June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
An Optimized, Patient-Customized Grid Maximizes Microperimetry Readouts in Geographic Atrophy: Evaluation of Average Threshold Test-Retest Reliability
Author Affiliations & Notes
  • Masara Issa
    Allegan, an AbbVie Company, Irvine, California, United States
  • Amber Lewis
    Allegan, an AbbVie Company, Irvine, California, United States
  • Kameran Lashkari
    Advanced Eye Centers Inc, North Dartmouth, Massachusetts, United States
    University of Massachusetts Dartmouth, Dartmouth, Massachusetts, United States
  • Karl Csaky
    Retina Foundation of the Southwest, Dallas, Texas, United States
  • Francisco J. Lopez
    Allegan, an AbbVie Company, Irvine, California, United States
  • Footnotes
    Commercial Relationships   Masara Issa AbbVie Inc, Code E (Employment); Amber Lewis AbbVie Inc, Code E (Employment); Kameran Lashkari Allergan, an AbbVie company, Code C (Consultant/Contractor); Karl Csaky Allergan (an AbbVie company), Genentech/Roche, Heidelberg Engineering, Johnson & Johnson, Merck & Co., Inc., NGM Biopharmaceuticals, Novartis, Retrotope, Allexion, Code C (Consultant/Contractor), Allergan (an AbbVIe company), NGM Biopharmaceuticals, IVERIC, Allexion, Genentech, Gyroscope, Code F (Financial Support); Francisco J. Lopez AbbVie Inc, Code E (Employment)
  • Footnotes
    Support  Study funded by AbbVie
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4544 – F0458. doi:
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      Masara Issa, Amber Lewis, Kameran Lashkari, Karl Csaky, Francisco J. Lopez; An Optimized, Patient-Customized Grid Maximizes Microperimetry Readouts in Geographic Atrophy: Evaluation of Average Threshold Test-Retest Reliability. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4544 – F0458.

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

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Purpose : Microperimetry is a useful assessment to evaluate visual function across the macula in detail. In geographic atrophy (GA), test points that fall within scotomas provide limited information. This study evaluates the feasibility and test-retest reliability of scotopic and mesopic microperimetry in patients with GA, using an optimized patient-customized grid.

Methods : This is a prospective pilot study conducted at 2 sites in the United States. At each of the 4 study visits (Baseline, Day 7, Months 3 and 6), scotopic then mesopic microperimetry were performed using an S-MAIA (CenterVue, Padova, Italy). Customized grids were generated by a reading center. Nine points were placed on the subject’s preferred retinal locus and ~50 equidistantly spaced points were distributed in two concentric rings 200 and 450 μm from the lesion border. Test-retest reliability of average threshold sensitivities was assessed by evaluating data from the Baseline (test) and Day 7 (re-test) visits. Spearman correlations and Bland-Altman plots were used to evaluate association and equivalency between measurements, respectively. The coefficient of repeatability (CR) was also computed with 95% confidence intervals (CI) to quantify the smallest real difference between test and re-test. Values presented are means ± standard error of the mean unless otherwise stated. Statistical analysis was conducted using R Software (v4.1.2) under RStudio.

Results : Eleven subjects were enrolled (82% female). Median age was 80 years (range 63-91). GA lesion area was 19.8±1.5 mm2, and mean best-corrected visual acuity was 56.5±5.3 letters. The average threshold sensitivity for each visit was: 7.3±2.2, 6.9±2.4, 5.4±2.5, and 5.2±1.9 dB for scotopic; 11.6±1.7, 12.1±1.7, 11.0±2.1, and 10.3±1.9 dB for mesopic conditions. In general, scotopic microperimetry was less reliable than mesopic (lower Spearman correlation and wider Bland-Altman limits of agreement). Similarly, average threshold sensitivity CRs were 13.6 dB for scotopic and 2.9 dB for mesopic, 95% CI [0, 17.2] and [0.1, 3.1].

Conclusions : This study demonstrates that patient-customized grids in GA offer a feasible and reliable way to conduct microperimetry in large scale clinical trials, particularly with mesopic microperimetry. Analysis of individual point sensitivity “by zone” and its reliability is currently ongoing.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.


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