Evaluation of a mobile app for dark adaptation measurement in individuals with age-related macular degeneration

We present clinical evaluation of a mobile app for dark adaptation (DA) measurement in age-related macular degeneration (AMD) patients and in older adults (age > 50 years) without AMD or other retinal disorders (NV). The outcome measures were the area under dark adaptation curve (AUDAC) and the time for visual sensitivity to recover by 3 log units (T-R). Larger AUDAC and T-R values indicated worse DA response. The association of AUDAC with AMD was analyzed using linear regression, while time-to-event analysis was used for T-R. 32 AMD patients (mean +/- SD; age:72 +/- 6.3 years, VA:0.09 +/- 0.08 logMAR) and 25 NV subjects (mean +/- sd; age:65 +/- 8.7 years, VA:0.049 +/- 0.07 logMAR) were measured with the app. Controlling for age, VA, and cataract severity, the AMD presence was significantly associated with higher AUDAC (beta = 0.41, 95% CI 0.18-0.64, p = 0.001) and with slower sensitivity recovery (beta = 0.32, 95% CI 0.15-0.69, p = 0.004). DA measurements with the app were highly correlated with those obtained with AdaptDx-an established clinical device (n = 18, rho = 0.87, p < 0.001). AMD classification accuracy using the app was 72%, which was comparable to the 71% accuracy of AdaptDx. Our findings indicate that the mobile app provided reliable and clinically meaningful DA measurements that were strongly correlated with the current standard of care in AMD.