June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Diagnostic power of rapid ETDRS-grid matched objective perimetry in early- to late-stage AMD
Author Affiliations & Notes
  • Ted Maddess
    John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
  • Bhim Bahadur Rai
    John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
  • Corinne Carle
    John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
  • Emilie Rohan
    John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
  • Joshua van Kleef
    John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
  • Rohan W Essex
    Ophthalmology, Canberra Hosptial, Canberra, Australian Capital Territory, Australia
  • Faran Sabeti
    Optometry and Vision Science, University of Canberra, Canberra, Australian Capital Territory, Australia
    John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia
  • Footnotes
    Commercial Relationships   Ted Maddess, EyeCo (I), Konan Medical USA (F), Konan Medical USA (P); Bhim Rai, None; Corinne Carle, Konan Medical USA (F), Konan Medical USA (P); Emilie Rohan, None; Joshua van Kleef, Konan Medical USA (F); Rohan Essex, None; Faran Sabeti, Konan Medical USA (F)
  • Footnotes
    Support  Rebecca L Cooper Foundation
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 316. doi:
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      Ted Maddess, Bhim Bahadur Rai, Corinne Carle, Emilie Rohan, Joshua van Kleef, Rohan W Essex, Faran Sabeti; Diagnostic power of rapid ETDRS-grid matched objective perimetry in early- to late-stage AMD. Invest. Ophthalmol. Vis. Sci. 2021;62(8):316.

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

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Abstract

Purpose : To examine the diagnostic power of a new version of multifocal pupillographic objective perimetry. The new test has 18 test-regions per eye, which match the ETDRS retinal thickness grid used in OCTs, and tests both eyes concurrently in 80-seconds.

Methods : We recruited 34 AMD patients and 26 normal control subjects, mean ages (±SD) of 72.6 ± 7.06 and 73.1 ± 8.17 years respectively. Among our 68 patient eyes the distribution of eyes per AREDS step was: AREDS1: 28, AREDS2: 18, AREDS3: 13 and AREDS4: 9. The 9 AREDS4 eyes were all neovascular-AMD. Given that the severity was often different between eyes the Receiver Operator Characteristic plot analysis was done by eye rather than by subject. We also estimated Effect-sizes as Hedge’s g. The new M18 test matches the pattern of the of the ETDRS grid with two stimuli that bi-sect each grid sector. The 18 stimuli/eye thus assess the central 6 mm (20 deg). We used an FD-cleared prototype of the Konan Objectified Analyser (OFA). Both eyes are tested concurrently in 80 s. We obtained % Areas under the Curve (%AUC) for ROC plots for diagnosis of AREDS group vs. controls. Separate %AUCs were calculated for the mean of the worst 3, and the worst 9, per-region response delays. %AUCs are also done for Best Corrected Visual Acuity (BCVA).

Results : BCVA showed no diagnostic power for AREDS1 and 2 (Table 1), whereas M18 per-region delays provide values in the range of 72.8 ± 6.65 to 84.3 ± 4.21 (mean ± SE) (Table 2). AREDS3 and 4 were diagnosed at 86.8 ± 5.33 to 92.9 ± 3.93. Effect-sizes (right two columns of Table 2) up to 2.48 were found.

Conclusions : The M18 test provided superior %AUC performance compared to BCVA. Reasonable diagnostic power was found, even for AREDS 1. M18 stimuli are easily compared with retinal thickness data obtained for the ETDRS grid pattern given that pairs of M18 stimuli exactly match each of the ETDRS grid regions popular with OCT manufacturers, thus allowing simple structure-function comparisons.

This is a 2021 ARVO Annual Meeting abstract.

 

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