Rafael Malach


PURPOSE. Most patients with neovascular AMD are detected at a stage where the lesion is subfoveal, large and considerable visual loss has already occurred. A method is critically needed that can serve as a home monitoring device for the detection of CNV at an earlier stage . The aim of this study was to compare between the Macular Computerized Psychophysical Test (MCPT), a novel self-monitoring home-use method for assessing the macular visual field and the Amsler grid in a group of patients with neovascular AMD. The MCPT method takes advantage of the rapid evolvement of hyper-acuity processes compared to the slower development (>1-2 seconds) of filling-in phenomena. Thus, through rapid presentation, the extreme sensitivity of hyper-acuity can be fully manifested by the patients before the masking effects of filling-in are expressed.

METHOD. Thirty-nine patients with Choroidal Neovascularization (CNV) secondary to AMD underwent complete eye examination. Only patients with visual acuity equal or better then 20/200 were included. Of these, 23 were with subfoveal CNV and 16 were with non-subfoveal CNV (either juxta or extra fovea). The average visual acuity in the subfoveal group was 20/80 compared to 20/32 in the non-subfoveal group. The MCPT was performed on a PC screen and operated by the patients trained briefly in its use. In the MCPT a virtual line composed of dots was flashed across different macular loci to a perifoveal radius of 70. All patients underwent supervised Amsler grid

RESULTS. Of the subfoveal group 22 (95%) were positive on the MCPT compared to 10 (43%) on the Amsler grid, and of the non-subfoveal group 14 (87%) were positive on the MCPT compared to 2 (13%) on the Amsler grid. Of the non-subfoveal patients 10 were asymptomatic at the time of diagnosis and the CNV was an accidental finding. Of these only one (10%) was negative on the MCPT.

CONCLUSIONS. The MCPT detects AMD related CNV considerably better than the Amsler grid at both subfoveal and extra/juxta foveal location, while visual acuity is still preserved. The MCPT promises to be a reliable and feasible method, holding great potential for early self-detection of AMD-related macular lesions.


Year: 2001

Program Number: 3:20 pm

Author Affiliation: Dep. of Neurobiology, Weizmann Institute

Co-Authors: Yuval Yassur, Ayala Polack, Michaela Goldstein, Amira Springer, Omer Refaeli, Yair Alster, Isaac Avni, Amir Buckelman

Co-Author Affiliation: n/a

Room: Room103