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TOWARD EARLIER DETECTION OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO AGE-RELATED MACULAR DEGENERATION: Multicenter Evaluation of a Preferential Hyperacuity Perimeter Designed as a Home Device

Loewenstein, Anat MD*; Ferencz, Joseph R MD; Lang, Yaron MD; Yeshurun, Itamar MD§; Pollack, Ayala MD; Siegal, Ruth MD**; Lifshitz, Tova MD††; Karp, Joseph MD‡‡; Roth, Daniel MD§§; Bronner, Guri MD¶¶; Brown, Justin MD***; Mansour, Sam MD†††; Friedman, Scott MD‡‡‡; Michels, Mark MD§§§; Johnston, Richards MD¶¶¶; Rapp, Moshe PhD****; Havilio, Moshe PhD****; Rafaeli, Omer MD****; Manor, Yair PhD****

doi: 10.1097/IAE.0b013e3181d1a75e
Original Article

Purpose: The primary purpose of this study was to evaluate the ability of a home device preferential hyperacuity perimeter to discriminate between patients with choroidal neovascularization (CNV) and intermediate age-related macular degeneration (AMD), and the secondary purpose was to investigate the dependence of sensitivity on lesion characteristics.

Methods: All participants were tested with the home device in an unsupervised mode. The first part of this work was retrospective using tests performed by patients with intermediate AMD and newly diagnosed CNV. In the second part, the classifier was prospectively challenged with tests performed by patients with intermediate AMD and newly diagnosed CNV. The dependence of sensitivity on lesion characteristics was estimated with tests performed by patients with CNV of both parts.

Results: In 66 eyes with CNV and 65 eyes with intermediate AMD, both sensitivity and specificity were 0.85. In the retrospective part (34 CNV and 43 intermediate AMD), sensitivity and specificity were 0.85 ± 0.12 (95% confidence interval) and 0.84 ± 0.11 (95% confidence interval), respectively. In the prospective part (32 CNV and 22 intermediate AMD), sensitivity and specificity were 0.84 ± 0.13 (95% confidence interval) and 0.86 ± 0.14 (95% confidence interval), respectively. Chi-square analysis showed no dependence of sensitivity on type (P = 0.44), location (P = 0.243), or size (P = 0.73) of the CNV lesions.

Conclusion: A home device preferential hyperacuity perimeter has good sensitivity and specificity in discriminating between patients with newly diagnosed CNV and intermediate AMD. Sensitivity is not dependent on lesion characteristics.

A home device preferential hyperacuity perimeter has good sensitivity and specificity in discriminating between patients with newly diagnosed CNV and intermediate AMD. Sensitivity is not dependent on lesion characteristics.

From the the †Meir Medical Center, Kfar Saba, Israel; ‡HaEmek Medical Center, Afula, Israel; §Wolfson Medical Center, Holon, Israel; ¶Kaplan Medical Center, Rehovot, Israel; **Rabin Medical Center, Petah Tikvah, Israel; ††Soroka Medical Center, Beer Sheba, Israel; ‡‡Machon Mor, Ramat Gan, Israel; §§Retina-Vitreous Center, Toms River, New Jersey; ¶¶Foxman Foxman & Margolis, Retinal and Ophthalmic Consultants, Northfield, New Jersey; ***Charlotte Eye Ear Nose & Throat Associates, Charlotte, North Carolina; †††Virginia Retina Center, Leesburg, Virginia; ‡‡‡Central Florida Retina Institute, Lakeland, Florida; §§§Retina Care Specialists, Palm Beach Gardens, Florida; ¶¶¶Edina Retina Consultants, Edina, Minnesota; and ****Notal Vision, Ltd, Tel Aviv, Israel.

Anat Loewenstein, MD, is a consultant to Notal Vision, Ltd., which developed the technology.

Reprint requests: Anat Loewenstein, MD, Department of Ophthalmology, Tel-Aviv Medical Center, 6 Weitzmann Street, Tel Aviv 64239, Israel; e-mail: anatlow@tasmc.health.gov.il

© The Ophthalmic Communications Society, Inc.