Preferential Hyperacuity Perimeter (PreView PHP) for detecting choroidal neovascularization study.
OBJECTIVE
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.


METHODS
Prospective, comparative, concurrent, nonrandomized, multicenter study.


METHODS
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.


METHODS
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.
Alster
Yair
Y
Clin Reg Consulting Services Inc., Irvine, California, USA.
Bressler
Neil M
NM
Bressler
Susan B
SB
Brimacombe
Judith A
JA
Crompton
R Michael
RM
Duh
Yi-Jing
YJ
Gabel
Veit-Peter
VP
Heier
Jeffrey S
JS
Ip
Michael S
MS
Loewenstein
Anat
A
Packo
Kirk H
KH
Stur
Michael
M
Toaff
Techiya
T
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010781:Photography / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014792:Visual Acuity; D058609:Visual Field Tests / Q000379:methods*