June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Reliability of Computer-Based Metamorphopsia Measurement in Macular Diseases
Author Affiliations & Notes
  • Daniela Claessens
    Gemeinschaftspraxis Lindenthal, Augenheilkunde Lindenthal, Cologne, Germany
  • Ronald V. Krüger
    app4eyes GmbH & Co. KG, Düsseldorf, Germany
  • Alexander Karl-Georg Schuster
    Eye Clinic, Johannes Gutenberg-University Mainz, Mainz, Germany
  • Bernd Kirchhof
    Eye Clinic, University of Cologne, Cologne, Germany
  • Footnotes
    Commercial Relationships   Daniela Claessens, app4eyes GmbH & Co. KG (C), app4eyes GmbH & Co. KG (P); Ronald Krüger, app4eyes GmbH & Co. KG (F), app4eyes GmbH & Co. KG (P); Alexander Schuster, None; Bernd Kirchhof, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1803. doi:
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    • Get Citation

      Daniela Claessens, Ronald V. Krüger, Alexander Karl-Georg Schuster, Bernd Kirchhof; Reliability of Computer-Based Metamorphopsia Measurement in Macular Diseases. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1803.

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

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Purpose : The reliability of metamorphopsia measurement using a PC-based measuring method was determined in patients with macular diseases in this clinical observational study.

Methods : In patients with macular pathology metamorphopsia was quantified employing the software AMD - A Metamorphopsia Detector®: magnitude, eccentricity and area of visual distortion give a Metamorphopsia Index (MI). Patients were recruited in a private practice from May 2016 to August 2016. Metamorphopsia measurements of 36 eyes with macular diseases (36 patients, 15 women and 21 men, 19 right and 17 left eyes) were included in the study. The average age was 70.5 ± 11.6 years. All participants signed informed consent according to the declaration of Helsinki prior to the study. In cases with bilateral maculopathy, the included eye was randomly selected using a computer generated sequence. Inclusion criterion was macular disease documented by spectral domain optical coherence tomography, exclusion criterion was best corrected visual acuity < 20/200. Metamorphopsia was measured twice one hour apart with appropriate correction. To determine the agreement of two repeated measurements the intraclass correlation coefficient (ICC) was calculated as a reliability measure. Bland-Altman diagrams were prepared to exemplify systematic bias.

Results : Diagnoses were intermediate age related macular degeneration (AMD) in 7, late AMD in 15, diseases of the vitreoretinal interface in 4 and macular edema due to various causes in 10 eyes. The geometric average and median of BCVA was 20/30. The intraclass correlation coefficient ICC for the Metamorphopsia Index MI was 0.97 (95%, KI 0.93; 0.98), p<0.001. For the parameter magnitude d an ICC of 0.95 was found (95%, KI 0.91; 0.98), p<0.001. For the parameter eccentricity ε an ICC of 0.96 (95%, KI 0.92; 0.98), p<0.001 was calculated. For the parameter area A the ICC was 0.95 (95%, KI 0.90; 0.97), p<0.001.

Conclusions : In this study the metamorphopsia measurement with AMD - A Metamorphopsia Detector® showed reproducible metamorphopsia measurements in patients with maculopathies with high reliability and therefore represents a supplement for screening and monitoring of this patient-relevant endpoint in clinical routine as well as in clinical studies.

This is a 2020 ARVO Annual Meeting abstract.


Bland-Altman Diagram of MI

Bland-Altman Diagram of MI


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