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Updated: Jun 28, 2026
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Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition
Published on: July 21, 2020
Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated
Renu V Jivrajka1, Janet K Kim, Wolfgang Fink
1VMR Institute, 7677 Center Avenue, Suite 400, Huntington Beach, CA 92647, USA.
Summary
Specialized Amsler grid testing detected visual field abnormalities in 16% of patients missed by standard methods. Low contrast revealed larger defects in diabetic macular edema and age-related macular degeneration, aiding diagnosis.
Area of Science:
- Ophthalmology
- Medical Imaging
- Visual Science
Background:
- Standard Amsler grid testing has limitations in detecting subtle central visual field (CVF) abnormalities.
- Diabetic macular edema (DME) and exudative age-related macular degeneration (AMD) are leading causes of vision loss.
- Early detection and monitoring of CVF deficits are crucial for managing these conditions.
Purpose of the Study:
- To evaluate the efficacy of specialized Amsler grid testing, including contrast sensitivity, for detecting previously unidentified CVF abnormalities.
- To characterize distinct patterns of CVF deficits in DME and AMD using advanced Amsler grid methods.
- To assess the potential of these methods for quantitative disease assessment and monitoring.
Main Methods:
- 3D computer-automated threshold Amsler grid testing (3D-CTAG) was employed in one eye of 37 patients (16 with DME, 21 with AMD).
- Testing was conducted across five contrast levels to assess CVF sensitivity.
- Data analysis focused on detecting abnormalities, quantifying defect characteristics, and comparing results between DME and AMD groups.
Main Results:
- 3D-CTAG identified CVF abnormalities in 16% of patients who had normal results with conventional Amsler grids.
- DME patients exhibited a higher number of CVF deficits (3.56 defects/eye) compared to AMD patients (1.24 defects/eye).
- Low contrast significantly increased CVF deficit surface area in both DME (295%) and AMD (150%), with distinct abnormality shapes (inverted cone for DME, cylindrical for AMD).
Conclusions:
- 3D-CTAG is a valuable tool for detecting subtle CVF deficits missed by standard methods, particularly under low-contrast conditions.
- Distinct 3D-CTAG profiles for DME and AMD allow for diagnostic discrimination.
- This quantitative method can serve as a sensitive measure of disease severity and a valuable outcome measure for therapeutic interventions.
