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Maximilian Pfau, Moritz Lindner, Philipp Mueller, Johannes Birtel, Robert P. Finger, Wolf M. Harmening, Monika Fleckenstein, Frank G Holz, Steffen Schmitz-Valckenberg; Effective dynamic range and retest-reliability of two-color dark-adapted fundus-controlled perimetry in patients with macular diseases. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2481.
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Differential rod versus cone dysfunction has been observed in various retinal diseases including age-related macular degeneration making it an interesting biomarker. Traditionally rod function is tested through two-color dark-adapted perimetry (Jacobson et al. 1986).The recently introduced S-MAIA microperimeter (Scotopic-Macular-Integrity-Assessment, CenterVue, Italy) device allows for two-color dark-adapted fundus-controlled perimetry (FCP). We investigated the effective-dynamic-range (EDR), retest-reliability and number of discriminable steps (DS) of the S-MAIA.
52 eyes of 52 subjects (mean age 62.0±16.9 years, range 19.1–90.1 years) with various macular diseases were examined by duplicate mesopic (achromatic stimuli, 400-800 nm), dark-adapted cyan (505 nm) and red (627 nm) FCP using a grid of 61 stimuli covering 18° of the central retina. The EDR and the number of DS were analyzed as proposed by Wall and associates 2010. Coefficients-of-repeatability (CoR) were used as measure for point-wise-sensitivity (PWS) retest-reliability. The effects of fixation stability, sensitivity and age on retest-reliability were examined using mixed-effects models.
The EDR was 10-30 dB with 5 DS for mesopic and 4-17 dB with 4 DS for dark-adapted cyan and red testing. PWS retest-reliability was good among all three types of retinal sensitivity assessments (CoR: ±5.79, ±4.72, and ±4.77 dB, respectively) and was independent from eccentricity, fixation stability and age. PWS had no effect on retest-reliability in dark-adapted cyan and red testing and a minor effect in mesopic testing.
Combined mesopic and two-color dark-adapted FCP allows for reliable topographic testing of cone and rod function in patients with various macular diseases with and without foveal fixation. Retest-reliability is homogeneous across eccentricities and various degrees of scotoma depth including zones at risk for disease progression. The reliability estimates inform future clinical trial designs that incorporate combined mesopic and two-color dark-adapted FCP as a functional outcome measure.
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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