title: Threshold Amsler grid testing in diabetic retinopathy.
abstract: The Amsler grid is a suprathreshold target used to assess the central 10 degrees of the visual field; thus, it may fail to detect relative central scotomas. Low luminance conditions can be created by viewing the white grid on a black background through two cross-polarizing filters that vary light transmission and change the procedure to a threshold Amsler grid (TAG) test, thereby increasing its sensitivity. A total of 26 patients with diabetic retinopathy were tested by standard Amsler grid, TAG, and tangent screen. Four scotomas were detected by Amsler grid testing; each of these scotomas expanded in size on retesting with the TAG. TAG testing revealed 22 scotomas more than five times the number seen with conventional Amsler grid testing; tangent-screen examination confirmed 9 of these defects. In many cases, fundus photography and fluorescein angiography revealed pathology that correlated with the scotomas detected only by TAG testing. It thus appears that the TAG test is a rapid, high-yield, and sensitive means of assessing the central visual field in patients with diabetic retinopathy.
authors.affiliation: Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles.
authors.forename: K A
authors.initials: KA
authors.lastname: Wolfe
authors.forename: A A
authors.initials: AA
authors.lastname: Sadun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003119:Color Perception Tests; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012607:Scotoma / Q000175:diagnosis / Q000473:pathology; D012684:Sensory Thresholds; D014787:Vision Tests / Q000295:instrumentation*; D014792:Visual Acuity; D014794:Visual Fields