Test-Retest Reliability of Scotopic and Mesopic Fundus-Controlled Perimetry Using a Modified MAIA (Macular Integrity Assessment) in Normal Eyes

Abstract

Purpose: To assess the intrasession test-retest reliability of scotopic cyan and scotopic red fundus-controlled perimetry (FCP) in normal subjects using a modified MAIA “microperimeter” (macular integrity assessment) device. Methods: Forty-seven normal eyes of 30 subjects (aged 33.8 years) underwent duplicate mesopic (achromatic stimuli, 400-800 nm), scotopic cyan (505 nm), and scotopic red (627 nm) FCP, using a grid of 49 stimuli over 14° of the central retina. Test-retest reliability for pointwise sensitivity (PWS), stability of fixation, reaction time and test duration were analyzed using mixed-effects models. Results: PWS test-retest reliability was good among all 3 types of retinal sensitivity assessments (coefficient of repeatability of 4.75 dB for mesopic, 5.26 dB for scotopic cyan, and 4.06 dB for scotopic red testing). While the mean sensitivity decreased with eccentricity for both mesopic and scotopic red testing, it was highest at 7° eccentricity for the scotopic cyan assessment (p < 0.001). Conclusions: The modified MAIA device allows for reliable scotopic FCP in normal subjects. Our findings suggest that testing of scotopic cyan sensitivity largely reflects rod function.

Visual field indices and patterns of visual field deficits in mesopic and dark-adapted two-colour fundus-controlled perimetry in macular diseases

“…Especially in dark-adapted cyan testing, the variability-weighted indices (that represent maximum-likelihood estimators by taking into account the variability of each test location in normal eyes) performed slightly better than the non-weighted indices with regard to reproducibility. This is most likely attributable to the uneven variability across the visual field for dark-adapted cyan testing 10. In the setting of glaucoma and standard automated perimetry, an increase of the retest variability (short-term fluctuation) for test points with low sensitivity has been observed, suggesting that imperfect reproducibility of threshold determinations is representative of disease severity 24.…”

“…A dataset of 47 normal eyes of 30 subjects (age 42.7±21.08 years, range 12.8-80.1, 14 females) with duplicate mesopic, dark-adapted cyan and dark-adapted red FCP was used as normative data 10. The hierarchical nature of the data (stimulus position nested in eye nested in patient) was taken into account using mixed-effects models to obtain the normative data.…”

“…normal ). A cyan–red difference close to 0 dB would be indicative of normal rod function, whereas more negative values would indicate rod dysfunction 10. The dashed lines indicate the 95% CI of the retinotopic normative cyan–red difference.…”

“…Recently, the S-MAIA (Scotopic Macular Integrity Assessment, CenterVue, Padova, Italy) device has become available that allows for dark-adapted two-colour fundus-controlled perimetry (FCP) even in patients without foveal fixation through simultaneous confocal scanning laser ophthalmoscopy combined with eye tracking 10–12. For the interpretation of dark-adapted two-colour FCP data, the normal data must be considered 10. Briefly, with the current stimulus luminance settings of the S-MAIA device, a cyan–red difference close to 0 dB (as observed at eccentricities of 5° and 7° in fully dark-adapted normal eyes) would be indicative of normal rod function 10.…”

“…For the interpretation of dark-adapted two-colour FCP data, the normal data must be considered 10. Briefly, with the current stimulus luminance settings of the S-MAIA device, a cyan–red difference close to 0 dB (as observed at eccentricities of 5° and 7° in fully dark-adapted normal eyes) would be indicative of normal rod function 10. Isolated rod dysfunction would result in a decrease of the cyan sensitivity.…”