The Asia-Pacific Journal of Ophthalmology

Asia-Pacific Journal of Ophthalmology:

Issue 1, January/February 2017 Review Article

The Use of Microperimetry to Detect Functional Progression in Non-Neovascular Age-Related Macular Degeneration: A Systematic Review

Wong, Evan N.; Chew, Avenell L.; Morgan, William H.; Patel, Praveen J.; Chen, Fred K.



Author Information


From the *Centre for Ophthalmology and Visual Science (Lions Eye Instiute), University  of Western Australia; †Department of Ophthalmology, Sir Charles Gairdner Hospital;  ‡Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia; §NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust;  and ¶UCL Institute of Ophthalmology, London, UK.

 

Reprints: Fred K. Chen, MBBS (Hons), PhD, FRANZCO Lions Eye Institute, 2 Verdun   Street, Nedlands, WA, 6009, Australia. E-mail: fredchen@lei.org.au.

 


Abstract


We reviewed the current literature on the ability of micro-perimetry to detect non-neovascular age-related macular degeneration (AMD) disease progression. The index test was retinal sensitivity mea-surement assessed by microperimetry and comparators were other func-tional measures (best-corrected and low-luminance visual acuities, and fixation stability) and structural parameters [retinal thickness, choroidal thickness, and area of geographic atrophy (GA) determined by color fun-dus photographs, short-wave or near-infrared fundus autofluorescence]. The reference standard was area of GA. The literature search was con-ducted in January 2016 and included MEDLINE, EMBASE, the Cochrane Library, Biosis, Science Citation Index, ProQuest Health and Medicine, CINAHL, and Highwire Press. We included 6 studies that enrolled 41 eyes with intermediate AMD (from a single study) and 80 eyes with GA secondary to AMD. Retinal sensitivity measured by microperimetry was the only functional measure that consistently detected progression in each cohort. Insufficient reported data precluded meta-analysis. Various micro-perimetry parameters were used to assess cohort-level change in retinal sensitivity, but the methods of analysis have yet to mature in complexity in comparison with established glaucoma field progression analysis. Micro-perimetry-assessed retinal sensitivity measurement may be more sensitive in detecting progression than other functional measures in non-neovascu-lar AMD. However, the lack of standardized testing protocol and methods of progression analysis hindered comparison. Harmonization of testing protocol and development of more robust methods of analyzing raw mi-croperimetric data will facilitate clinical implementation of this valuable retinal assessment tool.



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