Effect of illumination on reading performance in Japanese patients with age-related macular degeneration
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CLINICAL INVESTIGATION
Effect of illumination on reading performance in Japanese patients with age‑related macular degeneration Tomoko Ro‑Mase1 · Satoshi Ishiko2 · Akitoshi Yoshida1 Received: 5 December 2019 / Accepted: 16 July 2020 © Japanese Ophthalmological Society 2020
Abstract Purpose Several studies of Western patients with age-related macular degeneration (AMD) have investigated reading performance that improved at high levels of illumination; however, the relation between reading performance and macular function has not been evaluated in detail in Japan. The goals of this study were to evaluate the effect of different levels of illumination on reading performance in Japanese patients with AMD and determine the factors, such as macular function, that affect these results. Study design Cross-sectional study. Methods We prospectively included 39 patients with bilateral AMD or maculopathy. We evaluated reading performance; reading acuity (RA), critical print size (CPS), and maximal reading speed (MRS) using charts with Japanese sentences based on the MNREAD-J in 500–7500 lx. Patients were classified into two groups based on the presence of a central scotoma (CS) or no CS (NCS) diagnosed by microperimetry. Results The RA improved significantly in 500–7500 lx in both groups (NCS, p = 0.001; CS, p = 0.046). The RA improvement differed significantly (2000 lx, p = 0.021; 5,000 lx; p = 0.021; 7500 lx, p = 0.047) between 500 lx and other illumination levels only in the NCS group and then plateaued over 2000 lx. The CPS and MRS did not improve significantly at any illumination level. Conclusions These results suggest that the difference in macular function was related to improvement in the RA with increased illumination in Japanese patients with AMD. Keywords Age-related macular degeneration · Illumination · Reading performance · Macular function · Japanese
Introduction In patients with age-related macular degeneration (AMD) the central visual field is impaired with disease progression, which results in impaired visual acuity (VA) and reading performance. It is noteworthy that, in advanced macular diseases the reading performance declines as a result of the presence of a central scotoma (CS) [1]. Corresponding Author: Satoshi Ishiko * Satoshi Ishiko ishiko@asahikawa‑med.ac.jp 1
Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
Department of Medicine and Engineering Combined Research Institute, Asahikawa Medical University, 2‑1‑1‑1 Midorigaoka Higashi, Asahikawa 078‑8510, Japan
2
Supplemental lighting is the basic tool for improving reading performance in patients with AMD. When determining the optimal illumination levels for individuals, the reading performance must be evaluated using various illumination levels [2]. The effect of illumination on VA and reading performance of low-vision patients has been studied. It is agreed that most low-vision patients achieve improved VA with increasing illumination [3–5]. Previous studies also suggest that most patients with AMD require
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