Face memory deficits in subjects with eye diseases: a comparative analysis between glaucoma and age-related macular degeneration patients from a developing country.

PURPOSE: Older people present significant declines in face recognition with age. Spatial vision (high-contrast acuity) and age are the best predictors of face recognition. Visual disabilities are more common in the older population due to aging eye diseases. The purpose of the study was to compare the face recognition memory deficit between primary open angle glaucoma (POAG) and age-related macular degeneration (ARMD) patients living in a developing country. METHODS: This was a cross-sectional, observational study. The sample comprised 64 patients with POAG, 48 with ARMD, and 52 controls. All groups were matched for age, gender, comorbidity, and ethnic distribution. Evidence of cognitive impairment was ruled out and subjects with even mild cognitive impairment were not included in the study. After a complete eye examination including measurement of the best-corrected visual acuity, fundus evaluation, and automated visual field, all subjects underwent the Cambridge face memory test (CFMT). CFMT score in percentage (%) was the main outcome measure and data were compared with ANOVA. RESULTS: The mean age was 66.6 ± 9.2, 69.8 ± 9.3, and 63.4 ± 7.3 years, for POAG, ARMD, and controls, respectively (P = 0.152). Gender, ethnicity, and comorbidity were evenly distributed among the groups. The CFMT score was 53.3 ± 15.2%, 49.8 ± 14.2%, and 62.1 ± 15.9% for POAG, ARMD, and controls, respectively (P < 0.001). CONCLUSION: ARMD and POAG patients have higher face recognition memory deficit as compared to normal controls. This might be due to a visual disability.

Expediency of the Automated Perimetry Using the Goldmann V Stimulus Size in Visually Impaired Patients with Glaucoma.

INTRODUCTION: White-on-white standard automated perimetry (AP) uses a white round stimulus with 0.43° diameter and 4.0 mm2 area (Goldmann size III). Patients with low vision have difficulty seeing such a small stimulus and are often tested with perimetry using the size V stimulus with 1.72° diameter and 64 mm2 area. We undertook an observational case-control study to compare the performance of patients on AP using two differently sized stimuli. METHODS: Patients with glaucoma and visual acuity worse than 20/100 underwent AP using the standard size III stimulus Swedish Interactive Threshold Algorithm (SITA) standard test and size V stimulus full threshold test. All patients were familiar with the procedure, having done the test at least twice previously. Another group of glaucoma patients with visual acuity better than 20/40 served as controls. The main outcome measures included test time, mean retinal sensitivity (MRS), foveal sensitivity (FS), fixation loss (FL), false positive (FP), false negative (FN), and the patient's subjective preference. RESULTS: Fifty patients were included in the study. Most preferred the size V stimulus target size test. For glaucoma patients, test time was shorter with size III; MRS and FS were higher with size V; FL, FP, and FN did not differ between the tests. CONCLUSION: AP with stimulus size V may be a good alternative to standard size III in selected visually debilitated patients who report difficulty undergoing a standard SITA 24-2 test.

A Comparative Analysis of the Fear of Falling Between Glaucoma and Age-Related Macular Degeneration Patients From a Developing Country.

PURPOSE: Falls are very prevalent in the older population. Visually impaired elderly patients are prone to falls as the result of visual loss and ageing. The purpose of the study was to compare the fear of falling (FoF) between primary open angle glaucoma (POAG) and age-related macular degeneration (ARMD) patients who live in a developing country. METHODS: This was a cross-sectional observational study. After a complete eye examination including measurement of best-corrected visual acuity, ophthalmoscopy, and automated visual field, all subjects completed the Fall Efficacy Scale International Brazil (FES-I-Brazil) questionnaire. RESULTS: The sample comprised 64 patients with POAG, 48 with ARMD, and 52 controls. All groups were matched for age, sex, comorbidity, and ethnic distribution. The FES-I score was 24.6 ± 8.7, 25.3 ± 6.3, and 24.2 ± 7.7 for glaucoma, ARMD, and controls, respectively (P = 0.894). A post hoc analysis comparing all subjects with advanced visual field defect (mean deviation [MD] < -12 dB) revealed a higher FES-I score in ARMD patients as compared to POAG ones (46.2 ± 16.8 and 24.0 ± 7.7 for ARMD and POAG, respectively, P < 0.001). CONCLUSION: In this cohort of elderly subjects with eye diseases, the FoF was similar among groups; however, ARMD patients with more compromised visual field had higher FoF as compared to POAG patients and controls. TRANSLATIONAL RELEVANCE: A high rate of fear of falling exists in ARMD patients with compromised visual field. This finding may be useful in developing multidimensional strategies to decrease fear of falling and improve quality of life in older persons living in a developing country.