June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
MACUSTAR cross-sectional data: Repeatability and discriminatory power of visual function tests
Author Affiliations & Notes
  • Hannah M P Dunbar
    Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Charlotte Behning
    Institute of Biomedical Statistics, Computer Science and Epidemiology, Bonn, Germany
  • Deanna J Taylor
    City University of London, London, London, United Kingdom
  • Bethany Elora Higgins
    City University of London, London, London, United Kingdom
  • Giovanni Montesano
    City University of London, London, London, United Kingdom
  • Alison Binns
    City University of London, London, London, United Kingdom
  • Jan Henrik Terheyden
    Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
  • Amina Abdirahman
    Institute of Ophthalmology, University College London, London, London, United Kingdom
  • Nadia Zakaria
    Novartis Institute for Biomedical Research, Massachusetts, United States
  • Stephen Poor
    Novartis Institute for Biomedical Research, Massachusetts, United States
  • Gary S Rubin
    Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Matthias Schmid
    Institute of Biomedical Statistics, Computer Science and Epidemiology, Bonn, Germany
  • David P. Crabb
    City University of London, London, London, United Kingdom
  • Ulrich F O Luhmann
    Roche Pharma Research and Early Development, F. Hoffmann-La Roche Ltd, Basel, Switzerland
  • Footnotes
    Commercial Relationships   Hannah Dunbar, Boehringer Ingelheim (C); Charlotte Behning, None; Deanna Taylor, None; Bethany Higgins, None; Giovanni Montesano, None; Alison Binns, None; Jan Terheyden, Carl Zeiss MedicTec (F), CenterVue (F), Heidelberg Engineering (F), Optos (F); Amina Abdirahman, None; Nadia Zakaria, Novartis Institute for Biomedical Research (E); Stephen Poor, Novartis Institute for Biomedical Research (E); Gary Rubin, None; Matthias Schmid, None; David P. Crabb, None; Ulrich Luhmann, F. Hoffmann-La Roche Ltd (E)
  • Footnotes
    Support  Innovative Medicines Initiative 2 Joint Undertaking 439 under grant agreement No 116076. This Joint Undertaking receives support from the 440 European Union’s Horizon 2020 research and innovation programme and EFPIA.
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 302. doi:
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      Hannah M P Dunbar, Charlotte Behning, Deanna J Taylor, Bethany Elora Higgins, Giovanni Montesano, Alison Binns, Jan Henrik Terheyden, Amina Abdirahman, Nadia Zakaria, Stephen Poor, Gary S Rubin, Matthias Schmid, David P. Crabb, Ulrich F O Luhmann; MACUSTAR cross-sectional data: Repeatability and discriminatory power of visual function tests. Invest. Ophthalmol. Vis. Sci. 2021;62(8):302.

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

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Abstract

Purpose : To examine the repeatability of a visual function (VF) test battery and its power to discriminate between structurally defined age-related macular degeneration (AMD) stages.

Methods : Subjects with no AMD and Beckman defined early(e), intermediate(i) and late(l) AMD were recruited across 18 European study sites. All subjects performed a VF battery at day 0 and 14 ± 7 comprising chart-based [Best-Corrected Visual Acuity (BCVA), Low Luminance Visual Acuity (LLVA), Moorfields Acuity Test (MAT), Pelli Robson Contrast Sensitivity (CS) and International Reading Speed Test (IReST); and novel tests [Mesopic (MesAT) and Scotopic (ScoAT) average thresholds by S-MAIA microperimetry and AdaptDx Rod Intercept Time (RIT)]. Repeatability of all measures was assessed by Intraclass Correlation Coefficients (ICC). Discriminant ability to distinguish between those with and without AMD and between neighbouring disease severity states was evaluated using Receiver Operator Characteristic (ROC) analyses, reporting Area Under the Curve (AUC) and partial (pAUC) at 80% specificity. Here we report the ability to distinguish between no AMD and iAMD.

Results : 301 subjects were recruited. 290 completed both visits [eAMD (n=28), iAMD (n = 167), lAMD (n=41) and no AMD (n=54)]. The cohort was roughly 2/3rd female (62.1%) with a mean age of 71. Repeatability was higher for chart-based than novel tests, with chart-based ICCs ranging from 0.88 (CS) to 0.96 (BCVA), whereas novel test ICCs ranged between 0.27 (RIT) and 0.93 (ScoAT) when all cases were considered and 0.73 (RIT) and 0.93 (ScoAT) when 3 extrapolated RIT values were removed. Discriminatory power of chart-based tests between no AMD and iAMD was moderate with AUCs of between 0.57 (IReST, pAUC = 0.04) and 0.77 (CS, pAUC = 0.08). Considering novel tests, discriminatory ability of microperimetry between no AMD and iAMD was moderate, and higher for scotopic testing (MesAT: AUC = 0.67; pAUC = 0.05; ScoAT: AUC = 0.70; pAUC = 0.06), whereas RIT values were slightly better, particularly when pAUCs were considered (RIT: AUC = 0.71; pAUC = 0.09).

Conclusions : Though CS, MesAT, ScoAT and RIT demonstrate moderate discriminatory power between no AMD and iAMD, a sizable proportion of iAMD subjects had normal VF. Given the substantial phenotypic variation in structurally defined iAMD, subgroup analyses are required to identify those with poorest VF and potential structural correlates.

This is a 2021 ARVO Annual Meeting abstract.

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