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People with glaucomatous macular damage may be face blind

25 Sep 2020

Glaucomatous macular damage appears to impair the ability of patients to recognize faces, a study has found. This is despite having good visual acuity (VA).

Researchers examined 144 eyes of 72 patients (mean age, 67 years; 56.9 percent female) with open angle glaucoma in one or both eyes and a visual acuity of 20/40 or better in each eye. They assessed macular function using spectral-domain optical coherence tomography with the 10-2 visual field (VF), as well as contrast sensitivity (CS) using the Freiburg Visual Acuity and Contrast Test.

In the facial recognition testing, patients viewed six target faces at three different viewing angles for 3 seconds each. Then, they underwent 51 forced-choice recognition trials, wherein they must identify the previously seen target face from an additional two unfamiliar faces.

Of the 72 better eyes, 44 (61 percent) had macular damage. Eyes with vs without macular damage had had more severe glaucoma and required more intraocular pressure-lowering medications. There was no difference in VA, number of eyes with early cataract, axial length, spherical equivalent (phakic eyes), or significant astigmatism. Macular damage was associated with a significant decline in facial recognition (p<0.0001).

Results for the 72 worse eyes were consistent.

Overall, macular damage significantly predicted impaired facial recognition in multivariable models controlling for potential confounders including glaucoma severity, CS, age, and VA (better eye, p=0.004; worse eye, p=0.019).

The researchers pointed out that facial recognition might be impaired via diminished CS or paracentral VF loss, both of which are functions of macular damage that are captured by the 10-2 VF.

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