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Biomarker-Specific Test-Retest Repeatabilities of Microperimetry in Neovascular Age-Related Macular Degeneration
Laetitia Hinterhuber1,2, Klaudia Birner1, Johannes Schrittwieser1
1Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Purpose:
To evaluate the biomarker-specific intradevice and interdevice repeatability of microperimetry (MP) examinations in patients with neovascular age-related macular degeneration (nAMD).
Design:
Cross-sectional study.
Subjects:
Twenty eyes of 20 individuals with nAMD.
Methods:
Patients underwent 2 consecutive MP assessments on the MP-3 (photopic) and Macular Integrity Assessment ([MAIA], mesopic), each in a randomized sequence. The pointwise sensitivity values were obtained using a 45-stimuli grid and were coregistered with the OCT volumes. Intraretinal fluid (IRF), subretinal fluid, and pigment epithelium detachment (PED) were quantified with deep learning, whereas subretinal hyperreflective material (SHRM) and ellipsoid zone (EZ) loss were manually annotated. Intradevice repeatability was assessed using Bland-Altman plots, coefficient of repeatability (CoR) and intraclass correlation coefficient. Differences in fixation stability and examination time were calculated using mixed-effect models.
Main Outcome Measures:
Intradevice and interdevice repeatability and impact of OCT biomarkers on repeatability.
Results:
Analysis of a total of 3600 stimuli points revealed a CoR of ±6.37 decibel and ±5.68 for MP-3 and MAIA, respectively. Presence of OCT biomarkers had a significant impact on repeatability in the MP-3 for IRF (P < 0.0001), SHRM (P = 0.015), and EZ loss (P < 0.0001). Statistically significant results were obtained in the MAIA for IRF (P < 0.0001), PED (P < 0.0001), SHRM (P = 0.0005), and EZ loss (P < 0.0001). Intraclass correlation coefficients revealed excellent intradevice repeatability and good interdevice repeatability, ranging from 0.83 [95% confidence interval [CI]: 0.60-0.91] to 0.94 [95% CI: 0.93-0.94].
Conclusions:
OCT biomarkers IRF, SHRM, and EZ loss significantly impacted repeatability under photopic and mesopic testing conditions with the MAIA also revealing a statistically significant association for PED. These findings demonstrate the viability of the MP devices to detect functional variability associated with nAMD biomarkers. Repeatability between consecutive MP tests in 2 commonly used MP devices showed good-to-excellent metrics in nAMD, which further supports the use of MP as a viable outcome measure in clinical trials and practice.
Financial Disclosures:
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
