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A Loewenstein, A Pollack, AP SchachatMacular Computerized Psychophysical Test (MCPT) Alpha Research Group; Results of a Multicentered, Masked Clinical Trial to Evaluate the Macular Computerized Psychophysical Test (MCPT) for Detection of Age-related Macular Degeneration (AMD) . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1213.
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Purpose: To report on the results of a multicentered, masked, clinical trial, comparing MCPT to the Amsler grid for the detection of AMD-related macular lesions. Methods: Patients with and without various stages of AMD underwent protocol refraction, standardized visual-acuity examination, MCPT and conventional supervised Amsler grid examinations performed following a standard protocol by a trained technician masked to the patients retinal condition, and stereoscopic macular color photographs. In the MCPT, which is based on the hyperacuity phenomenon, a dotted line is flashed across different macular loci in a perifoveal radius of 7 degrees. Any distortion or scotoma perceived by the examinee are recorded and automatically analyzed yielding a map of the macular visual fields. Color photographs were graded by a Photograph Reading Center grader (Wilmer Eye Institute, Baltimore) who was masked to the retinal diganosis. Results: 151 eyes of 151 patients were included. Visual acuity ranged from 20/20 to 20/160, median 20/32. Of the 19 eyes with neovascular AMD, 19 (100%) were positive on the MCPT and 10 (53%) on the Amsler grid. Of the 27 eyes with geographic atrophy, 26 (96%) were positive on the MCPT and 12 (44%) on the Amsler grid. Of the 20 eyes with non-neovascular AMD with high-risk characteristics (HRC) (defined as the presence of ≷ 5 large drusen), 14 (70%) were positive on the MCPT and 4 (20%) on the Amsler grid. Of the 51 eyes with non-neovascular AMD without HRC, 21 (41%) were positive on the MCPT and 4 (8%) on the Amsler grid. Of the 33 eyes with no AMD, 6 (18%) were positive on the MCPT and none (0%) on the Amsler grid. Conclusion: In a multicentered, masked clinical trial, the MCPT detected various AMD-related lesions more often than the Amsler grid, although the MCPT had a higher false positive rate. The MCPT may be the most efficient way currently available for self-detection of AMD-related lesions.
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