1
|
Volfart A, Rossion B. The neuropsychological evaluation of face identity recognition. Neuropsychologia 2024; 198:108865. [PMID: 38522782 DOI: 10.1016/j.neuropsychologia.2024.108865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
Facial identity recognition (FIR) is arguably the ultimate form of recognition for the adult human brain. Even if the term prosopagnosia is reserved for exceptionally rare brain-damaged cases with a category-specific abrupt loss of FIR at adulthood, subjective and objective impairments or difficulties of FIR are common in the neuropsychological population. Here we provide a critical overview of the evaluation of FIR both for clinicians and researchers in neuropsychology. FIR impairments occur following many causes that should be identified objectively by both general and specific, behavioral and neural examinations. We refute the commonly used dissociation between perceptual and memory deficits/tests for FIR, since even a task involving the discrimination of unfamiliar face images presented side-by-side relies on cortical memories of faces in the right-lateralized ventral occipito-temporal cortex. Another frequently encountered confusion is between specific deficits of the FIR function and a more general impairment of semantic memory (of people), the latter being most often encountered following anterior temporal lobe damage. Many computerized tests aimed at evaluating FIR have appeared over the last two decades, as reviewed here. However, despite undeniable strengths, they often suffer from ecological limitations, difficulties of instruction, as well as a lack of consideration for processing speed and qualitative information. Taking into account these issues, a recently developed behavioral test with natural images manipulating face familiarity, stimulus inversion, and correct response times as a key variable appears promising. The measurement of electroencephalographic (EEG) activity in the frequency domain from fast periodic visual stimulation also appears as a particularly promising tool to complete and enhance the neuropsychological assessment of FIR.
Collapse
Affiliation(s)
- Angélique Volfart
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Australia.
| | - Bruno Rossion
- Centre for Biomedical Technologies, Queensland University of Technology, Australia; Université de Lorraine, CNRS, IMoPA, F-54000, Nancy, France.
| |
Collapse
|
2
|
Taylor DJ, Alquiza PJ, Jones PR, Wilson I, Bi W, Sim DA, Crabb DP. Tablet-based tests of everyday visual function in a diabetic macular oedema (DME) clinic waiting area: A feasibility study. Ophthalmic Physiol Opt 2024; 44:388-398. [PMID: 38131130 DOI: 10.1111/opo.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE (1) To assess the feasibility of conducting tablet-based vision tests in hospital clinic waiting areas; (2) To test the hypothesis that increasing severity of diabetic macular oedema (DME) is associated with the performance of tablet-based surrogates of everyday tasks and self-reported visual function. METHODS Sixty-one people with mild (n = 28), moderate (n = 24) or severe (n = 9) DME performed two tablet-based tests of 'real-world' visual function (visual search and face recognition) while waiting for appointments in a hospital outpatient clinic. Participants also completed a tablet-based version of a seven-item, visual-functioning (VF-7) patient-reported outcome measure. Test performance was compared to previously published 99% normative limits for normally sighted individuals. RESULTS Thirty-four participants (56%; 95% confidence interval [CI] 43%-68%) exceeded normative limits for visual search, while eight (13%; 95% CI 65%-24%) exceeded normative limits for face discrimination. Search duration was significantly longer for people with severe DME than those with mild and moderate DME (p = 0.01). Face discrimination performance was not significantly associated with DME severity. VF-7 scores were statistically similar across DME severity groups. Median time to complete all elements (eligibility screening, both tablet-based tasks and the VF-7) was 22 (quartiles 19, 25) min. Further, 98% and 87% of participants, respectively, reported the search task and face discrimination task to be enjoyable, while 25% and 97%, respectively, reported finding the two tasks to be difficult. CONCLUSIONS Portable tablet-based tests are quick, acceptable to patients and feasible to be performed in a clinic waiting area with minimal supervision. They have the potential to be piloted in patients' homes for self-monitoring.
Collapse
Affiliation(s)
- Deanna J Taylor
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | | | - Pete R Jones
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Iain Wilson
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Wei Bi
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Dawn A Sim
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - David P Crabb
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| |
Collapse
|
3
|
Žugelj N, Peterlin L, Muznik U, Klobučar P, Jaki Mekjavić P, Vidović Valentinčić N, Fakin A. Face Recognition Characteristics in Patients with Age-Related Macular Degeneration Determined Using a Virtual Reality Headset with Eye Tracking. J Clin Med 2024; 13:636. [PMID: 38276142 PMCID: PMC10816606 DOI: 10.3390/jcm13020636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/28/2023] [Accepted: 01/05/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Face recognition is one of the most serious disabilities of patients with age-related macular degeneration (AMD). Our purpose was to study face recognition using a novel method incorporating virtual reality (VR) and eye tracking. MATERIALS AND METHODS Eighteen patients with AMD (seven male; median age 83 years; 89% with bilateral advanced AMD) and nineteen healthy controls (five male; median age 68 years) underwent the face recognition test IC FACES (Synthesius, Ljubljna, Slovenia) on a VR headset with built-in eye tracking sensors. Analysis included recognition accuracy, recognition time and fixation patterns. Additionally, a screening test for dementia and imaging with fundus autofluorescence and optical coherence tomography was performed. RESULTS AMD patients had significantly lower face recognition accuracy (42% vs. 92%; p < 0.001) and longer recognition time (median 4.0 vs. 2.0 s; p < 0.001) in comparison to controls. Both parameters were significantly worse in patients with lower visual acuity. In both groups, eye-tracking data revealed the two classical characteristics of the face recognition process, i.e., fixations clustering mainly in the nose-eyes-mouth triangle and starting observation in the nasal area. CONCLUSIONS The study demonstrates usability of a VR headset with eye tracking for studying visual perception in real-world situations which could be applicable in the design of clinical studies.
Collapse
Affiliation(s)
- Nina Žugelj
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.Ž.); (L.P.); (U.M.); (P.K.); (P.J.M.); (N.V.V.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Lara Peterlin
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.Ž.); (L.P.); (U.M.); (P.K.); (P.J.M.); (N.V.V.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Urša Muznik
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.Ž.); (L.P.); (U.M.); (P.K.); (P.J.M.); (N.V.V.)
| | - Pia Klobučar
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.Ž.); (L.P.); (U.M.); (P.K.); (P.J.M.); (N.V.V.)
| | - Polona Jaki Mekjavić
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.Ž.); (L.P.); (U.M.); (P.K.); (P.J.M.); (N.V.V.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Nataša Vidović Valentinčić
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.Ž.); (L.P.); (U.M.); (P.K.); (P.J.M.); (N.V.V.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Ana Fakin
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (N.Ž.); (L.P.); (U.M.); (P.K.); (P.J.M.); (N.V.V.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| |
Collapse
|
4
|
Venugopal D, Wood JM, Black AA, Bentley SA. Effect of low luminance on face recognition in adults with central and peripheral vision loss. Ophthalmic Physiol Opt 2023; 43:1344-1355. [PMID: 37392062 DOI: 10.1111/opo.13198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/01/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE To investigate the effect of low luminance on face recognition, specifically facial identity discrimination (FID) and facial expression recognition (FER), in adults with central vision loss (CVL) and peripheral vision loss (PVL) and to explore the association between clinical vision measures and low luminance FID and FER. METHODS Participants included 33 adults with CVL, 17 with PVL and 20 controls. FID and FER were assessed under photopic and low luminance conditions. For the FID task, 12 sets of three faces with neutral expressions were presented and participants asked to indicate the odd-face-out. For FER, 12 single faces were presented and participants asked to name the expression (neutral, happy or angry). Photopic and low luminance visual acuity (VA) and contrast sensitivity (CS) were recorded for all participants and for the PVL group, Humphrey Field Analyzer (HFA) 24-2 mean deviation (MD). RESULTS FID accuracy in CVL, and to a lesser extent PVL, was reduced under low compared with photopic luminance (mean reduction 20% and 8% respectively; p < 0.001). FER accuracy was reduced only in CVL (mean reduction 25%; p < 0.001). For both CVL and PVL, low luminance and photopic VA and CS were moderately to strongly correlated with low luminance FID (ρ = 0.61-0.77, p < 0.05). For PVL, better eye HFA 24-2 MD was moderately correlated with low luminance FID (ρ = 0.54, p = 0.02). Results were similar for low luminance FER. Together, photopic VA and CS explained 75% of the variance in low luminance FID, and photopic VA explained 61% of the variance in low luminance FER. Low luminance vision measures explained little additional variance. CONCLUSION Low luminance significantly reduced face recognition, particularly for adults with CVL. Worse VA and CS were associated with reduced face recognition. Clinically, photopic VA is a good predictor of face recognition under low luminance conditions.
Collapse
Affiliation(s)
- Dinesh Venugopal
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joanne M Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sharon A Bentley
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
5
|
Hemptinne C, Hupin N, Lochy A, Yüksel D, Rossion B. Spatial Resolution Evaluation Based on Experienced Visual Categories With Sweep Evoked Periodic EEG Activity. Invest Ophthalmol Vis Sci 2023; 64:17. [PMID: 36881407 PMCID: PMC10007901 DOI: 10.1167/iovs.64.3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Purpose Visual function is typically evaluated in clinical settings with visual acuity (VA), a test requiring to behaviorally match or name optotypes such as tumbling E or Snellen letters. The ability to recognize these symbols has little in common with the automatic and rapid visual recognition of socially important stimuli in real life. Here we use sweep visual evoked potentials to assess spatial resolution objectively based on the recognition of human faces and written words. Methods To this end, we tested unfamiliar face individuation1 and visual word recognition2 in 15 normally sighted adult volunteers with a 68-electrode electroencephalogram system. Results Unlike previous measures of low-level visual function including VA, the most sensitive electrode was found at an electrode different from Oz in a majority of participants. Thresholds until which faces and words could be recognized were evaluated at the most sensitive electrode defined individually for each participant. Word recognition thresholds corresponded with the VA level expected from normally sighted participants, and even a VA significantly higher than expected from normally sighted individuals for a few participants. Conclusions Spatial resolution can be evaluated based on high-level stimuli encountered in day-to-day life, such as faces or written words with sweep visual evoked potentials.
Collapse
Affiliation(s)
- Coralie Hemptinne
- Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,Ophthalmology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Nathan Hupin
- Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,Ophthalmology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Aliette Lochy
- Cognitive Science and Assessment Institute, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Demet Yüksel
- Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,Ophthalmology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Bruno Rossion
- Institute of Neuroscience, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,University of Lorraine, CNRS, CRAN, Lorraine, France
| |
Collapse
|
6
|
Lindgren EC, Källstrand J, Alftberg Å, Johansson P, Kristén L, Håman L, Ivarsson A, Carlsson IM. Empowerment-Based Physical Activity Intervention for People with Advanced Dry Age-Related Macular Degeneration: Mixed-Methods Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:643. [PMID: 36612963 PMCID: PMC9819966 DOI: 10.3390/ijerph20010643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Age-related macular degeneration (AMD) is the most common cause of incurable visual impairment and impacts daily life. These impacts include loss of social activities, decreased functional independence, and reduced physical activity. This protocol aims to describe a prospective, mixed-methodology for studying a population with AMD before, during, and after an empowerment-based physical activity intervention (EPI). A study framework was also developed for EPI. The intervention will include 20 older individuals (age 65+ years) with AMD recruited in Sweden. The intervention period is six months and comprises adapted physical activity and social activities in a group twice a week and individual health coaching on three occasions. The quantitative pre-test and three follow-ups include physical functional tests, an accelerometer that monitors physical activity continuously for one week, and questionnaires. Individual and focus-group interviews and ethnographic observations will explore the experience of living with AMD and what it means to participate in the EPI for individuals with AMD. The chosen methodology offers a structured way for researchers to explore the experiences and factors that may provide insights into the potential of creative supervised, adapted physical activity in groups, health coaching, and socialising that are significant to enable well-being among older individuals with AMD.
Collapse
Affiliation(s)
- Eva-Carin Lindgren
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Jeanette Källstrand
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Åsa Alftberg
- Department of Social Work, Faculty of Health and Society, Malmö University, SE-20506 Malmö, Sweden
| | - Pia Johansson
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Lars Kristén
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Linn Håman
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Ing-Marie Carlsson
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| |
Collapse
|
7
|
Bentley SA, Black AA, Hindmarsh GP, Owsley C, Wood JM. Concept Mapping to Identify Content for a Performance-Based Measure of Low Luminance Vision-Related Activities of Daily Living. Transl Vis Sci Technol 2022; 11:27. [PMID: 36166222 PMCID: PMC9526368 DOI: 10.1167/tvst.11.9.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to identify low luminance activities of daily living (ADL) relevant to adults with vision impairment using a concept-mapping approach. Methods “Group concept mapping” was utilized to identify specific ADLs that persons with vision impairment find challenging under low light conditions. In the first “brainstorming” phase, 24 adults with vision impairment from a range of eye conditions (mean age = 73 years, SD = 14 years) and 26 international low vision experts (mean experience = 22, SD = 11 years) generated statements to the focus prompt, “Thinking as broadly as possible, generate a list of statements detailing specific day-to-day activities a person with vision impairment might find challenging under low light conditions, such as in a poorly lit room or outside at dusk.” In the second phase, participants sorted activities by similarity and rated the importance of each activity. Multidimensional scaling and hierarchical cluster analysis were applied to produce concept maps showing clusters of prioritized activities. Results One hundred thirteen unique ideas/activities were generated, rated and sorted. Eight clusters were identified (from highest to lowest importance): hazard detection and safety outside; social interactions; navigation; near reading; selfcare and safety at home; distance spotting; searching around the home; and cooking and cleaning. Conclusions The conceptual framework and low luminance ADLs identified (the most important being hazard detection and safety outside, and social interactions) provide a basis for developing a performance-based measure of low luminance visual function. Translational Relevance A performance-based measure of low luminance vision-related ADLs is required for comprehensively and objectively assessing efficacy of eye treatments and low vision rehabilitation outcomes in adults with vision impairment.
Collapse
Affiliation(s)
- Sharon A Bentley
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Gregory P Hindmarsh
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joanne M Wood
- School of Optometry and Vision Science, Centre of Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
8
|
Dinah C, Enoch J, Ghulakhszian A, Taylor DJ, Crabb DP. Intravitreal treatment for geographic atrophy: coming soon to a patient near you? Eye (Lond) 2022; 36:1121-1123. [PMID: 34007061 PMCID: PMC9046256 DOI: 10.1038/s41433-021-01591-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/21/2021] [Accepted: 04/28/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Christiana Dinah
- grid.439325.a0000 0000 9897 4348Ophthalmology Department, London North West University Healthcare NHS Trust, Central Middlesex Hospital, London, UK
| | - Jamie Enoch
- grid.28577.3f0000 0004 1936 8497Department of Optometry and Visual Sciences, City, University of London, London, UK
| | - Arevik Ghulakhszian
- grid.439325.a0000 0000 9897 4348Ophthalmology Department, London North West University Healthcare NHS Trust, Central Middlesex Hospital, London, UK
| | - Deanna J. Taylor
- grid.28577.3f0000 0004 1936 8497Department of Optometry and Visual Sciences, City, University of London, London, UK
| | - David P. Crabb
- grid.28577.3f0000 0004 1936 8497Department of Optometry and Visual Sciences, City, University of London, London, UK
| |
Collapse
|
9
|
Macnamara A, Chen C, Schinazi VR, Saredakis D, Loetscher T. Simulating Macular Degeneration to Investigate Activities of Daily Living: A Systematic Review. Front Neurosci 2021; 15:663062. [PMID: 34483815 PMCID: PMC8414246 DOI: 10.3389/fnins.2021.663062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Investigating difficulties during activities of daily living is a fundamental first step for the development of vision-related intervention and rehabilitation strategies. One way to do this is through visual impairment simulations. The aim of this review is to synthesize and assess the types of simulation methods that have been used to simulate age-related macular degeneration (AMD) in normally sighted participants, during activities of daily living (e.g., reading, cleaning, and cooking). Methods: We conducted a systematic literature search in five databases and a critical analysis of the advantages and disadvantages of various AMD simulation methods (following PRISMA guidelines). The review focuses on the suitability of each method for investigating activities of daily living, an assessment of clinical validation procedures, and an evaluation of the adaptation periods for participants. Results: Nineteen studies met the criteria for inclusion. Contact lenses, computer manipulations, gaze contingent displays, and simulation glasses were the main forms of AMD simulation identified. The use of validation and adaptation procedures were reported in approximately two-thirds and half of studies, respectively. Conclusions: Synthesis of the methodology demonstrated that the choice of simulation has been, and should continue to be, guided by the nature of the study. While simulations may never completely replicate vision loss experienced during AMD, consistency in simulation methodology is critical for generating realistic behavioral responses under vision impairment simulation and limiting the influence of confounding factors. Researchers could also come to a consensus regarding the length and form of adaptation by exploring what is an adequate amount of time and type of training required to acclimatize participants to vision impairment simulations.
Collapse
Affiliation(s)
- Anne Macnamara
- Cognitive Ageing and Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Celia Chen
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Victor R Schinazi
- Department of Psychology, Faculty of Society & Design, Bond University, Gold Coast, QLD, Australia.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Dimitrios Saredakis
- Cognitive Ageing and Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Tobias Loetscher
- Cognitive Ageing and Impairment Neurosciences Laboratory, UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| |
Collapse
|
10
|
Caswell D, Caswell W, Carlton J. Seeing Beyond Anatomy: Quality of Life with Geographic Atrophy. Ophthalmol Ther 2021; 10:367-382. [PMID: 34089491 PMCID: PMC8319273 DOI: 10.1007/s40123-021-00352-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/12/2021] [Indexed: 10/28/2022] Open
Abstract
Quality of life (QoL) is a complex idea without a clear consensus definition. Generally speaking, QoL refers to several subjective measures of wellbeing that vary by individual and circumstance. QoL can decline noticeably as a disease progresses. This is particularly true for geographic atrophy (GA), an advanced form of age-related macular degeneration. GA leads to vision loss for which there is no currently approved pharmacological treatment. There is a lack of qualitative, patient-driven research on QoL in GA. There is also limited information available to both patients and physicians about GA, existing support groups and available assistive technologies. To address this, we have collated the experiences of a person with GA and those of her partner and carer with the current literature on QoL in GA. We have also outlined some of the wide range of developing technologies available to help people with GA carry out daily tasks and hobbies. It is clear that support, whether through informal or structured care, is vital to the wellbeing of people with GA. Despite this, the general public are often unaware of care work, which may result in this integral role being undervalued and under acknowledged. Furthermore, it is apparent that the general public have fundamental misunderstandings around what vision loss entails and are unaware that blindness is a vast spectrum. This feeds into the seemingly paradoxical mix of isolation and dependence on others that often results from GA and vision loss. Through this qualitative examination of a patient's experiences, we hope to inform and educate both patients and physicians about GA as well as precipitate discussion around the frameworks that should be in place to support both newly diagnosed and long-term patients with GA and other retinal diseases. Seeing beyond anatomy: quality of life with geographic atrophy (WMV 29479 kb).
Collapse
Affiliation(s)
- Dolores Caswell
- Canadian National Institute for the Blind, Toronto, Ontario, Canada
- Patient author, Vancouver, British Columbia, Canada
| | | | - Jill Carlton
- School of Health and Related Research, University of Sheffield, Sheffield, UK.
| |
Collapse
|
11
|
Scholl HPN, Boyer D, Giani A, Chong V. The use of neuroprotective agents in treating geographic atrophy. Ophthalmic Res 2021; 64:888-902. [PMID: 34153966 DOI: 10.1159/000517794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/12/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Hendrik P N Scholl
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - David Boyer
- Retina-Vitreous Associates Medical Group, Los Angeles, California, USA
| | - Andrea Giani
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Victor Chong
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| |
Collapse
|
12
|
Abstract
In healthy vision, the fovea provides high acuity and serves as the locus for fixation achieved through saccadic eye movements. Bilateral loss of the foveal regions in both eyes causes individuals to adopt an eccentric locus for fixation. This review deals with the eye movement consequences of the loss of the foveal oculomotor reference and the ability of individuals to use an eccentric fixation locus as the new oculomotor reference. Eye movements are an integral part of everyday activities, such as reading, searching for an item of interest, eye-hand coordination, navigation, or tracking an approaching car. We consider how these tasks are impacted by the need to use an eccentric locus for fixation and as a reference for eye movements, specifically saccadic and smooth pursuit eye movements. Expected final online publication date for the Annual Review of Vision Science, Volume 7 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Preeti Verghese
- The Smith-Kettlewell Eye Research Institute, San Francisco, California 94115, USA;
| | - Cécile Vullings
- The Smith-Kettlewell Eye Research Institute, San Francisco, California 94115, USA;
| | - Natela Shanidze
- The Smith-Kettlewell Eye Research Institute, San Francisco, California 94115, USA;
| |
Collapse
|
13
|
Hirji SH, Hood DC, Liebmann JM, Blumberg DM. Association of Patterns of Glaucomatous Macular Damage With Contrast Sensitivity and Facial Recognition in Patients With Glaucoma. JAMA Ophthalmol 2021; 139:27-32. [PMID: 33151275 DOI: 10.1001/jamaophthalmol.2020.4749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Importance Facial recognition is a critical activity of daily living that relies on macular function. Glaucomatous macular damage may result in impaired facial recognition that may negatively affect patient quality of life. Objective To evaluate the association of patterns of glaucomatous macular damage with contrast sensitivity and facial recognition among patients with glaucoma. Design, Setting, and Participants In this prospective cohort study at a single tertiary care center, 144 eyes of 72 consecutive patients with glaucoma with good visual acuity (20/40 or better in each eye) were studied. Data were collected from March to April 2019. Exposures Eyes with macular damage were categorized as having focal, diffuse, or mixed (focal and diffuse) damage based on optic disc and macular spectral-domain optical coherence tomography and 10-2 visual field (VF) damage. Only eyes with focal or diffuse damage were included. Higher-acuity and lower-acuity eyes were determined by 10-2 VF mean deviation (MD). Facial disability was defined as facial recognition scores at the 2% level of normal participants. Main Outcomes and Measures (1) Monocular contrast threshold as measured by the Freiburg Visual Acuity and Contrast Test and (2) binocular facial recognition as measured by the Cambridge Face Memory Test. Results Of the 72 included patients, 49 (68%) were White and 41 (57%) were female, and the mean (SD) age was 67.0 (11.6) years. Eyes with diffuse damage had greater contrast impairment compared with eyes with focal damage (β = -0.5; 95% CI, -0.6 to -0.4; P < .001) after adjusting for 10-2 VF MD, 24-2 VF MD, age, presence of an early cataract, and number of drops. Similarly, Cambridge Face Memory Test scores were significantly lower in patients with diffuse rather than focal macular damage, regardless of eye (better-seeing eye: β = 10.0; 95% CI, 2.0 to 18.2; P = .001; worse-seeing eye: β = 5.5; 95% CI, 0.8 to 10.0; P = .23). Relative risk of facial disability was greater for patients with diffuse but not focal macular damage in the better-seeing eye (relative risk, 86.2; 95% CI, 2.7 to 2783.3; P = .01). Conclusions and Relevance In this cohort study, diffuse rather than focal glaucomatous macular damage was associated with diminished facial recognition and contrast sensitivity. Evaluation of macular optical coherence tomography and 10-2 VF and resultant detection of diffuse macular damage may help minimize glaucoma-related visual disability.
Collapse
Affiliation(s)
- Sitara H Hirji
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Donald C Hood
- Department of Psychology, Columbia University, New York, New York.,Department of Ophthalmology, Columbia University, New York, New York
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Dana M Blumberg
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
14
|
Higgins BE, Taylor DJ, Binns AM, Crabb DP. Are Current Methods of Measuring Dark Adaptation Effective in Detecting the Onset and Progression of Age-Related Macular Degeneration? A Systematic Literature Review. Ophthalmol Ther 2021; 10:21-38. [PMID: 33565038 PMCID: PMC7887145 DOI: 10.1007/s40123-020-00323-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Dark adaptation (DA) has been proposed as a possible functional biomarker for age-related macular degeneration (AMD). In this systematic review we aim to evaluate current methodology used to assess DA in people with AMD, the evidence of precision in detecting the onset and progression of AMD, and the relationship between DA and other functional and structural measures. METHODS MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, PsycARTICLES were searched for studies published between January 2006 and January 2020 that assessed DA in people with AMD. Details of eligible studies including study design, characteristics of study population and outcomes were recorded. All included studies underwent quality appraisal using approved critical appraisal tools. This systematic review follows PRISMA guidelines (PROSPERO registration number: CRD42019129486). RESULTS Forty-eight studies were eligible for inclusion, reporting a variety of instruments and protocols to assess different DA parameters. Twenty of these studies used the AdaptDx (MacuLogix, Hummelstown, PA, USA) instrument and assessed rod-intercept time (RIT). Most of these reported that RIT was delayed in people with AMD and this delay worsened with AMD severity. Four studies, involving 533 participants, reported estimates of diagnostic performance of AdaptDx to separate people with AMD from visually healthy controls. DA has been compared to other measures of visual function, patient-reported outcome measures (PROMs) and structural measures. Ten studies specifically considered evidence that the presence of certain structural abnormalities was associated with impaired DA in AMD. CONCLUSIONS This systematic review indicates overwhelming evidence of reasonable quality for an association between impaired DA and AMD. Data on the repeatability and reproducibility of DA measurement are sparse. There is evidence that structural abnormalities such as reticular drusen are associated with prolongation of DA time. Fewer studies have explored an association between DA and other measures of visual function or PROMs. We found no studies that had compared DA with performance-based measures.
Collapse
Affiliation(s)
- Bethany E Higgins
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Deanna J Taylor
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Alison M Binns
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - David P Crabb
- Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK.
| |
Collapse
|
15
|
Higgins BE, Taylor DJ, Bi W, Binns AM, Crabb DP. Novel computer-based assessments of everyday visual function in people with age-related macular degeneration. PLoS One 2020; 15:e0243578. [PMID: 33284855 PMCID: PMC7721163 DOI: 10.1371/journal.pone.0243578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/23/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To test the hypothesis that the performance in novel computer-based tasks of everyday visual function worsens with disease severity in people with non-neovascular age-related macular degeneration. METHODS Participants with and without non-neovascular age-related macular degeneration (≥60 years, minimum logMAR binocular visual acuity 0.7) performed a series of standard visual function tests and two novel computer-based tasks. In a visual search task, participants had to locate an image of a single real-world object within an array of 49 distractor images. Next, in a series of simulated dynamic driving scenes, participants were asked to identify one or two approaching real-world road signs and then select these road signs from four options. Outcome measures were median response times and total correct responses. RESULTS Forty-nine participants had no macular disease (n = 11), early/intermediate age-related macular degeneration (n = 16) or geographic atrophy (n = 22). Groups were age-similar with median (interquartile range) logMAR visual acuity of 0.00 (-0.08,0.12), 0.13 (-0.08,0.70) and 0.32 (0.12,0.70) respectively. Median (interquartile range) visual search response times were 1.9 (1.0,2.4), 1.8 (1.1,3.7) and 2.4 (1.2,6.0) seconds respectively. Median (interquartile range) road sign response times (single road signs) were 1.2 (0.4,1.7), 1.5 (0.9,2.8) and 1.8 (1.0,5.5) seconds respectively. Median (interquartile range) road sign response times (double road signs) were 1.7 (0.7,2.4), 2.3 (1.2,3.1) and 2.5 (1.7,6) seconds respectively. Participants with geographic atrophy recorded slower response times in all tasks and over 50% performed outside the normative limit for task performance. There were no significant differences between groups in total correct responses across all tasks. CONCLUSIONS In a novel computer-based assessment, people with increasing severity of age-related macular degeneration take longer to perform visual search of everyday objects and take longer to identify road signs than those with no age-related macular degeneration. These novel assessments could be useful as patient-relevant, secondary outcomes for clinical trials.
Collapse
Affiliation(s)
- Bethany E Higgins
- Optometry and Visual Sciences, School of Health Sciences, University of London, London, United Kingdom
| | - Deanna J Taylor
- Optometry and Visual Sciences, School of Health Sciences, University of London, London, United Kingdom
| | - Wei Bi
- Optometry and Visual Sciences, School of Health Sciences, University of London, London, United Kingdom
| | - Alison M Binns
- Optometry and Visual Sciences, School of Health Sciences, University of London, London, United Kingdom
| | - David P Crabb
- Optometry and Visual Sciences, School of Health Sciences, University of London, London, United Kingdom
| |
Collapse
|
16
|
Hirji SH, Liebmann JM, Hood DC, Cioffi GA, Blumberg DM. Macular Damage in Glaucoma is Associated With Deficits in Facial Recognition. Am J Ophthalmol 2020; 217:1-9. [PMID: 32360859 DOI: 10.1016/j.ajo.2020.04.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This report examines the relationship between glaucomatous macular damage and facial recognition. In addition, it assesses the role of contrast sensitivity (CS) as an intermediary step in the causal pathway between macular damage and impairment of facial recognition. DESIGN Prospective cross-sectional study. METHODS This study was conducted in a single tertiary care center. The study population included 144 eyes of 72 participants with a diagnosis of open angle glaucoma in one or both eyes and a visual acuity of 20/40 or better in each eye. The presence or absence of macular damage was determined by comparing corresponding regions of the retinal nerve fiber layer and the retinal ganglion cell layer with spectral-domain optical coherence tomography with the 10-2 visual field (VF). Better and worse eye was determined by 10-2 VF mean deviations (MDs). Interventions were 1) macular function as measured by 10-2 VF and 2) CS as measured by the Freiburg Visual Acuity and Contrast Test (FrACT). The primary outcome measure was the Cambridge Face Memory Test (CFMT) score. RESULTS Regardless of eye, there was a significant correlation between facial recognition and 10-2 VF MD (P < .0001 better, worse eye). The 10-2 VF MD remained a significant predictor of facial recognition after adjusting for potential confounders including glaucoma severity, CS, age, and visual acuity (P = .004 better eye, P = .019 worse eye). CONCLUSIONS Even with good central visual acuity, patients with glaucomatous macular damage exhibit diminished facial recognition, which is partly mediated through diminished CS.
Collapse
|
17
|
Burguera-Giménez N, García-Lázaro S, España-Gregori E, Gallego-Pinazo R, Burguera-Giménez N, Rodríguez-Vallejo M, Jonna G. Multimodal Evaluation of Visual Function in Geographic Atrophy versus Normal Eyes. Clin Ophthalmol 2020; 14:1533-1545. [PMID: 32669830 PMCID: PMC7337178 DOI: 10.2147/opth.s246245] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/30/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To comprehensively evaluate visual function in eyes with geographic atrophy (GA) as compared to normal eyes. Patients and Methods Sixty-three eyes from 63 patients ≥50 years old were recruited for this observational study; 31 were identified as normal macular health eyes and 32 with GA. Visual function was tested with best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), low luminance deficit (LLD), reading speed, macular integrity microperimetry, fixation stability, and contrast sensitivity function (CSF). Anatomic function was evaluated with spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF). Quality of life and vision were assessed with the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Results Visual function and quality of life are reduced in patients with GA. Moderate and strong correlations in the GA group were found between maximum reading speed (r = 0.787) (p˂0.01), CS spatial frequency 3 cpd (r = 0.441) (p˂0.05), CS spatial frequency 6 cpd (r = 0.524) (p˂0.01), fixation P1 (r = 0.379) (p˂0.05), macular sensitivity (r = 0.484) (p˂0.05) and atrophic area (r = -0.689) (p˂0.01), and the VFQ-25 composite score. Conclusion The decreased visual function is reflected in a poor quality of life in patients with GA. Reading speed, contrast sensitivity, fixation, and macular sensitivity are strongly associated with vision-related quality of life. The results suggest the importance of the reading letter size in patients with GA. Microperimetry and reading speed are useful tools to better assess visual impairment in patients with GA.
Collapse
Affiliation(s)
- Noemi Burguera-Giménez
- Ophthalmology Department, Retina Research Center, Austin, Texas, USA.,Optometry Department, University of Valencia, Valencia, Spain.,Ophthalmology Department, Qvision, Hospital Vithas Virgen Del Mar, Almeria, Spain
| | | | - Enrique España-Gregori
- Ophthalmology Department, La Fe University Hospital, Valencia, Spain.,Surgery Department, University of Valencia, Valencia, Spain
| | | | | | | | - Gowtham Jonna
- Ophthalmology Department, Retina Research Center, Austin, Texas, USA
| |
Collapse
|
18
|
Jones PR, Tigchelaar I, Demaria G, Wilson I, Bi W, Taylor DJ, Crabb DP. Refinement and preliminary evaluation of two tablet-based tests of real-world visual function. Ophthalmic Physiol Opt 2019; 40:35-46. [PMID: 31879994 PMCID: PMC7028122 DOI: 10.1111/opo.12658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/09/2019] [Indexed: 01/07/2023]
Abstract
Purpose To describe, refine, evaluate, and provide normative control data for two freely available tablet‐based tests of real‐world visual function, using a cohort of young, normally‐sighted adults. Methods Fifty young (18–40 years), normally‐sighted adults completed tablet‐based assessments of (1) face discrimination and (2) visual search. Each test was performed twice, to assess test‐retest repeatability. Post‐hoc analyses were performed to determine the number of trials required to obtain stable estimates of performance. Distributions were fitted to the normative data to determine the 99% population‐boundary for normally sighted observers. Participants were also asked to rate their comprehension of each test. Results Both tests provided stable estimates in around 20 trials (~1–4 min), with only a further reduction of 14%–17% in the 95% Coefficient of Repeatability (CoR95) when an additional 40 trials were included. When using only ~20 trials: median durations for the first run of each test were 191 s (Faces) and 51 s (Search); test‐retest CoR95 were 0.27 d (Faces) and 0.84 s (Search); and normative 99% population‐limits were 3.50 d (Faces) and 3.1 s (Search). No participants exhibited any difficulties completing either test (100% completion rate), and ratings of task‐understanding were high (Faces: 9.6 out of 10; Search: 9.7 out of 10). Conclusions This preliminary assessment indicated that both tablet‐based tests are able to provide simple, quick, and easy‐to‐administer measures of real‐world visual function in normally‐sighted young adults. Further work is required to assess their accuracy and utility in older people and individuals with visual impairment. Potential applications are discussed, including their use in clinic waiting rooms, and as an objective complement to Patient Reported Outcome Measures (PROMs).
Collapse
Affiliation(s)
- Pete R Jones
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - Iris Tigchelaar
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Ocusweep, Turku, Finland.,Doctoral Program in Clinical Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Giorgia Demaria
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, Groningen, the Netherlands
| | - Iain Wilson
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Wei Bi
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - Deanna J Taylor
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - David P Crabb
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| |
Collapse
|
19
|
Mazzoli LS, Urata CN, Kasahara N. Face memory deficits in subjects with eye diseases: a comparative analysis between glaucoma and age-related macular degeneration patients from a developing country. Graefes Arch Clin Exp Ophthalmol 2019; 257:1941-1946. [DOI: 10.1007/s00417-019-04380-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/20/2019] [Accepted: 05/25/2019] [Indexed: 11/29/2022] Open
|
20
|
Lane J, Rohan EMF, Sabeti F, Essex RW, Maddess T, Barnes N, He X, Robbins RA, Gradden T, McKone E. Improving face identity perception in age-related macular degeneration via caricaturing. Sci Rep 2018; 8:15205. [PMID: 30315188 PMCID: PMC6185956 DOI: 10.1038/s41598-018-33543-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/26/2018] [Indexed: 11/09/2022] Open
Abstract
Patients with age-related macular degeneration (AMD) have difficulty recognising people's faces. We tested whether this could be improved using caricaturing: an image enhancement procedure derived from cortical coding in a perceptual 'face-space'. Caricaturing exaggerates the distinctive ways in which an individual's face shape differs from the average. We tested 19 AMD-affected eyes (from 12 patients; ages 66-93 years) monocularly, selected to cover the full range of vision loss. Patients rated how different in identity people's faces appeared when compared in pairs (e.g., two young men, both Caucasian), at four caricature strengths (0, 20, 40, 60% exaggeration). This task gives data reliable enough to analyse statistically at the individual-eye level. All 9 eyes with mild vision loss (acuity ≥ 6/18) showed significant improvement in identity discrimination (higher dissimilarity ratings) with caricaturing. The size of improvement matched that in normal-vision young adults. The caricature benefit became less stable as visual acuity further decreased, but caricaturing was still effective in half the eyes with moderate and severe vision loss (significant improvement in 5 of 10 eyes; at acuities from 6/24 to poorer than <6/360). We conclude caricaturing has the potential to help many AMD patients recognise faces.
Collapse
Affiliation(s)
- Jo Lane
- Research School of Psychology, and ARC Centre of Excellence in Cognition and its Disorders, The Australian National University, Canberra, ACT, Australia
| | - Emilie M F Rohan
- John Curtin School of Medical Research (JCSMR), The Australian National University, Canberra, ACT, Australia
| | - Faran Sabeti
- John Curtin School of Medical Research (JCSMR), The Australian National University, Canberra, ACT, Australia
- Discipline of Optometry and Vision Science, The University of Canberra, Bruce, ACT, Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, The Australian National University, Canberra, ACT, Australia
| | - Ted Maddess
- John Curtin School of Medical Research (JCSMR), The Australian National University, Canberra, ACT, Australia
| | - Nick Barnes
- Research School of Engineering, The Australian National University, and Data61, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, ACT, Australia
| | - Xuming He
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Rachel A Robbins
- Research School of Psychology, The Australian National University, Canberra, ACT, Australia
| | - Tamara Gradden
- Research School of Psychology, The Australian National University, Canberra, ACT, Australia
| | - Elinor McKone
- Research School of Psychology, and ARC Centre of Excellence in Cognition and its Disorders, The Australian National University, Canberra, ACT, Australia.
| |
Collapse
|