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P. Amini, L. Cheng, K. Hartmann, D.-U. Bartsch, H. Klein, M. Gomez, W. R. Freeman; Reproducibility and Determination of Normative Values of Scanning Laser Ophthalmoscope Imaging Stabilized Microperimetry. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2506.
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© ARVO (1962-2015); The Authors (2016-present)
To determine reproducibility and normative retinal sensitivity values using a novel microperimeter with SLO, combining eye tracking with live views of the fundus. Additionally to determine the reproducibility of central and eccentric testing, and to elucidate normative sensitivities using the SLO microperimeter (OPKO, Miami, Fla).
72 eyes of 36 patients with a normal ophthalmic exam using SLO/Microperimetry (OPKO, Miami, Fla) were tested using different custom patterns to determine sensitivity and reproducibility in macular areas and along major vascular arcades. 1500-2000 points of data were examined for reproducibility. Prior to testing, a short simplified practice pattern used to test both eyes of each patient was given to eliminate the practice effect. After the practice session, each eye underwent two sessions of testing in each area studied to determine reproducibility. Each patient was given a rest period of 15 minutes prior to a second session of testing. The mean retinal sensitivities between examinations were compared with GEE. The reproducibility was calculated between the individual retinal points in the two exams representing the same location. We used both Bland-Altman and Intraclass correlation.
Utilizing GEE analysis, we found that the mean sensitivity from exam one (15.7204 dB) was nearly identical to the mean of exam two (15.7295 dB), p=0.9. When comparing individual points between exam 1 and 2 using a Bland-Altman plot, we found that 95% of the retinal sensitivity values of the second exam were within 4 db of the first (coefficiency of repeatability was 4). Utilizing the polar 3 pattern of three concentric rings, we were able to formulate a normative database of retinal sensitivities. Average normative values at distances from the fovea between 1.7 and 3.0 mm were 15.4 ± 2.4 db. Values within the central 1.5 mm diameter were higher. Peripheral retinal sensitivities external to the major vascular arcades were lower.
SLO microperimetry is a useful test to measure retinal function in the living human eye; this test can be overlaid directly onto SD OCT and fundus images taken by the same instrument. The practice effect can be reduced or eliminated with a brief session of customized testing pattern which we developed for this purpose. Reproducibility of retinal sensitivity in normal eyes is plus minus 4db (95%). We have created a statistically useful data base of normative values in the macular area, extra macular region between the arcades and along the major vascular arcades.
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