First Author: D.Taylor UK
Co Author(s): P. Jones N. Smith A. Binns D. Crabb
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The aim of this study was to assess response anxiety with different everyday mobility situations in people with dry AMD using a novel computer-based test.
Cross-sectional case-control study conducted at City, University of London. Participants were recruited from Moorfields Eye Hospital Trust London, optometrists local to the university, the membership of the Macular Society, and through a local database of research volunteers.
Patients were required to have dry AMD in their better-seeing eye, with no other ocular or systemic diseases or medication that could affect visual function, and LogMAR visual acuity (VA) of 0.7 or better. Eligibility criteria for controls was the same as for AMD patients except participants were required to have no AMD in either eye, and LogMAR VA 0.3 or better. All participants were required to pass a cognitive screening test. Participants were shown a series of short movies on a computer screen during which they appear to move through different everyday scenarios. Participants were asked to press on a large red button (the ‘big button’) during scenes which would cause them anxiety or discomfort. Pressure on the ‘big button’ was recorded throughout the test and this was used as an outcome measure. The distribution of pressure data was skewed so nonparametric tests were used to test for differences between groups.
Thirty participants performed the ‘big button’ test; these were grouped as having no AMD or early AMD (controls; no pigmentary abnormalities, no drusen or drusen ≤125 µm, n=8), intermediate AMD (drusen >125 µm and/or pigmentary abnormalities, n=7) and geographic atrophy (n = 15 [GA]). Median (interquartile range [IQR]) LogMAR VA for each group was 0.04 (-0.04, 0.18), 0.26 (0.10, 0.40) and 0.32 (0.20, 0.56) respectively. Groups were age-similar (median [IQR] age of 77 [72, 80], 82 [70, 86] and 75 [70, 78] years respectively; p=0.36). People with intermediate AMD or GA applied more pressure to the button, on average, than those without AMD (Kruskal-Wallis test, p = 0.02). Movies of walking up and down steps, crossing roads and situations involving public transport seemed to cause most concern to participants with intermediate AMD and GA compared to controls.
People with intermediate or advanced dry AMD are likely to experience higher levels of concern/anxiety during everyday mobility tasks than those without. The ‘big button’ test highlights areas of specific concern to patients. The results from this study have the potential to be useful both in patient management and in educating members of the public about the effects of AMD on everyday life.