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A. Loewenstein, PHP Research Group; Differentiating Intermediate AMD from Recent Onset CNV with the Preferential Hyperacuity Perimetry (PHP) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1740.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the ability of Preferential Hyperacuity Perimetry (PHP) to discriminate between patients with choroidal neovascularization (CNV) and intermediate AMD based on AREDS criteria. Methods: Patients suspected of having intermediate AMD or recently developed CNV underwent corrected visual acuity and eye examination. In addition, after signing an IRB-approved consent, PHP was performed prior to pupillary dilation by an examiner masked to the patient’s diagnosis. Each patient suspected of having intermediate AMD without CNV had stereoscopic color fundus photographs obtained and reviewed. Each patient suspected of having CNV had a fluorescein angiogram obtained and reviewed. In the PHP, based on the phenomenon of hyperacuity, distortions or scotomata were recorded within a perifoveal radius of 70 and automatically analyzed yielding a map of the macular visual field as well as an automatic interpretation utilizing previously determined pattern recognition algorithms designed to indicate whether CNV was suspected to be present or not. A retina specialist who was masked to the PHP results graded the color photographs and angiograms. Results: Of 82 patients who entered the study, 10 were excluded (3 with early AMD, 2 with geographic atrophy, 2 with no AMD, one with pattern dystrophy, and 2 with poor photographic quality). Of the remaining patients, age ranged from 54 to 88 years (median 75). Of 27 eyes with documentation of CNV, 23 (85%) were identified as having CNV on the PHP. Of 45 eyes with documentation of intermediate AMD with no CNV, 6 (14%) were identified as having CNV on the PHP. These results yielded a sensitivity of 85% ± 13% (95% confidence interval [CI] [72%, 98%]) and a specificity of 87% ± 10% (95% CI [77%,97%]). Conclusion: The PHP appears to differentiate between CNV and intermediate AMD, and thus may be beneficial for monitoring intermediate AMD patients for development of CNV.
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