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Scientific description of the project [<<]
Overall objectivs of the project
The main objective of the AMD-READ project is the development of tools for testing macular function, which consider the disabilities caused by age-related macular degeneration (AMD), mainly disability of reading and motion control, in order to maintain, restitute or optimise these functions and therefore quality of life. These include psychophysical tests (e.g. contrast sensitivity, parafoveal letter recognition, figure/ground interaction, reading), eye movement recording with an eye-tracker during fixation and reading, evaluation of motion perception and exploration, assessment of fixation by Scanning Laser Ophthalmoscope, and objective measurements by multifocal electroretinography with fixation control

Experimental approach and working method
A variety of established methods were tested for their suitability to be recommended as a standard test battery for the standardised assessment of residual visual function in AMD-patients and other low-vision patients. New standardised texts for reading speed measurement have been developed to obtain comparable examination conditions in four different languages. Some sophisticated methods to measure fixation locus and stability and reading eye movements were compared with some simpler methods that are easier to apply. The precision and reliability of the latter methods was evaluated in order to decide if they can be recommended for a broader application. The improved methodology was used to evaluate training effects. The influence of visual function on motor control was studied and the possibility to train the hand-eye coordination in AMD-patients was examined. Image processing strategies were evaluated for their potential to help low-vision patients to discriminate objects.
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Achievements and results to date
334 patients with AMD were included. A set of standardised texts to measure reading speed in English, German, French, and Finish was developed and tested in a study with 200 normal subjects. The texts are comparable between languages and can be used for repeated examinations. The Macular Mapping test was modified and showed to be a good tool to detect early AMD. A modified slit-lamp was used to assess fixation behaviour. Fixation and reading was assessed with a scanning laser ophthalmoscope and a video eye tracker. Eye movements proved to be a good indicator for the reading impairment. A European standard test battery for low vision examination was developed and will be provided in the near future. Motion perception and balance were improved by visuo-motor training. The examination of figure/ground-interaction showed the influence of contrast modification on image recognition.

The five most relevant publications emanating from the project
(1) Crossland MD et al.: Evaluation of a new quantitative technique to assess the number and content of preferred retinal loci in macular disease.
Vision Research, 44:1537-1546 (2004)

(2) Trauzettel-Klosinski S et al.: Assessment of parafoveal function in maculopathy: a comparison between the Macular Mapping Test and kinetic manual perimetry.
Graefe's Archive of Clinical and Experimental Ophthalmology, 241: 988-995 (2003).

(3) M.D. Crossland et al.: Predicting reading fluency in patients with macular disease.
Optometry and Vision Science, 82: 111-17 (2005).

(4) D. Thibault et al.: Second-order motion sensitivity in normal aging and AMD patients.

(5) C. Bordier et al.: The influence of background attenuation on critical bandwith for image recognition in normal vision and age-related macular degeneration.

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