Dark Adaptometry and Its Role in AMD Diagnosis

Transcript:

The future should be to go back and intervene at intermediate

After so many years of dealing with GA we realized that intervening at this late stage will be very difficult so we need to move a little bit backwards into intermediate AMD. So we need to be able to prevent intermittent AMD to get into a late AMD. We know in our intermediate patients there is it’s very consistent that we can distinguish soft drusen phenotype from reticular drusen phenotype. So if there’s a phenotype, we have a normal deck adaptation but if it is within a few seconds more than a normal patient. Dark adaptation, it’s quite an idler for particular drusen. So those patients even if they have 20/20, no GA, and diffuse reticular they have very poor function at night. When you ask them they say, “Yes doctor, I see very bad.” Even if they’re 20/20 and they adapt much longer than twenty seconds so it’s been very helpful in proving that functionally soft drusen phenotype and reticular drusen phenotype are very different functionally. Since our hypothesis is that drusen phenotype has an impact on progression and on pathways, additional proof of that is showing that the function of those early patients that still have very good vision – they’re 20/20, they have no GA yet, just drusen, so we need two additional proofs that the impact is different so even in those 20/20, no GA patients, dark adaptation is a way to detect changes in those patients. The future should be to go back and intervene at intermediate. Dark adaptometry will play more of a role when the community will focus on intermediate. Then now, the community is more focused on late.