July 2018
Volume 59, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2018
Static and dynamic assessment of fixation stability in Stargardt disease
Author Affiliations & Notes
  • Etienne M Schonbach
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
    Medicine, University of Maryland Midtown Campus, Baltimore, Maryland, United States
  • Artur V Cideciyan
    Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Mohamed A Ibrahim
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Rupert Wolfgang Strauss
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
    Ophthalmology, University of Basel, Basel, Switzerland
  • David G Birch
    Retina Foundation of the Southwest, University of Texas, Dallas, Texas, United States
  • Janet S Sunness
    Hoover Low Vision Rehabilitation Services, Greater Baltimore Medical Center, Baltimore , Maryland, United States
  • Srinivas R. Sadda
    Doheny Eye Institute, UCLA David Geffen School of Medicine, Los Angeles, California, United States
  • Hendrik P Scholl
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
    Department of Ophthalmology University of Basel, Basel, Switzerland
  • Footnotes
    Commercial Relationships   Etienne Schonbach, Leopoldina Fellowship Program Grant No LPDS 2015-14 (F); Artur Cideciyan, None; Mohamed Ibrahim, None; Rupert Strauss, None; David Birch, 4D Molecular Therapeutics (F), Acucela (C), AGTC (F), AGTC (C), Genentech (C), Ionis Pharmaceuticals (F), Ionis Pharmaceuticals (C), Nacuity (C), NightstaRX (F), NightstaRX (C); Janet Sunness, None; Srinivas Sadda, Allergan (F), Allergan (C), Carl Zeiss Meditec (F), Genentech (F), Genentech (C), Iconic (C), Novartis (C), Optos (F), Optos (C), Thrombogenics (C); Hendrik Scholl, Acucela Inc. (F), Astellas Institute for Regenerative Medicine (C), Boehringer Ingelheim Pharma GmbH & Co. KG (C), Daiichi Sankyo (C), Foundation Fighting Blindness Clinical Research Institute (FFB CRI) (F), Foundation Fighting Blindness Clinical Research Institute (FFB CRI) (R), Genentech Inc./F. Hoffmann-La Roche Ltd (R), Gensight Biologics (C), Genzyme Corp./Sanofi (R), Gerson Lehrman Group (C), Guidepoint (C), Intellia Therapeutics (C), National Centre of Competence in Research (NCCR) Molecular Systems Engineering (University of Basel and ETH Zürich), Swiss National Science Foundation (F), NightstaRx Ltd (F), Novelion Therapeutics Inc (F), QLT, Inc. (F), ReNeuron Group Plc/Ora Inc (R), Shire (C), Shulsky Foundation (F), U.S. Department of Defense USAMRMC TATRC, Fort Meade, Maryland (grant numbers W81-XWH-07-1-0720 and W81XWH-09-2-0189) (F)
  • Footnotes
    Support  Foundation Fighting Blindness Clinical Research Institute (FFB CRI) and a grant to FFB CRI by the U.S. Department of Defense USAMRMC TATRC, Fort Meade, Maryland (grant numbers W81-XWH-07-1-0720 and W81XWH-09-2-0189).
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 788. doi:https://doi.org/
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    • Get Citation

      Etienne M Schonbach, Artur V Cideciyan, Mohamed A Ibrahim, Rupert Wolfgang Strauss, David G Birch, Janet S Sunness, Srinivas R. Sadda, Hendrik P Scholl; Static and dynamic assessment of fixation stability in Stargardt disease. Invest. Ophthalmol. Vis. Sci. 2018;59(9):788. doi: https://doi.org/.

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

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Abstract

Purpose : Sensitive, reproducible visual function biomarkers are necessary to evaluate the efficacy of emerging treatments for Stargardt disease type 1 (STDG1) in clinical trials. We previously demonstrated that fixation stability may serve as a secondary outcome parameter for visual function loss. However, the test duration and protocol have an unknown effect on the assessment of fixation stability. Here, we hypothesize that separate fixation testing with a single target is different from combined fixation testing using the same target with simultaneous perimetry testing.

Methods : Microperimetry data from the multicenter prospective Progression of Atrophy Secondary to Stargardt Disease (ProgStar, NCT01977846) study were used for the analysis. Patient selection criteria are defined in ProgStar Report No.1 (Ophthalmology 123: 817-28; doi: 10.1016/j.ophtha.2015.12.009). The MP-1 microperimeter (Nidek Technologies) was used to record all fixation events. During a separate fixation exam, the patient’s fixation stability (FS) was tested using a red cross as a target. During the macular sensitivity exam, the patient’s attention was also at the fixation target while the subject was simultaneously instructed to detect light stimuli projected in the visual field. The first 30s of the test duration were extracted for fixation data analysis.

Results : The demographic features from the ProgStar cohort are detailed in ProgStar Report No.1. A total of 438 eyes from 235 patients were included. The mean 1SD-BCEA (Bivariate Contour Ellipse Area) was smaller for the cross fixation compared to the 30s sample extracted from the full macular sensitivity exam (4.9± 9.3 deg2 vs 5.48± 7.7 deg2; p<0.001). The 1SD-BCEA was also smaller for the 30s extracted versus the full macular sensitivity exam (5.48± 7.7 deg2 vs 12.6±16.2 deg2; p<0.001). The correlation of FS from the 30s with FS from the separate fixation test was weaker (ρ= 0.361, p<0.001, N= 391) compared to the correlation of the FS from the 30s with the FS from the full macular sensitivity test (ρ= 0.662, p<0.001; N= 404).

Conclusions : Our data suggest that differences in static and dynamic assessment of fixation stability are not only dependent on different test durations but also on the testing protocol of a single fixation target versus fixation target plus simultaneous perimetry testing.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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