title: The macular automated photostress test.
abstract: OBJECTIVE
  To introduce a standardized macular photostress test using an automated perimeter as a method to quantify macular disease severity and as a tool to distinguish optic neuropathy from macular pathology.
  
  
  METHODS
  Prospective interventional pilot study.
  
  
  METHODS
  Twenty-five bilaterally pseudophakic subjects aged range, 65 to 84: 15 patients with varying severity of non-neovascular age-related macular degeneration (AMD), five patients with no ocular disease, and five patients with moderate primary open-angle glaucoma (POAG). Previously reported normative values served as controls for this study. Patients underwent foveal threshold testing using the Humphrey Visual Field Perimeter Model 750 (Carl Zeiss Meditec, Inc, Dublin, California, USA). Baseline measurements were compared to threshold sensitivity after photostress at one minute and then two-minute intervals until sensitivity returned to baseline. Main outcome measures were baseline foveal threshold sensitivity, foveal threshold depression, and recovery following photostress.
  
  
  RESULTS
  Automated macular photostress testing in macular disease (AMD) causes a decrease (P < .001) in baseline foveal sensitivity and a delay (P < .001) in recovery time to baseline sensitivity. Optic nerve pathology (POAG) does not affect (P = .343) the foveal response curve.
  
  
  CONCLUSIONS
  The macular automated photostress (MAP) test is an inexpensive, noninvasive, and readily accessible adjunct for evaluating patients with macular disease. This standardized protocol is useful in objectively defining disease severity, may be used to follow response to treatment, and could aid in distinguishing optic neuropathy from macular pathology.
authors.affiliation: Barnes Retina Institute, St Louis, Missouri, USA. Mandeep.S.Dhalla@gmail.com <Mandeep.S.Dhalla@gmail.com>
authors.forename: Mandeep Singh
authors.initials: MS
authors.lastname: Dhalla
authors.forename: Aldo
authors.initials: A
authors.lastname: Fantin
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Blinder
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Bakal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D010775:Photic Stimulation; D010865:Pilot Projects; D011446:Prospective Studies; D019591:Pseudophakia / Q000150:complications; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields