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Ee Lin Ong, Yingfeng Zheng, Gay M. Verdon-Roe, David F. Garway-Heath, Ciara Bergin, Tien Y. Wong, Tin Aung, Alicia How; Diagnostic performance of the Moorfields Motion Displacement Test for glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):180.
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© ARVO (1962-2015); The Authors (2016-present)
The Moorfields Motion Displacement Test (MMDT, ESTA Version 1, London, UK) is a 31-point suprathreshold test for visual field assessment using moving line stimuli displayed on a standard laptop computer. Our purpose was to evaluate the diagnostic performance of the MMDT for discriminating between healthy eyes and eyes with glaucoma.
This was an observational case-control study of glaucoma subjects and normal controls. All participants underwent a standardized ophthalmological examination including visual field testing, the MMDT and Heidelberg Retina Tomography (HRT, Heidelberg Engineering, Heidelberg, Germany) scanning of the optic disc. Glaucoma was defined on clinical examination as loss of neuroretinal rim with cup:disc ratio of ≥0.7 and a HRT Moorfields Regression Analysis (HRA) result of "outside normal limits" in any sector with adequate image quality. Normal eyes were defined as having an intraocular pressure of ≤21mmHg with cup-disc ratio <0.6 and HRA analysis of "within normal limits". The Pandora response version of Enhanced Standard Threshold Algorithm (ESTA) was used for the MMDT in this study. The MMDT was performed without optical correction. Subjects with a false positive response of ≥15% were excluded. In the MMDT, a measure of probability of true damage (PTD, 0-100%) was derived for each location. Global PTD was calculated as a sum of individual PTD values for all 31 locations expressed as a quotient of 100. An abnormal result was defined as a global PTD ≥ 2.0. Data analysis using area under the curve (AUC) receiver operating characteristic (ROC), sensitivity, and specificity was then performed to evaluate the diagnostic performance of the MMDT. Only right eyes were used for analysis.
A total of 78 subjects with glaucoma (mean age: 66.6+/-13.1, male gender: 55.1%) and 363 healthy subjects (mean age: 55.6+/-9.5, male gender: 35.5%) were analyzed. The AUC was 0.920 (95% confidence interval: 0.883, 0.958) for global PTD in identifying eyes with glaucoma. At 85% specificity, the Moorfields MDT demonstrated a sensitivity of 88.5%. This decreased to 73.1% at 95% specificity. At the global PTD cut off point value of 2.0, the sensitivity was 85.9% and the specificity was 92.6%.
The suprathreshold MMDT showed good diagnostic performance for glaucoma diagnosis when glaucoma was defined by a structural criterion.
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