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Daniela Claessens, Ronald V. Krueger; Three dimensions of quantitative metamorphopsia measurement – do disease specific patterns exist?. Invest. Ophthalmol. Vis. Sci. 2017;58(8):14.
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© ARVO (1962-2015); The Authors (2016-present)
The computer based App AMD - A Metamorphopsia Detector® is a monitoring tool to document 3 metamorphopsia aspects: amplitude of distortion (d), excentricity (ε) and area (a). This study was performed to investigate whether disease-specific patterns exist.
The AMD App is based on the Amsler grid. The patient straightens lines he monocularly perceives distorted. 3 dimensions of metamorphopsia are measured and build a global index (GI). In 166 eyes (male 75 =, female= 91; age 36-97 years) metamorphopsia measurement and SD-OCT were performed: neovascular age related macular degeneration (nvAMD) = 25, intermediate AMD with large drusen (iAMD-dru) = 30, intermediate AMD with abnormalities of retinal pigment epithelium with at least medium drusen (iAMD-RPE) = 20, geographic atrophy = 9, retinal pigment detachment = 6 ,diabetic macular edema (DME) = 12, epiretinal gliosis = 34, macular edema due to venous thrombosis (vtME) = 6, uveitis = 9 or myopia = 3, vitelliform maculopathy= 5, central serous maculopathy =3, macular hole (MH) = 4. Prior to the study all patients signed informed consent according to the declaration of Helsinki/ Edinburgh.
For each diagnosis group the distribution of GI and single dimensions is documented as well as diagnosis specified correlation of single dimensions with GI. Strongest correlation of single dimension and GI was found in nvAMD for distortion (Pearson correlation coefficient ρ = 0.95), in iAMD-RPE for excentricity (ρ = 0.9) and in DME for area (ρ = 0.97). Contrary to nvAMD and iAMD-RPE local degree of distortion (d/a) was higher than distortion index (d) in large drusen (iAMD-dru) (d/a: mean 3.2, median 2.3, CI (2.6;3.8); d: mean 2.1, median 1.9, CI (1.8;2.3) and likewise in geographic atrophy, macular hole and DME. nvAMD, iAMD-RPE and vtME showed highest GI- and single dimension values. GI of nvAMD (median 7.9,mean= 7.4, CI = (6.6;8.2)) and iAMD-RPE (median 6.7, mean= 6.7,CI=(6.1;7.6)) were significantly higher than iAMD-dru (median 3.2, mean= 3.3, CI=(2.8;3.8)).
AMD – A Metamorphopsia Detector® provides quantitative evaluation of 3 dimensions of metamorphopsia as a patient relevant outcome. DME was characterized by higher amplitude peaks, GI in vtME, iAMD-RPE and nvAMD were significantly higher than in iAMD-dru. Based on typical patterns global index, single dimensions and amplitude peaks can serve as a diagnostic hint.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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