Role of Flicker Perimetry in Predicting Onset of Late-Stage Age-Related Macular Degeneration

Luu, Chi D; Dimitrov, Peter; Robman, Liubov; Varsamidis, Mary; Makeyeva, Galina; Aung, Khin Zaw; Vingrys, Algis J.; Guymer, Robyn H.

doi:10.1001/archophthalmol.2012.277

Cited by 35 publications

(66 citation statements)

References 20 publications

(17 reference statements)

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“…Examining their rate of change in sensitivity with time would allow us to differentiate those with progression from those without, as reported here and in a recent publication. 15 The test-retest reliability for static and flicker perimetry found in our study was approximately 65 dB. Thus, small changes in sensitivity should be interpreted with caution.…”

Section: Discussionsupporting

confidence: 45%

“…3,15 The sensitivity of the Medmont automated perimeter has been reported to be comparable to that of the Humphrey field analyser. 19 The M-700 is a bowl perimeter that uses lightemitting diodes (LEDs) of 565 nm wavelength.…”

Section: Perimetrymentioning

confidence: 98%

“…15 It has been suggested that retinal responses to flickering stimuli require much greater local metabolic demand compared to the responses to static stimuli. 16 In AMD, it is believed that thickening of Bruch's membrane creates a diffusion barrier between the choroid and retina, leading to a decrease in the metabolic supply to the retina.…”

mentioning

confidence: 99%

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Static and Flicker Perimetry in Age-Related Macular Degeneration

Luu

Dimitrov

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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Citation: Luu CD, Dimitrov PN, Wu Z, et al. Static and flicker perimetry in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2013;54:3560-3568. DOI:10.1167/ iovs.12-10465 PURPOSE. The relationship between clinical severity of age-related macular degeneration (AMD) and macular function has not been well established. In this study, we investigated the correlation between clinical severity and functional deficits as detected by static and flicker perimetry.METHODS. This cross-sectional study consisted of 279 AMD subjects and 24 control participants. AMD subjects were allocated into 1 of 10 AMD severity groups depending on the status of the designated study eye and the fellow eye, as assessed by color fundus photographs. Visual acuity, and static and flicker perimetry were tested on one eye during the same session. The geometric means, SDs, and percentage of abnormal eyes of static and flicker sensitivity of each AMD severity group were determined and compared. CONCLUSIONS. Static and flicker perimetry were affected similarly across the spectrum of AMD severity, and methods appeared to be valid techniques for assessing retinal sensitivity in AMD once drusen > 125 lm are present, but before the development of late AMD.

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Section: Discussionsupporting

confidence: 45%

Section: Perimetrymentioning

confidence: 98%

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Static and Flicker Perimetry in Age-Related Macular Degeneration

Luu

Dimitrov

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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“…[1][2][3][4][5][6] They have been reported to have potential prognostic value in diseases, such as age-related macular degeneration (AMD), especially before the development of vision-threatening complications or vision loss. [7][8][9][10] However, such measures are typically performed in controlled clinical or research environments using specialized equipment that can be expensive and often not portable. Advances in technology have led to the development of portable tablet devices where the resolution and luminance range of the touch-screens could allow visual function measures to be performed.…”

Section: Introductionmentioning

confidence: 99%

Measurement of Retinal Sensitivity on Tablet Devices in Age-Related Macular Degeneration

Guymer

Jung

et al. 2015

Trans. Vis. Sci. Tech.

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Purpose: We compared measurements of central retinal sensitivity on a portable, lowcost tablet device to the established method of microperimetry in age-related macular degeneration (AMD).Methods: A customized test designed to measure central retinal sensitivity (within the central 18 radius) on a tablet device was developed using an open-source platform called PsyPad. A total of 30 participants with AMD were included in this study, and all participants performed a practice test on PsyPad, followed by four tests of one eye and one test of the other eye. Participants then underwent standardized microperimetry examinations in both eyes. Results:The average test duration on PsyPad was 53.9 6 7.5 seconds, and no significant learning effect was observed over the examinations performed (P ¼ 1.000). The coefficient of repeatability of central retinal sensitivity between the first two examinations on PsyPad was 61.76 dB. The mean central retinal sensitivity was not significantly different between PsyPad (25.7 6 0.4 dB) and microperimetry (26.1 6 0.4 dB, P ¼ 0.094), and the 95% limits of agreement between the two measures were between À4.12 and 4.92 dB. Conclusions:The measurements of central retinal sensitivity can be performed effectively using a tablet device, displaying reasonably good agreement with those obtained using the established method of microperimetry.Translational Relevance: These findings highlight the potential of tablet devices as low-cost and portable tools for developing and performing visual function measures that can be easily and widely implemented.

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“…[24][25][26][27][28][29][30][31][32][33] Microperimetry has detected photoreceptor abnormalities even before GA develops, and this strategy can also predict the area where existing GA will likely progress. [34][35][36][37][38][39][40] These histopathologic, electrophysiologic, and microperimetric findings in eyes with GA, along with the early visual function deficits and symptoms observed in patients even before GA develops, 41 suggest that photoreceptor dysfunction precedes the appearance and progression of GA in some eyes. These findings would also suggest that an anatomic correlate should exist away from the margin of GA that could be visualized using SD-OCT imaging.…”

Section: Introductionmentioning

confidence: 99%

Predicting the Progression of Geographic Atrophy in Age-Related Macular Degeneration With SD-OCT En Face Imaging of the Outer Retina

Nunes¹,

Gregori²,

Yehoshua³

et al. 2013

Ophthalmic Surg Lasers Imaging Retina

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BACKGROUND AND OBJECTIVE: Spectral-domain optical coherence tomography (SD-OCT) en face imaging was used to measure the growth of geographic atrophy (GA) and identify baseline anatomic changes in the outer retina in eyes with nonexudative age-related macular degeneration (AMD). PATIENTS AND METHODS: In this prospective study, eyes were imaged using 200 × 200 and 512 × 128 A-scan raster patterns. Outer retinal anatomy was visualized using en face imaging of a 20-μm thick slab encompassing the inner segment/outer segment (IS/OS) band. RESULTS: En face SD-OCT imaging of the IS/OS region revealed a bilaterally symmetrical pattern of outer retinal disruption extending beyond the borders of GA that accurately predicted the progression of GA over 1 year in 13 of 30 eyes (43.3%). In the remaining cases, the area of disruption was much larger than the area of progression. CONCLUSION: En face imaging of the outer retina can predict the growth of GA in some eyes. Due to the bilateral symmetry of these findings, this imaging strategy may identify a genetic subset of patients in whom photoreceptor loss precedes the progression of GA. These areas with outer retinal disruption should be followed in clinical trials designed to test treatments for dry AMD. [ Ophthalmic Surg Lasers Imaging Retina. 2013;44:344–359.]

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Role of Flicker Perimetry in Predicting Onset of Late-Stage Age-Related Macular Degeneration

Abstract: Flicker sensitivity is reduced in eyes that go on to develop late AMD. The rate of change in flicker sensitivities over time was particularly useful in predicting eyes and areas within the eye that subsequently develop GA.

Cited by 35 publications

References 20 publications

Static and Flicker Perimetry in Age-Related Macular Degeneration

Static and Flicker Perimetry in Age-Related Macular Degeneration

Measurement of Retinal Sensitivity on Tablet Devices in Age-Related Macular Degeneration

Predicting the Progression of Geographic Atrophy in Age-Related Macular Degeneration With SD-OCT En Face Imaging of the Outer Retina

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