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J. Robinson, J. Prenner, D. Roth, K. Darvin, R. S. Kaiser; Efficacy of a Novel Technique in Predicting a Diagnosis of Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5101.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the efficacy of a novel device that utilizes responses to photostress in patients with age-related macular degeneration (AMD) to assess disease severity.
59 eyes of 49 patients with documented AMD of varying severity as well as 26 eyes of 14 patients with no known macular pathology were enrolled into the study cohort. Each study eye was tested individually, without visual correction. In all cases, the test was performed on the dilated eyes of fully consented patients prior to ophthalmologic examination. The test consisted of three 15-second trials with the MacScopeTM (Sensory Arts & Science, King of Prussia, PA), which is a handheld device that emits a strobed pattern of white light at various frequencies. Patients were then asked to describe what they observed. Color fundus photographs (CFPs) were obtained and subsequently categorized by two masked retina specialists into one of seven categories (no macular pathology, AREDS I, AREDS II, AREDS III, AREDS IV, wet non-disciform AMD or disciform scar). A third investigator, blinded to the CFP categorization, graded each of the patient observations by a number of characteristics including scotoma area.
Of the 85 eyes enrolled in the study, 21 were graded by the readers as no macular pathology (age = 68.5 ± 3.0), 5 as AREDS I (72.8 ± 5.1), 8 as AREDS II (72.4 ± 5.8), 14 as AREDS III (80.4 ± 3.2), 15 as AREDS IV (81.6 ± 1.7), 14 as wet non-disciform (80 ± 3.9) and 8 as disciform (81.1 ± 3.0). Intraocular pressure and cataract severity were not found to be significantly different among CFP categories. Of all trials, the frequency of scotoma as reported by the patient was 40% overall. The frequency of scotoma was 10 % for eyes categorized as no macular pathology, 20% for AREDS I, 33% for AREDS II, 43% for AREDS III, 40% for AREDS IV, 71% for wet non-disciform AMD, and 79% for disciform scar. A significant difference was detected between the aggregate data for eyes categorized as no pathology through AREDS II versus AREDS III through disciform scar in both scotoma frequency (16.7% versus 55.6%) and scotoma size (183 ± 36 mm2 versus 615 ± 97 mm2).
This initial study of a novel device for monitoring disease progression in patients with AMD demonstrates a strong correlation of test findings with disease severity as assessed by CFP.
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