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  • Dark Adaptation Survey and Screening for POAG

    By Jean Shaw
    Selected By: Henry D. Jampel, MD, MHS
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    Journal Highlights

    Ophthalmology Glaucoma, September/October 2019

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    Ramsey et al. set out to study the extent to which patients with primary open-angle glaucoma (POAG) have trouble with dark adaptation (DA) and with seeing in low-light conditions. In addi­tion, they correlated these findings with disease severity. The results showed that problems with DA and vision under low luminance are common in patients with POAG and that patients’ subjective self-assessment scores correlated with disease severity.

    For this pilot study, the researchers developed a questionnaire that was presented to patients with POAG during routine examinations in a hospital-based eye clinic. The questionnaire included such statements as “I have trouble reading the menu in a dimly lit restaurant” and “After looking at my cell phone, tablet, or computer screen in a dim room, I find it difficult to rec­ognize objects when I look away from the screen.”

    All told, 85 patients with POAG and 127 control participants completed the questionnaire. All were 40 years of age or older and had a visual acuity of 20/50 or better. The researchers then extract­ed data related to the patients’ ocular health and degree of glaucoma severity from their medical records. A multiple regression analysis was performed to create a predictive model for POAG.

    The results confirmed that vision problems in low light and issues with DA are common in patients with glau­coma. And although these problems become more prominent as the disease progresses, patients with POAG report more subjective visual dysfunction in the early stages of the disease than do healthy controls. With regard to the questionnaire’s ability to serve as a predictive tool, the DA survey score—when combined with cup-to-disc ratio and family history of glaucoma—showed an accuracy, sensitivity, and specificity of 96.7%, 92.9%, and 99.2%, respectively.

    The authors noted that patients with glaucoma are not always queried about DA problems and similar challenges during routine glaucoma care. A ques­tionnaire such as this one, when paired with family history and structural assessment of the optic nerve, might serve as a screening tool, they concluded.

    The original article can be found here.