March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Efficacy Of The Amsler Grid Test In Evaluating Glaucomatous Central Visual Field Defects
Author Affiliations & Notes
  • Andrew Greenberg
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
  • Daniel Su
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    Mount Sinai School of Medicine, New York, New York
  • Joseph Simonson
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
  • Sung Chul Park
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • Celso Tello
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • Jeffrey Liebmann
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    Ophthalmology, NYU School of Medicine, New York, New York
  • Robert Ritch
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • Footnotes
    Commercial Relationships  Andrew Greenberg, None; Daniel Su, None; Joseph Simonson, None; Sung Chul Park, None; Celso Tello, None; Jeffrey Liebmann, Carl Zeiss Meditec, Inc. (C); Robert Ritch, None
  • Footnotes
    Support  Derald H. Ruttenberg Foundation Research Fund of the New York Glaucoma Research Institute, New York, NY. Dr. Park is the Peter Crowley Research Scientist at the New York Eye and Ear Infirmary
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 177. doi:
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      Andrew Greenberg, Daniel Su, Joseph Simonson, Sung Chul Park, Celso Tello, Jeffrey Liebmann, Robert Ritch; Efficacy Of The Amsler Grid Test In Evaluating Glaucomatous Central Visual Field Defects. Invest. Ophthalmol. Vis. Sci. 2012;53(14):177.

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

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Abstract
 
Purpose:
 

To investigate the efficacy of the Amsler grid test compared to 10-2 standard automated perimetry in evaluating central visual field (VF) defects in glaucoma.

 
Methods:
 

Glaucoma patients with either a normal or abnormal 10-2 VF within the previous 4 months for both eyes were included. Eyes with known macular disease were excluded. An abnormal 10-2 VF was defined as having ≥3 adjacent points with P<5% and ≥1 point with P<1%. Amsler grid tests were administered for each eye using a black-on-white grid at a distance of 30 cm. The subjects were instructed to outline any perceived scotomas (areas with missing or blurred grid lines) that fall within the central 10 degrees of fixation, which were then defined as ‘Amsler grid scotomas’. The area of Amsler grid scotomas were measured using ImageJ software. Correlation analysis and linear and quadratic regression analyses were performed between the Amsler grid scotoma area and 10-2 VF parameters (mean deviation [MD], scotoma extent [number of test points with P<1% in total deviation map], and scotoma mean depth [mean value of test points with P<1% in total deviation map]).

 
Results:
 

Ninety-six eyes were enrolled (48 patients, mean age: 67.0±11.8yr). Mean 24-2 and 10-2 VF MD were -10.44±8.7 dB (range, 0.9 to -30.5) and -10.7±9.0 dB (range, 2.1 to -32.7), respectively. Among 10 eyes with normal 10-2 VF, 8 had normal Amsler grid test. Among 86 eyes with abnormal 10-2 VF, 58 (67%) had abnormal Amsler grid test. The 10-2 MD, 10-2 scotoma extent, and 10-2 scotoma mean depth were significantly correlated with the Amsler grid scotoma area (ρ[rho]=-0.727, 0.732, and -0.640, respectively; all P<0.001). Linear and quadratic regression analyses demonstrated that Amsler grid scotoma area had the strongest relationship with 10-2 MD (linear R2=0.626, quadratic R2=0.701; P<0.001), followed by 10-2 scotoma extent (linear R2=0.537, quadratic R2=0.634; P<0.001), and 10-2 scotoma mean depth (linear R2=0.319, quadratic R2=0.384; P<0.001) (Fig. A-C). The Amsler grid appeared to be more useful in detecting moderate to severe 10-2 VF defects.

 
Conclusions:
 

In glaucoma, the results of the Amsler grid tests approximate the 10-2 VF results. The Amsler grid may be a useful supplement to the 10-2 VF testing for evaluating and monitoring central VF loss in glaucoma.  

 
Keywords: visual fields • optic nerve 
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