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Abnormal dark adaptation potential early marker of macular dysfunction in cataract surgery candidates
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PHILADELPHIA — Abnormal dark adaptation is a potential marker of subclinical macular dysfunction among patients who are otherwise deemed good candidates for multifocal IOL implantation, according to a presentation here.
“In early [age-related macular degeneration], Snellen visual acuity is frequently undisturbed, but problems with night vision and vision in low-light conditions are frequently reported by patients.” Marta McKeague, MD, said at the Wills Eye Alumni Conference. The symptoms are similar to cataract symptoms, making it important to differentiate between the two, she added.
According to McKeague, dark adaptation screening for macular pathology in patients undergoing cataract surgery evaluation is needed because multifocal IOLs may reduce contrast sensitivity and impair visual function in patients with subclinical macular disease.
In a retrospective chart review of 193 patients in a comprehensive ophthalmology practice who underwent dark adaptation testing within a 13-month period, researchers selected 27 eyes with normal corneal topography identified as good candidates for multifocal IOL implantation. Of those 27 eyes, 17 (63%) had normal dark adaptation and 10 (37%) had abnormal dark adaptation.
“In the end, about one-third of our patients that would be theoretical candidates for multifocal lenses had abnormal dark adaptation,” McKeague said.
Mean age of patients with abnormal dark adaptation was 79 years (P = .018). Increase in age increased odds of abnormal dark adaptation; however, neither gender nor macular thickness as seen on optical coherence tomography (OCT) was associated with increased odds.
“The primary point of the study was to introduce dark adaptation and its use in comprehensive ophthalmology and in cataract evaluation to assess macular function rather than macular structure, as is the current standard with exam and OCT,” McKeague said. – by Kate Sherrer
Reference:
McKeague M. Using dark adaptation time to assess macular function prior to cataract surgery. Presented at: Wills Eye Alumni Conference; March 10-12, 2016; Philadelphia.
Disclosure: McKeague reports no relevant financial disclosures.