Loss of cone function in age-related maculopathy

PURPOSE. To evaluate cone visual function of subjects with age-related maculopathy (ARM). METHODS. Cone thresholds in 16 patients with ARM and 14 age-matched control subjects were compared. All subjects had visual acuity of 6/12 or better in the studied eye. A range of contrast thresholds were measured to evaluate diverse aspects of cone visual function under steady state conditions (spatio-temporal, color and luminance, and photopic sensitivity) or after bleaching (adaptation dynamics). RESULTS. ARM produced a diffuse loss across all cone steady state visual functions in 31% to 44% of subjects. The adaptation time constant of cone recovery was significantly prolonged in most (69%) ARM eyes. A cross-correlational analysis found adaptational kinetics to be independent of other steady state losses, with cone photopigment regeneration being the most affected visual function in ARM (chi(2) = 4.03, P < 0.05). CONCLUSIONS. The results show that cone-adaptational kinetics are affected in ARM more so than are steady state thresholds. Given that cone recovery is easy to examine in a clinical setting, this test may provide a useful index of photopic function in patients with ARM.