Bonn · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

68. J. Siedlecki

    City, University of London · LMU Klinikum · Ludwig-Maximilians-Universität München

    Affiliation as printed

    Ludwig-Maximilians-Universitaet Muenchen (LMU), University Eye Hospital Munich, Munich, Germany

    City University London, London, UK

69. Rufino Martins da Silva

    University Hospital Bonn · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

70. E. Souied

    Moorfields Eye Hospital NHS Foundation Trust · Moorfields Eye Hospital · Hôpital Intercommunal de Créteil

    Affiliation as printed

    Centre Hospitalier Intercommunal de Creteil (HIC), University Eye Clinic, CentreHospitalier Creteil, Paris, France

    Moorfields Eye Hospital NHSFoundation Trust (MBRC), London, UK

71. Giovanni Staurenghi

    University of Milan · University Hospital Bonn · Luigi Sacco Hospital · Institut für Medizinische Biometrie, Informatik und Epidemiologie

    Affiliation as printed

    Department of Ophthalmology Luigi Sacco Hospital, University of Milan, Milan, Italy

    Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany

72. Joana F Tavares

    Fondazione G.B. Bietti · Association for Innovation and Biomedical Research on Light and Image

    Affiliation as printed

    AIBILI Associaton for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal

    G. B.Bietti Eye Foundation-IRCCS, Rome, Italy

73. Deanna J. Taylor

    City, University of London · Universität Ulm

    Affiliation as printed

    City University London, London, UK

    Department of Ophthalmology, Universityof Ulm, Ulm, Germany

74. Adnan Tufail

    Moorfields Eye Hospital NHS Foundation Trust · Moorfields Eye Hospital

    Affiliation as printed

    Moorfields Eye Hospital NHSFoundation Trust (MBRC), London, UK

75. Philippe Valmaggia

    University Hospital Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie

    Affiliation as printed

    Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany

76. M. Varano

    Fondazione G.B. Bietti

    Affiliation as printed

    G. B.Bietti Eye Foundation-IRCCS, Rome, Italy

77. Armin Wolf

    Universität Ulm

    Affiliation as printed

    Department of Ophthalmology, Universityof Ulm, Ulm, Germany