title: Preferential Hyperacuity Perimeter (PreView PHP) for detecting choroidal neovascularization study.
abstract: 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.
authors.affiliation: Clin Reg Consulting Services Inc., Irvine, California, USA.
authors.forename: Yair
authors.initials: Y
authors.lastname: Alster
authors.forename: Neil M
authors.initials: NM
authors.lastname: Bressler
authors.forename: Susan B
authors.initials: SB
authors.lastname: Bressler
authors.forename: Judith A
authors.initials: JA
authors.lastname: Brimacombe
authors.forename: R Michael
authors.initials: RM
authors.lastname: Crompton
authors.forename: Yi-Jing
authors.initials: YJ
authors.lastname: Duh
authors.forename: Veit-Peter
authors.initials: VP
authors.lastname: Gabel
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Heier
authors.forename: Michael S
authors.initials: MS
authors.lastname: Ip
authors.forename: Anat
authors.initials: A
authors.lastname: Loewenstein
authors.forename: Kirk H
authors.initials: KH
authors.lastname: Packo
authors.forename: Michael
authors.initials: M
authors.lastname: Stur
authors.forename: Techiya
authors.initials: T
authors.lastname: Toaff
mesh_terms: 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*