Rai Bhim B, Sabeti Faran, Carle Corinne F, Rohan Emilie M, van Kleef Josh P, Essex Rohan W, Barry Richard C, Maddess Ted
The John Curtin School of Medical Research, Australian National University, Canberra, Australia.
Department of Ophthalmology, Jigme Dorji Wangchuck National Referral Hospital, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan.
Ophthalmol Sci. 2022 Mar 18;2(2):100143. doi: 10.1016/j.xops.2022.100143. eCollection 2022 Jun.
To study the power of an 80-second multifocal pupillographic objective perimetry (mfPOP) test tailored to the ETDRS grid to diagnose age-related macular degeneration (AMD) by Age-Related Eye Disease Study (AREDS) severity grade.
Evaluation of a diagnostic technology.
We compared diagnostic power of acuity, ETDRS grid retinal thickness data, new 80-second M18 mfPOP test, and two wider-field 6-minute mfPOP tests (Macular-P131, Widefield-P129). The M18 stimuli match the size and shape of bifurcated ETDRS grid regions, allowing easy structure-function comparisons. M18, P129, and P131 stimuli test both eyes concurrently. We recruited 34 patients with early-stage AMD with a mean ± standard deviation (SD) age of 72.6 ± 7.06 years. The M18 and P129 plus P131 stimuli had 26 and 51 control participants, respectively with mean ± SD ages of 73.1 ± 8.17 years and 72.1 ± 5.83 years, respectively. Multifocal pupillographic objective perimetry testing used the Food and Drug Administration-cleared Objective FIELD Analyzer (OFA; Konan Medical USA).
Percentage area under the receiver operator characteristic curve (AUC) and Hedge's g effect size.
Acuity and OCT ETDRS grid thickness and volume produced reasonable diagnostic power (percentage AUC) for AREDS grade 4 eyes at 83.9 ± 9.98% and 90.2 ± 6.32% (mean ± standard error), respectively, but not for eyes with less severe disease. By contrast, M18 stimuli produced percentage AUCs from 72.8 ± 6.65% (AREDS grade 2) to 92.9 ± 3.93% (AREDS grade 4), and 82.9 ± 3.71% for all eyes. Hedge's g effect sizes ranged from 0.84 to 2.32 (large to huge). Percentage AUC for P131 stimuli performed similarly and for P129 performed somewhat less well.
The rapid and objective M18 test provided diagnostic power comparable with that of wider-field 6-minute mfPOP tests. Unlike acuity or OCT ETDRS grid data, OFA tests produced reasonable diagnostic power in AREDS grade 1 to 3 eyes.
研究针对糖尿病视网膜病变早期治疗研究（ETDRS）网格定制的80秒多焦点瞳孔客观视野检查（mfPOP）测试，根据年龄相关性眼病研究（AREDS）严重程度分级诊断年龄相关性黄斑变性（AMD）的效能。
诊断技术评估。
我们比较了视力、ETDRS网格视网膜厚度数据、新的80秒M18 mfPOP测试以及两种更宽视野的6分钟mfPOP测试（黄斑-P131、广角-P129）的诊断效能。M18刺激与分叉的ETDRS网格区域的大小和形状相匹配，便于进行结构-功能比较。M18、P129和P131刺激同时对双眼进行测试。我们招募了34例早期AMD患者，平均年龄±标准差为72.6±7.06岁。M18以及P129加P131刺激分别有26名和51名对照参与者，平均年龄±标准差分别为73.1±8.17岁和72.1±5.83岁。多焦点瞳孔客观视野检查使用了美国食品药品监督管理局批准的客观视野分析仪（OFA；美国科南医疗公司）。
受试者工作特征曲线下面积（AUC）百分比和赫奇斯g效应量。
视力以及光学相干断层扫描（OCT）的ETDRS网格厚度和体积对AREDS 4级眼睛产生了合理的诊断效能（AUC百分比），分别为83.9±9.98%和90.2±6.32%（平均值±标准误），但对病情较轻的眼睛则不然。相比之下，M18刺激产生的AUC百分比从72.8±6.65%（AREDS 2级）到92.9±3.93%（AREDS 4级），所有眼睛的为82.9±3.71%。赫奇斯g效应量范围为0.84至2.32（从大到巨大）。P131刺激的AUC百分比表现相似，P129的表现稍差。
快速且客观的M18测试提供的诊断效能与更宽视野的6分钟mfPOP测试相当。与视力或OCT ETDRS网格数据不同，OFA测试在AREDS 1至3级眼睛中产生了合理的诊断效能。
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