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Night–Vision Symptoms as a Risk Factor for Vision Loss and Choroidal Neovascularization in the Complications of Age–related Macular Degeneration Prevention Trial (CAPT)

Ophthalmology, Scheie Eye Inst, Univ of Pa, Philadelphia, PA

Commercial Relationships: G. Ying, None; C. Liu, None; M.G. Maguire, None.

Support: SupNIH grant EY 12279, RC EY12211.

Abstract

Purpose:

To describe night–vision symptoms at baseline and assess their association with subsequent 3–lines loss in visual acuity (VA) and choroidal neovascularization (CNV) in untreated eyes of CAPT participants.

Methods:

1052 CAPT participants with 10 large drusen (>125µ) and visual acuity 20/40 in each eye participated. At baseline, each participant self–administered a 10–item questionnaire on night–vision symptoms (NVRQ–10) that was scaled to score participants with no symptoms as 100. Visual acuity testing (ETDRS Charts 1, 2) was performed by certified examiners at baseline, 6 months and annually. CNV was identified by trained readers using fluorescein angiography. Evaluation of baseline NVRQ–10 score as a risk factor for 3–lines loss in VA and CNV was performed by repeated–measures logistic regression and survival analysis, with and without the adjustment of participant characteristics (age and smoking status) and ocular characteristics (baseline area covered by drusen and focal hyperpigmentation).

Results:

At baseline, the mean (±SD) NVRQ–10 was 70 (±20), and the median was 73.0 (range: 3 –100). Median follow–up was 48 months. For untreated eyes, participants with lower ( median) NVRQ–10 scores were associated with increased risk of 3–lines loss in VA; odds ratio (OR) is 1.69 (95% C.I.: 1.24 – 2.31) compared to participants with higher scores (p=0.001). There was no statistically significant association between lower NVRQ–10 scores and CNV incidence; relative risk (RR) is 1.30 (95% C.I.: 0.85 – 1.99). These relationships were maintained after adjustment of participant and ocular characteristics (Table).

Table: Association of lower NVRQ–10 score with 3–lines loss in VA and CNV in untreated eyes

Conclusions:

CAPT participants who reported more night vision symptoms at baseline had an increased risk of 3–lines loss in VA but no apparent increased risk of CNV in their untreated eye. The association with VA loss is independent of established risk factors.

Keywords: age-related macular degeneration • visual acuity • choroid: neovascularization

© 2005, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any part of this abstract, contact the ARVO Office at arvo{at}arvo.org.