Resurrection of the Amsler chart in macular diseases

Abstract

Objectives To assess the validity of the Amsler chart as a screening test for the detection of macular diseases and to test its reliability in the follow-up of patients with macular diseases compared with other confirmatory investigative methods such as fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Background The Amsler chart provides a convenient method to detect and monitor macular diseases on the basis of a grid pattern that allows both scotomas (detected by missing or blurred lines) and metamorphopsia (bowed or distorted lines) to be detected. Since its discovery, the Amsler grid has become important in the evaluation of the central 20° of the visual field surrounding the fixation. Methods A total of 50 eyes of 50 patients with different types of macular diseases were tested by the Amsler chart and compared with other diagnostic investigations (fundus fluorescein angiography and optical coherence tomography) in each patient. These patients were followed at 1, 3, and 6 months by BCVA, the Amsler chart, and other investigations. Results Fifty patients (50 eyes) were analyzed statistically. The sensitivity of detection of macular disease by the Amsler grid was 88% (95% confidence interval: 77.9-97.6%). There was substantial agreement between the results of the Amsler grid and those of other investigations on the follow-up evaluation. Conclusion The Amsler chart is an accurate test in detecting macular disease, and if used properly, it could be effective in the early detection of macular diseases. The Amsler chart could be used for the follow-up of patients suffering from macular diseases with high reliability.