Patient-reported vision impairment in low luminance relates to visual function in age-related macular degeneration: A MACUSTAR study report

J Jan Henrik Terheyden C Charlotte Behning H Hannah M. P. Dunbar S Stephen Poor N Nadia Zakaria A Alison M. Binns M Marlene Saßmannshausen S Sergio Leal M Matthias Schmid F Frank G. Holz (Department of Ophthalmology, University of Bonn, Bonn, Germany) D David P. Crabb U Ulrich F. O. Luhmann R Robert P. Finger H H. Agostini I I. D. Aires L L. Altay R R. Atia F F. Bandello P P. G. Basile J J. Batuca C C. Behning M M. Belmouhand M M. Berger A A. Binns C C. J. F. Boon M M. Böttger J J. E. Brazier C C. Carapezzi J J. Carlton A A. Carneiro A A. Charil R R. Coimbra D D. Cosette M M. Cozzi D D. P. Crabb J J. Cunha-Vaz C C. Dahlke H H. Dunbar S S. Esposti R R. P. Finger E E. Fletcher M M. Gutfleisch F F. Hartgers B B. Higgins J J. Hildebrandt E E. Höck R R. Hogg F F. G. Holz C C. B. Hoyng A A. Kilani J J. Krätzschmar L L. Kühlewein M M. Larsen S S. Leal Y Y. T. E. Lechanteur U U. F. O. Luhmann A A. Lüning N N. Manivannan I I. Marques C C. Martinho K K. P. Moll Z Z. Mulyukov M M. Paques B B. Parodi M M. Parravano S S. Penas T T. Peters T T. Peto M M. Pfau S S. Priglinger S S. Ramamirtham S S. Ribeiro D D. Rowen G G. S. Rubin J J. Sahel C C. Sánchez O O. Sander M M. Saßmannshausen M M. Schmid S S. Schmitz-Valckenberg J J. Siedlecki R R. Silva E E. Souied G G. Staurenghi J J. Tavares D D. J. Taylor J J. H. Terheyden A A. Tufail P P. Valmaggia M M. Varano A A. Wolf N N. Zakaria

Abstract

Abstract Early stages of age-related macular degeneration (AMD) can lead to a number of visual function deficits, but the patient relevance of these deficits is largely unknown. We therefore investigated how bilateral visual function domains affected by age-related macular degeneration (AMD) are associated with patient-reports. Using data from the cross-sectional part of the MACUSTAR study with 245 individuals with AMD (34 early AMD, 168 intermediate (i) AMD, 43 late AMD), the Vision Impairment in Low Luminance (VILL) questionnaire (subscales: reading, VILL_R; mobility, VILL_M; emotional well-being, VILL_E) and visual function assessments from both eyes (best-corrected and low-luminance visual acuity, BCVA, LLVA; Moorfields acuity, MA; contrast sensitivity, CS) were included. Associations between VILL and visual function data (better and worse eyes defined based on BCVA) were investigated using age- and sex-adjusted regression models. In the overall sample, VILL_R and VILL_M were associated with all functional tests across eyes (p ≤ 0.0389), while VILL_E was associated with MA and CS (p ≤ 0.0302). Regression estimates for BCVA, LLVA, MA and CS in the better-seeing eyes were -2.70, -1.84, -1.83 and 1.08 (VILL_R); -2.71, -1.87, -1.90 and 1.88 (VILL_M), and -0.25, -0.22, -2.15 and 1.57 (VILL_E). In iAMD, CS and MA in the worse-seeing eye were associated with two VILL subscales, respectively (VILL_R and VILL_M; VILL_M and VILL_E, respectively; p ≤ 0.0395), while BCVA and LLVA in the worse-seeing eye were both associated with one VILL subscale (VILL_M; p ≤ 0.0317). CS in the better eye was associated with VILL_M (p = 0.0454). Thus, patient-reported outcomes are associated with visual function assessments in both eyes in people with AMD. Contrast vision seems particularly patient-relevant in iAMD. Our results further support the construct validity of the VILL questionnaire.

Article Details

Volume / Issue Vol. 15, Issue 1
Published October 09, 2025
ISSN 2045-2322
Publisher Nature Portfolio

Journal Info

Scientific Reports

Nature Portfolio

ISSN: 2045-2322 Open Access Life Sciences

Authors (92)

J

Jan Henrik Terheyden

C

Charlotte Behning

H

Hannah M. P. Dunbar

S

Stephen Poor

N

Nadia Zakaria

A

Alison M. Binns

M

Marlene Saßmannshausen

S

Sergio Leal

M

Matthias Schmid

F

Frank G. Holz

Department of Ophthalmology, University of Bonn, Bonn, Germany

D

David P. Crabb

U

Ulrich F. O. Luhmann

R

Robert P. Finger

H

H. Agostini

I

I. D. Aires

L

L. Altay

R

R. Atia

F

F. Bandello

P

P. G. Basile

J

J. Batuca

C

C. Behning

M

M. Belmouhand

M

M. Berger

A

A. Binns

C

C. J. F. Boon

M

M. Böttger

J

J. E. Brazier

C

C. Carapezzi

J

J. Carlton

A

A. Carneiro

A

A. Charil

R

R. Coimbra

D

D. Cosette

M

M. Cozzi

D

D. P. Crabb

J

J. Cunha-Vaz

C

C. Dahlke

H

H. Dunbar

S

S. Esposti

R

R. P. Finger

E

E. Fletcher

M

M. Gutfleisch

F

F. Hartgers

B

B. Higgins

J

J. Hildebrandt

E

E. Höck

R

R. Hogg

F

F. G. Holz

C

C. B. Hoyng

A

A. Kilani

J

J. Krätzschmar

L

L. Kühlewein

M

M. Larsen

S

S. Leal

Y

Y. T. E. Lechanteur

U

U. F. O. Luhmann

A

A. Lüning

N

N. Manivannan

I

I. Marques

C

C. Martinho

K

K. P. Moll

Z

Z. Mulyukov

M

M. Paques

B

B. Parodi

M

M. Parravano

S

S. Penas

T

T. Peters

T

T. Peto

M

M. Pfau

S

S. Priglinger

S

S. Ramamirtham

S

S. Ribeiro

D

D. Rowen

G

G. S. Rubin

J

J. Sahel

C

C. Sánchez

O

O. Sander

M

M. Saßmannshausen

M

M. Schmid

S

S. Schmitz-Valckenberg

J

J. Siedlecki

R

R. Silva

E

E. Souied

G

G. Staurenghi

J

J. Tavares

D

D. J. Taylor

J

J. H. Terheyden

A

A. Tufail

P

P. Valmaggia

M

M. Varano

A

A. Wolf

N

N. Zakaria