TY - JOUR
T1 - Preferential Hyperacuity Perimeter (PreView PHP) for detecting choroidal neovascularization study
AU - Preferential Hyperacuity Perimetry Research Group
AU - Alster, Yair
AU - Bressler, Neil M
AU - Bressler, Susan B
AU - Brimacombe, Judith A
AU - Crompton, R Michael
AU - Duh, Yi-Jing
AU - Gabel, Veit-Peter
AU - Heier, Jeffrey S
AU - Ip, Michael S
AU - Loewenstein, Anat
AU - Packo, Kirk H
AU - Stur, Michael
AU - Toaff, Techiya
PY - 2005/10
Y1 - 2005/10
N2 - PURPOSE: To assess the ability of the Preferential Hyperacuity Perimeter (PreView PHP; Carl Zeiss Meditec, Dublin, CA) to detect recent-onset choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD) and to differentiate it from an intermediate stage of AMD.DESIGN: Prospective, comparative, concurrent, nonrandomized, multicenter study.PARTICIPANTS: Eligible participants' study eyes had a corrected visual acuity of 20/160 or better and either untreated CNV from AMD diagnosed within the last 60 days or an intermediate stage of AMD.METHODS: After obtaining consent, visual acuity with habitual correction, masked PHP testing, stereoscopic color fundus photography, and fluorescein angiography were performed. Photographs and angiograms were evaluated by graders masked to diagnosis and PHP results. The reading center's diagnosis determined if the patient was categorized as having intermediate AMD or neovascular AMD.MAIN OUTCOME MEASURES: A successful study outcome was defined a priori as a sensitivity of at least 80% and a specificity of at least 80%.RESULTS: Of 185 patients who gave consent to be enrolled, 11 (6%) had PHP results judged to be unreliable. An additional 52 were not included because they did not meet all eligibility criteria. Of the remaining 122 patients, 57 had an intermediate stage of AMD and 65 had neovascular AMD. The sensitivity to detect newly diagnosed CNV using PHP testing was 82% (95% confidence interval [CI], 70%-90%). The specificity to differentiate newly diagnosed CNV from the intermediate stage of AMD using PHP testing was 88% (95% CI, 76%-95%).CONCLUSIONS: Preferential Hyperacuity Perimeter testing can detect recent-onset CNV resulting from AMD and can differentiate it from an intermediate stage of AMD with high sensitivity and specificity. These data suggest that monitoring with PHP should detect most cases of CNV of recent onset with few false-positive results at a stage when treatment usually would be beneficial. Thus, this monitoring should be considered in the management of the intermediate stage of AMD.
AB - PURPOSE: To assess the ability of the Preferential Hyperacuity Perimeter (PreView PHP; Carl Zeiss Meditec, Dublin, CA) to detect recent-onset choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD) and to differentiate it from an intermediate stage of AMD.DESIGN: Prospective, comparative, concurrent, nonrandomized, multicenter study.PARTICIPANTS: Eligible participants' study eyes had a corrected visual acuity of 20/160 or better and either untreated CNV from AMD diagnosed within the last 60 days or an intermediate stage of AMD.METHODS: After obtaining consent, visual acuity with habitual correction, masked PHP testing, stereoscopic color fundus photography, and fluorescein angiography were performed. Photographs and angiograms were evaluated by graders masked to diagnosis and PHP results. The reading center's diagnosis determined if the patient was categorized as having intermediate AMD or neovascular AMD.MAIN OUTCOME MEASURES: A successful study outcome was defined a priori as a sensitivity of at least 80% and a specificity of at least 80%.RESULTS: Of 185 patients who gave consent to be enrolled, 11 (6%) had PHP results judged to be unreliable. An additional 52 were not included because they did not meet all eligibility criteria. Of the remaining 122 patients, 57 had an intermediate stage of AMD and 65 had neovascular AMD. The sensitivity to detect newly diagnosed CNV using PHP testing was 82% (95% confidence interval [CI], 70%-90%). The specificity to differentiate newly diagnosed CNV from the intermediate stage of AMD using PHP testing was 88% (95% CI, 76%-95%).CONCLUSIONS: Preferential Hyperacuity Perimeter testing can detect recent-onset CNV resulting from AMD and can differentiate it from an intermediate stage of AMD with high sensitivity and specificity. These data suggest that monitoring with PHP should detect most cases of CNV of recent onset with few false-positive results at a stage when treatment usually would be beneficial. Thus, this monitoring should be considered in the management of the intermediate stage of AMD.
KW - Aged
KW - Aged, 80 and over
KW - Choroidal Neovascularization/diagnosis
KW - Diagnosis, Differential
KW - False Positive Reactions
KW - Female
KW - Fluorescein Angiography
KW - Humans
KW - Macular Degeneration/complications
KW - Male
KW - Middle Aged
KW - Photography/methods
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Visual Acuity
KW - Visual Field Tests/methods
UR - http://www.scopus.com/inward/record.url?scp=25844458322&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2005.06.008
DO - 10.1016/j.ophtha.2005.06.008
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C2 - 16154198
SN - 0161-6420
VL - 112
SP - 1758
EP - 1765
JO - Ophthalmology
JF - Ophthalmology
IS - 10
ER -