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Measuring dynamic levels of self-perceived anxiety and concern during simulated mobility tasks in people with non-neovascular age-related macular degeneration
  1. Deanna J Taylor,
  2. Nicholas D Smith,
  3. Pete R Jones,
  4. Alison M Binns,
  5. David P Crabb
  1. Division of Optometry and Visual Science, City, University of London, London, UK
  1. Correspondence to Professor David P Crabb, Division of Optometry and Visual Science, City, University of London, London EC1V 0HB, UK; David.Crabb.1{at}


Background/aims To assess response to real-world mobility scenarios in people with dry age-related macular degeneration (AMD) using a computer-based test.

Methods Participants were shown 18 point-of-view computer-based movies simulating walking through real-world scenarios, and pressed a button during scenes which would cause them self-perceived anxiety or concern in their day-to-day life. Button pressure was recorded throughout. Pressure traces were generated, which aligned with each movie time point. Group averages based on AMD severity were generated. Bootstrapped confidence intervals (CIs) for responses by group were generated around traces. Traces were examined to discover events causing the greatest differences between groups.

Results Participants had early/no AMD (n=8), intermediate AMD (n=7) or geographic atrophy (n=15 (GA)). Median (IQR) logMAR visual acuity was 0.04 (−0.04, 0.18), 0.26 (0.10, 0.40) and 0.32 (0.20, 0.56), respectively. Participants with intermediate AMD or GA recorded greater pressure than those with early and no AMD (Kruskal-Wallis, p=0.04). Four events involving navigating stairs and three under low luminance elicited greatest differences between groups (p<0.001).

Conclusion People with intermediate AMD or GA likely experience higher levels of concern associated with mobility. The test highlights areas of specific concern. Results should be useful in patient management and educating the public about the everyday effects of AMD.

  • degeneration
  • macula
  • rehabilitation
  • vision

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  • Contributors DJT: study design, data collection, data analysis and manuscript preparation. NDS: study design. PRJ: data analysis and manuscript critique. DPC and AB: study conception and design, data analysis and manuscript critique.

  • Funding This study was funded as part of an unrestricted investigator-initiated research grant from Roche Products Ltd, UK, awarded to DPC.

  • Disclaimer The sponsor or funding organization had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by Nottingham 2 National Health Service (NHS) Research Ethics Committee, and was conducted according to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on request.

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