研究目的
To determine optimal test conditions for evaluating dark adaptation in intermediate age-related macular degeneration (iAMD) in order to minimize test time while maintaining diagnostic sensitivity.
研究成果
The 76% bleach at 12° eccentricity is recommended for longitudinal assessment of iAMD as it provides good separation from controls with recovery within 20 minutes, balancing sensitivity and practicality. The 5° location offers better sensitivity but longer times, making it less feasible for clinical use.
研究不足
The study had a small sample size, high proportion of missing data due to test invalidity or participant withdrawal, limited range of bleach intensities evaluated, and lack of grading for subretinal drusenoid deposits (SDD), which could affect results. Fatigue from multiple tests in one session may have impacted performance.
1:Experimental Design and Method Selection:
The study used a randomized test order with five test conditions varying bleach intensity (65%, 70%, 76%) and retinal eccentricity (5° and 12° inferiorly). Rod intercept time (RIT) was measured using an adaptometer after a photobleach, with a 30-minute washout period between tests to minimize adaptation effects. Statistical analyses included ROC curves, t-tests, and Mann-Whitney tests to compare groups.
2:Sample Selection and Data Sources:
Participants aged >55 years were recruited through advertisements and a database, including controls and individuals with various AMD stages. Inclusion criteria involved clear ocular media, adequate dilation, and specific AMD signs; exclusions included previous AMD treatment or other eye diseases.
3:List of Experimental Equipment and Materials:
Adaptometer (AdaptDX; Maculogix), spectral domain optical coherence tomography (SD-OCT; Spectralis device, Heidelberg Engineering), fundus camera (Topcon 3D OCT), ETDRS chart for visual acuity, tropicamide 1.0% for dilation if needed, and software for analysis (IBM SPSS, Excel, R).
4:0% for dilation if needed, and software for analysis (IBM SPSS, Excel, R).
Experimental Procedures and Operational Workflow:
4. Experimental Procedures and Operational Workflow: After consent and baseline assessments (visual acuity, OCT imaging), participants underwent dark adaptation for 30 minutes. RIT was measured using the adaptometer with randomized test conditions, each followed by a 30-minute washout. Fixation was monitored, and unreliable tests were repeated or excluded.
5:Data Analysis Methods:
Data normality was assessed with Shapiro-Wilk test. Group comparisons used independent samples t-test or Mann-Whitney U test. ROC curves were constructed to evaluate diagnostic sensitivity. ANOVA or Kruskal-Wallis tests compared RIT across conditions.
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