Associations between abnormal rod-mediated dark adaptation and health and functioning in older adults with normal macular health

Delayed rod-mediated dark adaptation (DA) is characteristic of early age-related macular degeneration (AMD) and also can be observed in some older adults in normal macular health. We examine cross-sectional associations between rod-mediated DA and risk factors for AMD in older adults in normal macul...

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Published in:Investigative ophthalmology & visual science 2014-05, Vol.55 (8), p.4776-4789
Main Authors: Owsley, Cynthia, Huisingh, Carrie, Jackson, Gregory R, Curcio, Christine A, Szalai, Alexander J, Dashti, Nassrin, Clark, Mark, Rookard, Kia, McCrory, Mark A, Wright, Tyler T, Callahan, Michael A, Kline, Lanning B, Witherspoon, C Douglas, McGwin, Jr, Gerald
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging - physiology
Cross-Sectional Studies
Dark Adaptation - physiology
Female
Humans
Macula Lutea - physiology
Macular Degeneration - physiopathology
Male
Middle Aged
Photic Stimulation
Psychometrics - methods
Reference Values
Retinal Rod Photoreceptor Cells - physiology
Visual Acuity
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Summary:Delayed rod-mediated dark adaptation (DA) is characteristic of early age-related macular degeneration (AMD) and also can be observed in some older adults in normal macular health. We examine cross-sectional associations between rod-mediated DA and risk factors for AMD in older adults in normal macular health. The sample consisted of adults aged ≥60 years old in normal macular health per grading of fundus photos using an established disease classification system. Rod-mediated DA was measured psychophysically following a photobleach using a computer-automated dark adaptometer with targets centered at 5° on the inferior vertical meridian. The speed of DA was characterized by the rod-intercept value, with abnormal DA defined as rod-intercept ≥ 12.3 minutes. We assessed several health and functional characteristics that the literature has suggested increase AMD risk (e.g., smoking, alcohol use, inflammatory markers, apolipoproteins, low luminance visual acuity, chronic medical conditions, body mass, family history). Among 381 participants (mean age, 68.5 years; SD, 5.5), 78% had normal and 22% had abnormal DA, with the prevalence of abnormal DA increasing with age. After age-adjustment, abnormal DA was associated with increased odds of elevated C-reactive protein (CRP), heavy use of or abstention from alcohol, high blood pressure, and drop in visual acuity under mesopic conditions. Despite having normal macular health according to accepted definitions of AMD presence, approximately one-quarter of older adults recruited from primary eye care clinics had abnormal DA, which was associated with known risk factors for AMD, including elevated CRP.
ISSN:1552-5783
0146-0404
1552-5783
DOI:10.1167/iovs.14-14502