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Published on: January 29, 2020
Microperimetry as an Outcome Measure in Choroideremia Trials: Reproducibility and Beyond
Purpose:
To determine test-retest repeatability of microperimetry testing (MP) in choroideremia (CHM) subjects using standard and personalized stimulus grids.
Methods:
Fifteen CHM subjects (28 eyes) underwent consecutive repeat examinations with the Macular Integrity Assessment (MAIA) microperimeter using a standard (10°) and a customized macular grid adapted to individual macular pathology. Repeatability of standard-grid mean (MS) and point-wise (PWS) sensitivity was determined and compared with age-matched controls (seven eyes), with PWS separately analyzed for loci within and outside the border of degeneration. Interpolated volumetric indices were used to estimate repeatability of customized grids and compare their performance to standard grids.
Results:
Test-retest measures of standard-grid MS yielded higher coefficients of variation (CV) in CHM subjects compared with controls (0.09 vs. 0.02). Volumetric indices from customized grids improved repeatability by driving CV values to 0.05 and close to 0.02 for region-of-interest (ROI) analysis. Variability of PWS was significantly higher in CHM, especially at the border of degeneration (10.68 vs. 4.74 dB at the central retina, P < 0.001).
Conclusions:
Microperimetry testing in CHM shows high test-retest variation at the border of degeneration, which influences repeatability of MS measures. Volumetric measures from customized grids can improve reliability of both global and regional sensitivity assessment. Nevertheless, inherent test-retest variation of individual points needs to be taken into account when assessing potential functional decline and/or disease progression.
Insights
Microperimetry testing in choroideremia (CHM) shows high variability, especially at disease borders. Customized grids improve repeatability, but individual point variation must be considered for monitoring disease progression.
Area of Science:
- Ophthalmology
- Visual Electrophysiology
- Retinal Imaging
Background:
- Choroideremia (CHM) is a rare X-linked genetic disorder causing progressive vision loss.
- Accurate assessment of visual function is crucial for monitoring disease progression in CHM patients.
- Microperimetry (MP) is a key functional test, but its test-retest reliability in CHM needs further investigation.
Purpose of the Study:
- To evaluate the test-retest repeatability of microperimetry (MP) in choroideremia (CHM) subjects.
- To compare the performance of standard versus personalized stimulus grids for MP testing in CHM.
- To assess the impact of stimulus grid customization on the reliability of sensitivity measurements.
Main Methods:
- Fifteen CHM subjects (28 eyes) underwent repeated MP testing using the Macular Integrity Assessment (MAIA) microperimeter.
- Both a standard 10° grid and a customized grid, adapted to individual macular pathology, were utilized.
- Point-wise sensitivity (PWS) and mean sensitivity (MS) were analyzed, with PWS assessed within and outside areas of degeneration. Interpolated volumetric indices were used for customized grids.
Main Results:
- Standard-grid MP testing showed higher coefficients of variation (CV) in CHM subjects (0.09) compared to controls (0.02).
- Customized grids, particularly with volumetric indices, improved repeatability (CV of 0.05 for global, 0.02 for regional analysis).
- Point-wise sensitivity (PWS) variability was significantly higher in CHM, especially at the border of degeneration (10.68 dB vs. 4.74 dB).
Conclusions:
- Microperimetry in CHM exhibits significant test-retest variability, particularly at the border of degeneration, impacting MS repeatability.
- Customized stimulus grids and volumetric measures enhance the reliability of both global and regional sensitivity assessments in CHM.
- The inherent test-retest variation of individual points necessitates careful consideration when evaluating functional decline and disease progression in CHM.
