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Test-Retest Repeatability of a Novel Photopic Microperimetry Approach in Patients with Geographic Atrophy
Neha R Tandon1, Eric Vasquez1, Karl G Csaky1
1Retina Foundation of the Southwest, Dallas, Texas.
Ophthalmology Science
|July 12, 2026
Summary
Focal photopic microperimetry demonstrates high test-retest repeatability for assessing central vision in geographic atrophy (GA) patients. This method offers a sensitive, patient-centered outcome for age-related macular degeneration research.
Area of Science:
- Ophthalmology
- Visual Neuroscience
- Medical Imaging
Background:
- Geographic atrophy (GA) is a leading cause of irreversible vision loss in age-related macular degeneration (AMD).
- Accurate assessment of central visual function is crucial for monitoring GA progression and evaluating treatment efficacy.
- Current microperimetry techniques may have limitations in precisely measuring subtle changes in the foveal region.
Purpose of the Study:
- To evaluate the test-retest repeatability of a novel focal photopic microperimetry approach targeting the central 1 mm of the fovea.
- To explore the relationships between this microperimetry measure and geographic atrophy (GA) lesion area.
- To investigate correlations with other established visual function metrics.
Main Methods:
- A prospective, single-arm, observational study involving 12 participants (17 eyes) with nonsubfoveal GA.
- Focal photopic tests were performed using a 45-loci grid (0.5° spacing, Goldmann II stimuli) on the Nidek MP-3 device.
- Test-retest repeatability was assessed by performing two tests within 4 weeks, analyzing mean sensitivity (MS) and point-wise sensitivity (PWS) using CoR and ICC.
Main Results:
- The focal photopic microperimetry showed excellent test-retest repeatability for MS (CoR=2.42 dB, ICC=0.98) and PWS (CoR=8.2 dB, ICC=0.89).
- Excluding the floor effect improved MS repeatability to 2.03 dB and PWS to 7.06 dB.
- Adjusted MS showed a significant correlation with low-luminance visual acuity (LLVA) and low-luminance quick contrast sensitivity function (qCSF), but weak correlation with GA lesion size and no correlation with BCVA.
Conclusions:
- Focal photopic microperimetry provides a highly repeatable measure of central cone-mediated function in patients with nonsubfoveal GA.
- Mean sensitivity is a robust, clinically relevant endpoint for longitudinal and interventional studies in AMD.
- This technique offers a sensitive, patient-centered outcome, potentially revealing visual impairment not captured by conventional measures.
