Abstract
Purpose :
Visual acuity (VA) is the most common quantitative parameter for vision loss in age-related macular degeneration (AMD). However, only central retinal function is quantified with VA. Meanwhile, microperimetry (MP) examinations offer a comprehensive assessment of retinal function, particularly for macular diseases involving non-foveal areas. We propose a prospective analysis for inter- and intra-device test-retest repeatability of point-wise sensitivity (PWS) on two commercially available MP devices in early to advanced AMD stages.
Methods :
Individuals with AMD were included and stratified by clinical disease stage. Subjects received two successive MP examinations on both MP3 (Nidek Co, Gamagori, Japan) and MAIA (CenterVue, Padova, Italy). The sequence in which the devices were acquired was randomized. Reliability was assessed using interclass correlations (ICCs), whereas coefficients of repeatability at a 95% level (CoR95) were used to determine the absolute repeatability. A linear mixed model estimated the impact of diagnosis, age, stimulus eccentricity and device on retinal PWS.
Results :
10,800 stimuli from four repeated MP assessments in 60 patients with AMD were acquired. For each disease stage (intermediate AMD, neovascular AMD and geographic atrophy (GA)), 20 patients were collected. Mean (SD) PWS was 26.23(3.2), 23.11(6.43) and 21.11(7.46)dB for MP3 and 22.63(3.44), 20.4(5.88) and 17.84 (6.99)dB for MAIA in iAMD, nAMD and GA, respectively. Intermediate AMD presented the best repeatability (CoR95 ±4.6dB, MP3; ±5.2dB, MAIA) followed by nAMD (CoR95 ±6.6dB, MP3; ±5.7dB, MAIA) and GA (CoR95 ±7.2dB, MP3; ±6.4dB, MAIA). Significant ICCs were found between every measurement (all p<0.001) and the mean [95%CI] inter- and intra-device correlation was excellent for iAMD (0.75 [0.71-0.78], nAMD (0.77 [0.75-0.8]) and GA (0.81[0.78-0.83]). Inter-device difference (-0.34, p<0.001), stimulus eccentricity (-0.13, p<0.001) and the interaction diagnosis*eccentricity (iAMD/GA: 0.79, p<0.001; iAMD/nAMD: 0.44, p<0.001) had a significant impact on PWS.
Conclusions :
Repeatability of MP was better in patients with higher mean retinal sensitivity. Functional monitoring of advanced AMD patients using microperimetry alone might be prone to error. A correlation with structural disease-specific biomarkers on a multimodal approach could help to increase reliability.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.