Abstract
PurposeTo test the effect of different dark adaptation conditions and reliability indices on the variability of two color scotopic microperimetry.MethodsWe analyzed data from 22 consecutive visually healthy adults. Scotopic microperimetry was performed (Macular Integrity Assessment microperimeter, CenterVue, Padua, Italy) with two wavelength stimuli, cyan (505 nm) and red (627 nm), after a dark adaptation time of 10, 20, or 30 minutes. All tests were repeated twice to measure test–retest variability with Bland–Altman plots. We also provide a method to more accurately quantify the false-positive (FP) responses based on response data (button pressing) from the device, similar to FP responses used in standard static perimetry. Data on fixation stability (95% bivariate contour ellipse area) and blind spot responses were also extracted. Their relationship with measured sensitivity (in decibels) and test–retest variability was quantified through linear mixed effect models.ResultsDark adaptation had a significant effect on the sensitivity (dB) measured with the cyan stimulus (P < 0.001), but no effect on the red stimulus. Of the three metrics, the novel FP responses showed the best association with test–retest variability and was the only predictor consistently significant for all tests (P < 0.01).ConclusionsDark adaptation protocols should be carefully standardized for scotopic testing, especially if a cyan stimulus is used. The proposed FP responses should be used to assess reliability of microperimetry examinations instead of other metrics.Translational RelevanceWe developed a method to calculate a more accurate estimate of the FP responses using data available to all researchers, generalizable to all Macular Integrity Assessment microperimeter tests.
Highlights
In recent years, perimetric tests have been acknowledged to be a useful tool for investigating macular disorders such as age-related macular degeneration (AMD)
Dark adaptation had a significant effect on the sensitivity measured with the cyan stimulus (P < 0.001), but no effect on the red stimulus
Dark adaptation protocols should be carefully standardized for scotopic testing, especially if a cyan stimulus is used
Summary
Perimetric tests have been acknowledged to be a useful tool for investigating macular disorders such as age-related macular degeneration (AMD). People with macular damage may not be able to reliably fixate on a central target throughout a test,[1] a requirement in standard automated perimetry. This factor could limit the spatial accuracy and reliability of the test. The MAIA uses a mesopic background (1.27 cd/m2) and tests the retinal sensitivity through the presentation of white stimuli (Goldmann III size).[6] People with early and intermediate AMD report worse visual function under dimly lit conditions. Scotopic-based investigation of visual function is pertinent in AMD research.[7,8] A modified version of the MAIA, the Scotopic MAIA (S-MAIA, CentreVue), allows for the
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