title: Performance of the Moorfields motion displacement test for identifying eyes with glaucoma.
abstract: OBJECTIVE
  The Moorfields Motion Displacement Test (MMDT; Enhanced Standard Threshold Algorithm [ESTA] version 1, London, UK) is a new 31-point suprathreshold test for visual field assessment using moving line stimuli displayed on a standard laptop computer. This study evaluated the diagnostic performance of the MMDT for discriminating between healthy eyes and eyes with glaucoma.
  
  
  METHODS
  Evaluation of diagnostic technology.
  
  
  METHODS
  Seventy-eight subjects with glaucoma and 348 healthy subjects.
  
  
  METHODS
  All participants underwent a standardized ophthalmologic examination, including the MMDT and Heidelberg Retina Tomography (HRT; Heidelberg Engineering, Heidelberg, Germany) scanning of the optic disc. The diagnosis of glaucoma was based on clinical examination with glaucomatous optic neuropathy defined by the presence of neuroretinal rim thinning, notching or excavation of the cup, cup-to-disc asymmetry between eyes of 0.25 or more, nerve fiber layer thinning (focal or diffuse), or a combination thereof; and HRT-based Moorfields Regression Analysis (MRA) results of outside normal limits in any sector. Normal eyes were defined as clinically having healthy neuroretinal rims and an MRA analysis of within normal limits in all sectors. The MMDT used a Pandora response version of the ESTA without optical correction. Subjects with a false-positive response of 15% or more in MMDT were excluded.
  
  
  METHODS
  The performance of the global probability of true damage (global PTD) for diagnosing glaucoma was assessed by sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The global PTD was calculated as a sum of individual PTD values, ranging from 0% to 100% for all 31 visual locations, and was expressed as a quotient of 100.
  
  
  RESULTS
  Seventy-eight subjects with glaucoma (mean age, 66.6±13.1 years; male gender, 55.1%) and 348 healthy subjects (mean age, 55.2±9.2 years; male gender, 35.3%) were analyzed. The AUC for the global PTD was 0.930 (95% confidence interval, 0.893-0.967) for diagnosing glaucoma. At 85% specificity, the MMDT demonstrated a sensitivity of 88.5%. This decreased to 83.3% at 95% specificity. At the global PTD cutoff point value of 2.0, the sensitivity was 85.9% and the specificity was 94.5%.
  
  
  CONCLUSIONS
  The suprathreshold MMDT showed good diagnostic performance for diagnosing glaucoma when glaucoma was defined by a structural criterion.
authors.affiliation: Singapore National Eye Center and Singapore Eye Research Institute, Singapore, Republic of Singapore.
authors.forename: Ee-Lin
authors.initials: EL
authors.lastname: Ong
authors.affiliation: Singapore National Eye Center and Singapore Eye Research Institute, Singapore, Republic of Singapore.
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Singapore National Eye Center and Singapore Eye Research Institute, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.affiliation: Singapore National Eye Center and Singapore Eye Research Institute, Singapore, Republic of Singapore.
authors.forename: Licia
authors.initials: L
authors.lastname: Tan
authors.affiliation: Singapore National Eye Center and Singapore Eye Research Institute, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Republic of Singapore; Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore, Republic of Singapore.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: Singapore National Eye Center and Singapore Eye Research Institute, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
authors.forename: Tien-Yin
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore National Eye Center and Singapore Eye Research Institute, Singapore, Republic of Singapore. Electronic address: aliciaclaire@yahoo.com.
authors.forename: Alicia
authors.initials: A
authors.lastname: How
mesh_terms: D000368:Aged; D005189:False Positive Reactions; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis*; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D009887:Ophthalmoscopy; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology; D012680:Sensitivity and Specificity; D014786:Vision Disorders / Q000175:diagnosis*; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields