Reference map of multimodal vision deficits in intermediate age-related macular degeneration: contrast sensitivity and low-contrast visual acuity

PURPOSE: To provide a reference map of deficits in contrast sensitivity (CS) and low-contrast visual acuity (LCVA) across stages of non-exudative age-related macular degeneration (AMD) and evaluate functional consequences of optical coherence tomography structural biomarkers. METHOD: Prospective cross-sectional study of 509 eyes of 358 subjects: 317 dry AMD eyes (99 early, 177 intermediate, 41 advanced), 192 healthy control eyes. Reference limits defined from control eye measures of best-corrected visual acuity (BCVA), quantitative contrast sensitivity function (CSF) measures of LCVA, area under the logarithm CSF (AULCSF), CS at multiple frequencies. Risk scores defined by the sum of structural biomarkers in each eye were associated with visual outcomes across and within AMD stages using multiple linear regression analyses. RESULTS: Compared with controls, AULCSF declined by 2.2 decibels (dB) in early AMD (eAMD), 3.7 dB in intermediate AMD (iAMD) and 8 dB in advanced AMD. Proportions iAMD eyes breaching reference limits: 50% for AULCSF, 36% for BCVA, 39% for LCVA. For eAMD and iAMD, risk scores were significantly correlated with AULCSF (p