Patient-reported vision impairment in low luminance relates to visual function in age-related macular degeneration: A MACUSTAR study report
Terheyden, J. H., Behning, C., Dunbar, H. M. P. , Poor, S., Zakaria, N., Binns, A. M., Saßmannshausen, M., Leal, S., Schmid, M., Holz, F. G., Crabb, D. P. 
ORCID: 0000-0001-8611-1155, Luhmann, U. F. O., Finger, R. P., Agostini, H., Aires, I. D., Altay, L., Atia, R., Bandello, F., Basile, P. G., Batuca, J., Behning, C., Belmouhand, M., Berger, M., Binns, A. ORCID: 0000-0001-8621-498X, Boon, C. J. F., Böttger, M., Brazier, J. E., Carapezzi, C., Carlton, J., Carneiro, A., Charil, A., Coimbra, R., Cosette, D., Cozzi, M., Crabb, D. P., Cunha-Vaz, J., Dahlke, C., Dunbar, H., Esposti, S., Finger, R. P., Fletcher, E., Gutfleisch, M., Hartgers, F., Higgins, B. ORCID: 0000-0002-4530-6156, Hildebrandt, J., Höck, E., Hogg, R., Holz, F. G., Hoyng, C. B., Kilani, A., Krätzschmar, J., Kühlewein, L., Larsen, M., Leal, S., Lechanteur, Y. T. E., Luhmann, U. F. O., Lüning, A., Manivannan, N., Marques, I., Martinho, C., Moll, K. P., Mulyukov, Z., Paques, M., Parodi, B., Parravano, M., Penas, S., Peters, T., Peto, T., Pfau, M., Priglinger, S., Ramamirtham, S., Ribeiro, S., Rowen, D., Rubin, G. S., Sahel, J., Sánchez, C., Sander, O., Saßmannshausen, M., Schmid, M., Schmitz-Valckenberg, S., Siedlecki, J., Silva, R., Souied, E., Staurenghi, G., Tavares, J., Taylor, D. J., Terheyden, J. H., Tufail, A., Valmaggia, P., Varano, M., Wolf, A. & Zakaria, N. (2025).
Patient-reported vision impairment in low luminance relates to visual function in age-related macular degeneration: A MACUSTAR study report.
Scientific Reports, 15(1),
article number 35223.
doi: 10.1038/s41598-025-14553-4
Abstract
Early stages of age-related macular degeneration (AMD) can lead to a number of visual function deficits, but the patient relevance of these deficits is largely unknown. We therefore investigated how bilateral visual function domains affected by age-related macular degeneration (AMD) are associated with patient-reports. Using data from the cross-sectional part of the MACUSTAR study with 245 individuals with AMD (34 early AMD, 168 intermediate (i) AMD, 43 late AMD), the Vision Impairment in Low Luminance (VILL) questionnaire (subscales: reading, VILL_R; mobility, VILL_M; emotional well-being, VILL_E) and visual function assessments from both eyes (best-corrected and low-luminance visual acuity, BCVA, LLVA; Moorfields acuity, MA; contrast sensitivity, CS) were included. Associations between VILL and visual function data (better and worse eyes defined based on BCVA) were investigated using age- and sex-adjusted regression models. In the overall sample, VILL_R and VILL_M were associated with all functional tests across eyes (p ≤ 0.0389), while VILL_E was associated with MA and CS (p ≤ 0.0302). Regression estimates for BCVA, LLVA, MA and CS in the better-seeing eyes were -2.70, -1.84, -1.83 and 1.08 (VILL_R); -2.71, -1.87, -1.90 and 1.88 (VILL_M), and -0.25, -0.22, -2.15 and 1.57 (VILL_E). In iAMD, CS and MA in the worse-seeing eye were associated with two VILL subscales, respectively (VILL_R and VILL_M; VILL_M and VILL_E, respectively; p ≤ 0.0395), while BCVA and LLVA in the worse-seeing eye were both associated with one VILL subscale (VILL_M; p ≤ 0.0317). CS in the better eye was associated with VILL_M (p = 0.0454). Thus, patient-reported outcomes are associated with visual function assessments in both eyes in people with AMD. Contrast vision seems particularly patient-relevant in iAMD. Our results further support the construct validity of the VILL questionnaire.
| Publication Type: | Article |
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| Additional Information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Publisher Keywords: | Vision-related quality of life, Age-related macular degeneration, Visual function, Validation |
| Subjects: | R Medicine > RE Ophthalmology |
| Departments: | School of Health & Medical Sciences School of Health & Medical Sciences > Department of Optometry & Visual Science |
| SWORD Depositor: |
Available under License Creative Commons: Attribution International Public License 4.0.
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