Toward earlier detection of choroidal neovascularization secondary to age-related macular degeneration: multicenter evaluation of a preferential hyperacuity perimeter designed as a home device.
OBJECTIVE
The primary purpose of this study was to evaluate the ability of a home device preferential hyperacuity perimeter to discriminate between patients with choroidal neovascularization (CNV) and intermediate age-related macular degeneration (AMD), and the secondary purpose was to investigate the dependence of sensitivity on lesion characteristics.


METHODS
All participants were tested with the home device in an unsupervised mode. The first part of this work was retrospective using tests performed by patients with intermediate AMD and newly diagnosed CNV. In the second part, the classifier was prospectively challenged with tests performed by patients with intermediate AMD and newly diagnosed CNV. The dependence of sensitivity on lesion characteristics was estimated with tests performed by patients with CNV of both parts.


RESULTS
In 66 eyes with CNV and 65 eyes with intermediate AMD, both sensitivity and specificity were 0.85. In the retrospective part (34 CNV and 43 intermediate AMD), sensitivity and specificity were 0.85 +/- 0.12 (95% confidence interval) and 0.84 +/- 0.11 (95% confidence interval), respectively. In the prospective part (32 CNV and 22 intermediate AMD), sensitivity and specificity were 0.84 +/- 0.13 (95% confidence interval) and 0.86 +/- 0.14 (95% confidence interval), respectively. Chi-square analysis showed no dependence of sensitivity on type (P = 0.44), location (P = 0.243), or size (P = 0.73) of the CNV lesions.


CONCLUSIONS
A home device preferential hyperacuity perimeter has good sensitivity and specificity in discriminating between patients with newly diagnosed CNV and intermediate AMD. Sensitivity is not dependent on lesion characteristics.
Meir Medical Center, Kfar Saba, Israel. anatlow@tasmc.health.gov.il
Anat
A
Loewenstein
Joseph R
JR
Ferencz
Yaron
Y
Lang
Itamar
I
Yeshurun
Ayala
A
Pollack
Ruth
R
Siegal
Tova
T
Lifshitz
Joseph
J
Karp
Daniel
D
Roth
Guri
G
Bronner
Justin
J
Brown
Sam
S
Mansour
Scott
S
Friedman
Mark
M
Michels
Richards
R
Johnston
Moshe
M
Rapp
Moshe
M
Havilio
Omer
O
Rafaeli
Yair
Y
Manor
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000209:etiology; D042241:Early Diagnosis; D004867:Equipment Design; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012648:Self Care / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D014792:Visual Acuity; D058609:Visual Field Tests / Q000295:instrumentation*