June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Reliability of a Novel Computer-Based Metamorphopsia Categorization Tool
Author Affiliations & Notes
  • Ronald V. Krüger
    app4eyes GmbH & Co. KG, Duesseldorf, NRW, Germany
  • Daniela Claessens
    app4eyes GmbH & Co. KG, Duesseldorf, NRW, Germany
  • Footnotes
    Commercial Relationships   Ronald Krüger, app4eyes GmbH & Co. KG (I), app4eyes GmbH & Co. KG (C); Daniela Claessens, app4eyes GmbH & Co. KG (I), app4eyes GmbH & Co. KG (C)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5067. doi:
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    • Get Citation

      Ronald V. Krüger, Daniela Claessens; Reliability of a Novel Computer-Based Metamorphopsia Categorization Tool. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5067.

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

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Purpose : Metamorphopsia categorization using the App MacuFix® was compared to metamorphopsia measurement with AMD - A Metamorphopsia Detector® in this clinical observational study.

Methods : The study included 71 eyes of 39 women and 32 men. The average age was 71± 10 years. Inclusion criterion was metamorphopsia (M+) and macular pathology documented by spectral domain optical coherence tomography in at least 1 eye. Exclusion criterion was BCVA < 20/200. All patients performed Amsler grid, Metamorphopsia categorization with the App MacuFix® and metamorphopsia measurement with the software AMD - A Metamorphopsia Detector®. MacuFix displays 4 x 4° grids with distorted lines, one standing out due to stronger distortions. The patient monocularly selects in > 10 scenes with varying distortion differences the grid he perceives most distorted. An algorithm determines the smallest detectable distortion difference categorized as MacuFix Class (MC).
AMD - A Metamorphopsia Detector® delivers a Metamorphopsia Index (MI) consisting of magnitude, eccentricity and area of metamorphopsia. To assess the reliability the intraclass correlation coefficient (ICC) was calculated. All participants signed informed consent according to the declaration of Helsinki prior to the study

Results : 42 eyes had metamorphopsia (M+) when tested with the Amsler grid, 29 did not. During examination with AMD - A Metamorphopsia Detector® 4 eyes reported M+ exclusively inside, 12 eyes only outside, 24 eyes inside and outside of 4°, 31 eyes had a MI of 0. Diagnoses were early age related macular degeneration (AMD) in 8, intermediate AMD in 24, late AMD in 8, diseases of the vitreoretinal interface in 13, non-AMD macular edema in 8, 10 eyes had no macular pathology. The geometric average and median of best corrected visual acuity was 20/40. MC mean test time per eye was 91 sec.
Intraclass correlation coefficient of MI and MC was excellent for eyes with M+ in the central 4° degrees only (ICC 0.98 (confidence interval CI 0.65; 1,0; p< 0.01), moderate regarding all eyes (ICC 0.67 (CI 0.47; 0.79; p< 0.01) and eyes with M+ inside and outside of 4°(0.64 (CI 0.17; 0.85; p< 0.01) and low for eyes with M+ exclusively outside of 4°(ICC 0.22 (CI 1.71; 0.78; p= 0.34).

Conclusions : Reliability of Macufix was excellent when metamorphopsia exist exclusively inside the central visual field of 4° and moderate when metamorphopsia were additionally present outside of 4°.

This is a 2020 ARVO Annual Meeting abstract.


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