SYMPTOMATIC ABNORMALITIES OF DARK-ADAPTATION IN PATIENTS WITH AGE-RELATED BRUCHS MEMBRANE CHANGE

Some patients with age-related changes at the level of Bruch's membran e and good visual acuity report poor vision in dim light, fading visio n in bright light, and a central scotoma noticeable in the dark. Ophth almic examination, scotopic thresholds, and dark adaptation kinetics w ere recorded in 12 eyes of 12 patients with such symptoms. All had mac ular drusen which were hypofluorescent on fluorescein angiography in n ine subjects, and six had evidence of prolonged choroidal filling on f luorescein angiography. Scotopic thresholds were depressed in six pati ents who all experienced a central scotoma in the dark or poor night v ision. The kinetics of dark adaptation were abnormal in all 10 patient s in whom reliable measurements were possible. The findings suggest th at visual symptoms reflect abnormality of both scotopic sensitivity an d the time course of dark adaptation in patients with age-related Bruc h's membrane change.