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Originally published In Press as doi:10.1167/iovs.08-1942 on September 12, 2008
 (Investigative Ophthalmology and Visual Science. 2009;50:482-487.)
© 2009 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.08-1942
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Postural Stability and Gait among Older Adults with Age-Related Maculopathy

Joanne M. Wood,1,2 Philippe F. Lacherez,1,2 Alex A. Black,1,2 Michael H. Cole,2,3 Mei Ying Boon,1,2 and Graham K. Kerr2,3

1From the School of Optometry, the 2Institute of Health and Biomedical Innovation, and the 3School of Human Movement Studies, Queensland University of Technology, Brisbane, Australia.

PURPOSE. To assess the postural stability and gait characteristics of adults with age-related maculopathy (ARM) and to identify the visual factors associated with postural stability and gait in this clinical population.

METHODS. Participants included 80 individuals with a range of severity of ARM (mean age, 77.2 years). Binocular visual function measures included visual acuity, contrast sensitivity, and merged binocular visual fields. Postural stability was assessed on both a firm and a foam surface using center-of-pressure measures derived from a force platform. Forty three of the participants underwent a three-dimensional motion analysis to quantify gait characteristics, including walking velocity, proportion of time spent with both feet in contact with the ground (double-support time), stride length, and step width.

RESULTS. After adjustment for age, sex, self-reported physical function, and cataract severity, all the vision measures were significantly associated with postural stability on the foam surface, with contrast sensitivity being the strongest correlate. In the analysis of the gait measures, only contrast sensitivity was significantly associated with walking velocity, step width, or stride length, whereas contrast sensitivity and visual field loss were both significantly associated with double-support time.

CONCLUSIONS. Impaired contrast sensitivity was associated with postural instability, slower walking velocity, increased step width, and reduced stride length. Impairments in either contrast sensitivity or visual fields were associated with increased double-support time. This result suggests that loss of contrast sensitivity and visual fields in patients with ARM can lead to balance and mobility problems.






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