June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Exploration of the Dynamic Range of the Moorfields MDT to Assess Suitability to Monitor Glaucoma
Author Affiliations & Notes
  • Marco Miranda
    National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Gay Verdon-Roe
    National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Ciara Bergin
    National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Tony Redmond
    National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • David Crabb
    Optometry and Visual Science, City University London, London, United Kingdom
  • David Garway-Heath
    National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships Marco Miranda, None; Gay Verdon-Roe, Moorfields MDT (P); Ciara Bergin, Moorfields MDT (P); Tony Redmond, None; David Crabb, Allergan Inc. (R), Moorfields MDT (P); David Garway-Heath, Moorfields MDT (P), Carl Zeiss Meditec (F), Heidelberg Engineering (F), Reichert Technoloies (F), Ziemer Ophthalmic Systems AG (F), Pfizer Inc (F), Allergan (F), Allergan (C), Allergan (R), Alcon (C), Alcon (R), Bausch & Lomb (R), Merck (R), Santen (R), Quark (C), Teva (C), Topcon (F), OptoVue (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3915. doi:
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      Marco Miranda, Gay Verdon-Roe, Ciara Bergin, Tony Redmond, David Crabb, David Garway-Heath; Exploration of the Dynamic Range of the Moorfields MDT to Assess Suitability to Monitor Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3915.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To compare the dynamic range between stimuli employed in Standard Automated Perimetry, SAP, and in the Moorfields Motion Displacement Test, MMDT.

 
Methods
 

Frequency-of-seeing curves (FOS) were obtained from data collected at 8 locations of the visual field (VF) in 23 subjects with a range of pointwise sensitivities (0 - 35dB on the Humphrey VF analyzer, Carl Zeiss Meditec., SITA-Standard). Four locations of the VF in one eye per subject were tested. The method of constant stimuli was used for both SAP- and MMDT-like stimuli with 15 bins and 8 presentations per bin used to build the FOS curve. SAP was performed using Goldmann size III stimuli presented for 200msec. For the MMDT, vertical lines of areas ranging from 0.27 to 6.10mm2, depending on eccentricity, oscillated for 600msec. Both types of stimuli were presented on an EIZO GS521 monochromatic monitor (0.17mm/pixel) using the MMDT software (v.1.8.3). The Psignifit toolbox (v.3.0) was used to plot the curves and estimate the 50%-seen threshold. Results were analyzed using a multiple linear regression analysis (least squares).

 
Results
 

SAP and MMDT thresholds were calculated from 184 FOS curves with truncation effects observed less frequently in SAP (7 cases) than in MMDT (19 cases). MMDT thresholds were measured across the range of SAP sensitivities from 36.8 to 7.8dB. The relationship between the two scales is significantly dependent (adjusted R2 = 0.76, p-value = 0.003; Figure 1) on the MMDT stimulus area and can be described by the formula: ThresholdSAP = − 0.65 × ThresholdMMDT − 0.63 × stimulus area + 36.61 (Eq.1)

 
Conclusions
 

A strong linear association between the values obtained with SAP and the MMDT was observed. Motion displacement threshold increased as VF sensitivity reduced. Although truncation of the FOS curves was more frequent with the MMDT, thresholds derived from staircase, as in clinical perimetry, would be more robust at this end of the scale. The results suggest that the MMDT has the potential to be used for monitoring glaucoma deterioration.

 
 
Figure 1: Relationship between thresholds (measured or projected 50%-seen level on the FOS curve) obtained with SAP (vertical axis) and the MMDT (horizontal axis) at the 8 locations tested. Solid line represents the multiple linear regression line (Eq.1) and dashed lines represent the 95% confidence intervals of the equation.
 
Figure 1: Relationship between thresholds (measured or projected 50%-seen level on the FOS curve) obtained with SAP (vertical axis) and the MMDT (horizontal axis) at the 8 locations tested. Solid line represents the multiple linear regression line (Eq.1) and dashed lines represent the 95% confidence intervals of the equation.
 
Keywords: 642 perimetry • 758 visual fields • 688 retina  
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