April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Early Detection Of Exudative Age-related Macular Degeneration With A Home-based Preferential Hyperacuity Perimeter
Author Affiliations & Notes
  • Howard F. Fine
    Ophthalmology, Robert Wood Johnson Medical School, Eatontown, New Jersey
  • Daniel B. Roth
    Ophthalmology, Robert Wood Johnson Med School, New Brunswick, New Jersey
  • Anat Loewenstein
    Ophthalmology, Tel-Aviv Medical Center, Tel Aviv, Israel
  • Michaella Goldstein
    Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel
  • Yaron Lang
    Ophthalmology, HaEmek Medical Center, Afula, Israel
  • Haya Katz
    Ophthalmology, Kaplan Medical Center, rehovot, Israel
  • Joseph R. Ferencz
    Ophthalmology, Meir Medical Center, Kfar-Saba, Israel
  • Jon-Marc Weston
    Ophthalmology, Weston Eye Center, Roseburg, Oregon
  • Nalin J. Mehta
    Colorado Retina Center, Denver, Colorado
  • Richard Johnston
    Ophthalmology, Edina Retina Consultants, Minnealpolis, Minnesota
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 3069. doi:
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    • Get Citation

      Howard F. Fine, Daniel B. Roth, Anat Loewenstein, Michaella Goldstein, Yaron Lang, Haya Katz, Joseph R. Ferencz, Jon-Marc Weston, Nalin J. Mehta, Richard Johnston; Early Detection Of Exudative Age-related Macular Degeneration With A Home-based Preferential Hyperacuity Perimeter. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3069.

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

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Abstract

Purpose: : In patients with exudative age-related macular degeneration (AMD), large randomized trials have demonstrated that better initial acuity and smaller lesion size are predictors of better absolute acuity following therapy. Therefore, early detection may afford better patient outcomes. The purpose of this study was to determine whether a home-based preferential hyperacuity perimeter (PHP) could detect early conversion from dry to wet AMD and to assess the stability of patient testing over time.

Methods: : Enrolled patients with intermediate AMD were instructed on daily use of the home-based PHP device, the ForeseeHome, which examines the macula for central visual field defects and automatically transmits results to a reading center. In the event of a change in test scores, the patient’s ophthalmologist was notified. All eyes with 40 tests or more were included in the analysis. Statistical distributions of the first 20 test scores and last 20 test scores were compared.

Results: : 80 eyes of 62 patients performed an average [range] of 82 [40-281] tests in a period of 157 [52-349] days with a usage frequency of 4.2±1.7 tests per week. No statistically significant differences in the average (p= 0.87) or standard deviation (p=0.65) of test scores were found when comparing the first and last 20 tests. Among 5 patients who demonstrated test-retest instability (deterioration in test scores), 3 were diagnosed with CNV and treated - all were asymptomatic upon diagnosis. The specificity of the test was 0.97.

Conclusions: : In patients with intermediate AMD, frequent monitoring with a home-based PHP was applied successfully with stable test scores over several months. New cases of CNV were detected with a high sensitivity and specificity in asymptomatic patients. The ForeseeHome device shows promise as a telemedicine approach for early detection of conversion from dry to wet AMD.

Clinical Trial: : http://www.clinicaltrials.gov NCT01083147

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: systems/equipment/techniques • choroid: neovascularization 
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