Comparison of the original Amsler grid with the preferential hyperacuity perimeter for detecting choroidal neovascularization in age-related macular degeneration

Abstract

The preferential hyperacuity perimeter has greater sensitivity than the Amsler grid in the detection of choroidal neovascularization among patients over 50 years of age and is a promising method for monitoring patients with age-related macular degeneration. Although the original Amsler grid is less sensitive, it is a portable method, not expensive, accessible and presents reasonable sensitivity and high specificity in the diagnosis of choroidal neovascularization. Its use can be recommended for self-monitoring in patients with age-related macular degeneration as an alternative to preferential hyperacuity perimeter and when this method is not available.

Randomized Trial of a Home Monitoring System for Early Detection of Choroidal Neovascularization Home Monitoring of the Eye (HOME) Study

“…20,21 Other studies of preferential hyperacuity perimetry have compared this technique directly with that of the Amsler grid, noting increased sensitivity of the preferential hyperacuity perimetry for detecting CNV development. 22 In other studies, the utility of the preferential hyperacuity perimetry for following the course of CNV was tested in the outpatient offices. 23 , 24 However, none of these studies were longitudinal or evaluated in randomized controlled trials, making the results of our study unique.…”

Environmental Amsler test as a monitoring tool for retreatment with ranibizumab for neovascular age-related macular degeneration

“…A comparison of the PHP to the original Amsler grid showed that although the former had greater sensitivity than the Amsler grid in the detection of NV AMD, no difference in the specificity and accuracy of the two methods were observed in the diagnosis of NVAMD. 10 Environmental Amsler is more practical and acceptable to patients. These functional vision tests include checking reading ability, monitoring straight edges for signs of distortion, overall image clarity, and colour intensity.…”

Functional and Morphologic Benefits in Early Detection of Neovascular Age-Related Macular Degeneration Using the Preferential Hyperacuity Perimeter

“…4 In a further study of 179 participants who were assigned to 5 groups based on ocular 3 While a series of small studies from a variety of investigators support the findings of superior sensitivity of the PHP in the detection of nvAMD and other conditions with exudative manifestations when compared with the Amsler, most have not found improved specificity for the former when compared with the latter. [8][9][10] It is worth noting that all the studies undertaken to date including those by the PHP users group have used a cross-sectional design to determine whether the distortion maps reflect the severity and type of macular disease. [2][3][4][8][9][10] On the contrary, the present study was linked to an ongoing clinical trial where patients were being monitored for progression to late AMD.…”

“…[8][9][10] It is worth noting that all the studies undertaken to date including those by the PHP users group have used a cross-sectional design to determine whether the distortion maps reflect the severity and type of macular disease. [2][3][4][8][9][10] On the contrary, the present study was linked to an ongoing clinical trial where patients were being monitored for progression to late AMD. Thus, we exploited the longitudinal follow-up design in an opportunistic manner to determine whether PHP could unmask functional deficits before the onset of symptoms.…”