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OBJECTIVE: This study aimed to determine which colour contrast sensitivity differences exist in early to advanced age-related macular degeneration (AMD) and examine the potential utility of the King-Devick Variable Color Contrast Sensitivity Chart in detecting AMD severity. METHODS AND ANALYSIS: A total of 85 participants (144 total eyes) were recruited from multiple clinical practices and enrolled in the study. The control group consisted of 57 healthy eyes. The non-exudative AMD (NE-AMD) group consisted of 45 eyes. The exudative AMD (E-AMD) group consisted of 42 eyes. In a single study visit, monocular best-corrected visual acuity (BCVA) at 40 cm with 100% black contrast was determined for each eye. Using the BCVA line, the number of letters correctly identified (out of 10) was recorded for various colour presentations (red, green, blue and yellow) and at decreasing contrast levels (100%, 75%, 50% and 25%). RESULTS: Our results show worse visual performance under various colour contrast settings in E-AMD patients compared with healthy controls and NE-AMD. Colour contrast performance using blue and yellow differentiated more advanced stages of disease in E-AMD from earlier NE-AMD disease. Blue and black colour contrast performance more accurately identified the E-AMD group from healthy controls and the NE-AMD group. CONCLUSION: The findings of this study demonstrate that colour contrast, particularly with black, blue and yellow, is impaired in E-AMD suggesting the potential for colour contrast measures to serve as an adjunctive clinical tool in identifying subtle altered visual function as well as the potential for detecting disease severity.
RESUMO
PURPOSE: To determine the long-term, all-cause mortality rate of diabetic patients requiring vitrectomy surgery for tractional retinal detachment (TRD). DESIGN: Institutional review board-approved, retrospective, comparative study. PARTICIPANTS: Four hundred eyes of 316 patients undergoing vitrectomy surgery from 2005 to 2015. METHODS: Long-term, all-cause mortality rates in the study population were compared with mortality in a historical control group of diabetic patients with minimal to no retinopathy. Subgroup analysis was done based on bilaterality of TRD and initial vision. Other concurrent associated diabetic comorbidities, use of insulin, and type 1 diabetes are also reported. Data were used to create Kaplan-Meier survival curves. MAIN OUTCOME MEASURE: Long-term, all-cause mortality rate of diabetic patients undergoing vitrectomy surgery from 2005 to 2015. RESULTS: Mean survival after diagnosis of TRD requiring vitrectomy surgery was 2.7 years (median, 2 years; range, 0.17-9.00 years). Kaplan-Meier survival curve analysis revealed a 48.7% (154/316 patients) long-term, all-cause mortality rate for diabetics requiring vitrectomy surgery for TRDs at 10 years, compared with a mean 2% long-term, all-cause mortality rate in diabetics with minimal to no retinopathy. Subgroup analysis of those patients with bilateral TRDs requiring surgery revealed a 48.9% mortality rate with a mean survival after diagnosis of TRD of 2.6 years (median, 2 years; range, 0.25-9.00 years). Those patients with count fingers or worse vision in one or both eyes at diagnosis had a 52.0% mortality rate (P < 0.05), with a mean survival after diagnosis of 2.6 years (median, 2 years; range, 0.17-9.00 years). CONCLUSIONS: In our population, diabetic patients with TRDs requiring surgery have a 48.7% long-term, all-cause mortality rate, with those presenting with count fingers or worse vision having a higher mortality rate. Diabetic TRD requiring vitrectomy surgery is a marker of poor long-term survival.
