Test-Retest-Reliability of Computer-Based Metamorphopsia Measurement in Macular Diseases

Abstract

In this study, the test-retest-reliability as one aspect of reliability of metamorphopsia measurements using a computer-based measuring method was determined in patients with macular diseases. Metamorphopsia amplitude, position, and area were quantified using AMD – A Metamorphopsia Detector software (app4eyes GmbH & Co. KG, Germany) in patients with diabetic, myopic, or uveitic macular edema, intermediate or neovascular age-associated macular degeneration, epiretinal membrane, vitelliform maculopathy, Irvine-Gass syndrome, or macular edema due to venous retinal occlusion. The intraclass correlation coefficient (ICC) was calculated in order to determine the repeatability of two repeated measurements and was used as an indicator of the reliability of the measurements. In this study, metamorphopsia measurements were conducted on 36 eyes with macular diseases. Metamorphopsia measurements made using AMD – A Metamorphopsia Detector software were highly reliable and repeatable in patients with maculopathies. The intraclass correlation coefficient of all indices was excellent (0.95 – 0.97). For diseases of the vitreoretinal interface or macular diseases with intra- or subretinal edema, this metamorphopsia measurement represents a supplement for visual function testing in the clinic, as well as in clinical studies.

Key words

metamorphopsia - quantitative metamorphopsia measurement - reliability - repeatability - Information Technology - test-retest-reliability

Publication History

Received: 21 June 2020

Accepted: 31 August 2020

Article published online:
07 December 2020

• References/Literatur

• 1 Amsler M. Quantitative and qualitative vision. Trans Ophthalmol Soc U K 1949; 69: 397-410
• 2 Förster R. Metamorphopsie. Ein Symptom partieller Schrumpfung der Retina (Retinitis circumscripta). Ophthalmologische Beiträge 1862; 162: 1-59
• 3 Kitahara S. Über klinische Beobachtungen bei der in Japan häufig vorkommenden Chorioretinitis centralis serosa. Klin Monbl Augenheilkd 1936; 97: 345-362
• 4 Wiecek E, Lashkari K, Dakin SC. et al. Novel quantitative assessment of metamorphopsia in maculopathy. Invest Ophthalmol Vis Sci 2014; 56: 494-504 doi:10.1167/iovs.14-15394
• 5 Watanabe A, Arimoto S, Nishi O. Correlation between metamorphopsia and epiretinal membrane optical coherence tomography findings. Ophthalmology 2009; 116: 1788-1793 doi:10.1016/j.ophtha.2009.04.046
• 6 Okamoto F, Sugiura Y, Okamoto Y. et al. Associations between metamorphopsia and foveal microstructure in patients with epiretinal membrane. Invest Ophthalmol Vis Sci 2012; 53: 6770-6775 doi:10.1167/iovs.12-9683
• 7 Bringmann A. WP. Involvement of Müller glial cells in epiretinal membrane formation. Graefes Arch Clin Exp Ophthalmol 2009; 247: 865-883 doi:10.1007/s00417-009-1082-x
• 8 Ugarte M, Shunmugam M, Laidlaw DA. et al. Morphision: a method for subjective evaluation of metamorphopsia in patients with unilateral macular pathology (i.e., full thickness macular hole and epiretinal membrane). Indian J Ophthalmol 2013; 61: 653-658 doi:10.4103/0301-4738.117804
• 9 Midena E, Vujosevic S. Metamorphopsia: An Overlooked Visual Symptom. Ophthalmic Res 2015; 55: 26-36 doi:10.1159/000441033
• 10 Bouwens MD, Van Meurs JC. Sine Amsler Charts: a new method for the follow-up of metamorphopsia in patients undergoing macular pucker surgery. Graefes Arch Clin Exp Ophthalmol 2003; 241: 89-93 doi:10.1007/s00417-002-0613-5
• 11 Amsler M. Earliest symptoms of diseases of the macula. Br J Ophthalmol 1953; 37: 521-537
• 12 Crossland M, Rubin G. The Amsler chart: absence of evidence is not evidence of absence. Br J Ophthalmol 2009; 91: 391-393
• 13 Schuchard RA. Validity and interpretation of Amsler grid reports. Arch Ophthalmol 1993; 111: 776-780
• 14 Klatt C, Bunse A, Roider J. Erste klinische Erfahrungen mit PreView PHP (Zeiss) zur Quantifizierung von Metamorphopsien bei Erkrankungen der Makula. Klin Monbl Augenheilkd 2004; 221: V49 doi:10.1055/s-2004-828760
• 15 Chew EY, Clemons TE, Bressler SB. et al. Randomized trial of a home monitoring system for early detection of choroidal neovascularization home monitoring of the Eye (HOME) study. Ophthalmology 2014; 121: 535-544 doi:10.1016/j.ophtha.2013.10.027
• 16 Schmid MK, Thiel MA, Lienhard K. et al. Reliability and diagnostic performance of a novel mobile app for hyperacuity self-monitoring in patients with age-related macular degeneration. Eye (Lond) 2019; 33: 1584-1589 doi:10.1038/s41433-019-0455-6
• 17 Wang YZ, Wilson E, Locke KG. et al. Shape discrimination in age-related macular degeneration. Invest Ophthalmol Vis Sci 2002; 43: 2055-2062
• 18 Rajeev N, Tan E, Liyana R. et al. Shape discrimination thresholds among subjects with emmetropia and corrected myopia. Clin Exp Optom 2015; 98: 353-358 doi:10.1111/cxo.12249
• 19 Pitrelli Vazquez N, Harding SP, Heimann H. et al. Radial shape discrimination testing for new-onset neovascular age-related macular degeneration in at-risk eyes. PLoS One 2018; 13: e0207342 doi:10.1371/journal.pone.0207342
• 20 Loewenstein A, Ferencz JR, Lang Y. et al. Toward earlier detection of choroidal neovascularization secondary to age-related macular degeneration: multicenter evaluation of a preferential hyperacuity perimeter designed as a home device. Retina 2010; 30: 1058-1064 doi:10.1097/IAE.0b013e3181d1a75e
• 21 Claessens D, Schuster AK. Korrelation der quantitativen Metamorphopsiemessung und der zentralen Netzhautdicke bei diabetischem Makulaödem und altersassoziierter exsudativer Makuladegeneration. Klin Monbl Augenheilkd 2019; 236: 877-884 doi:10.1055/s-0043-125080
• 22 Claessens D, Krüger R. AMD – A Metamorphopsia Detector. Invest Ophthalmol Vis Sci 2015; 56: 4109
• 23 Claessens D, Krüger R. Three dimensions of quantitative metamorphopsia measurement – do disease specific patterns exist?. Denver: ARVO; 2017. Accessed May 8, 2017 at: https://iovs.arvojournals.org/article.aspx?articleid=2637206
• 24 Claessens D. Dynamics of metamorphopsia characteristics during progression from intermediate to advanced age-related macular degeneration Open Access. Invest Ophthalmol Vis Sci 2018; 59: 2375
• 25 Claessens D, Schuster AK. Longitudinal analysis of metamorphopsia measurement and its relation to change in drusen size and volume in intermediate age-related macular degeneration open access. Invest Ophthalmol Vis Sci 2019; 60: 3474
• 26 Krüger R, Claessens D. Metamorphopsia measurement with AMD – A Metamorphopsia Detector^® as a patient reported outcome (PRO). Invest Ophthalmol Vis Sci 2017; 58: 1522
• 27 Claessens D. Pro AMD Patient reported outcome documented by AMD – A Metamorphopsia Detector^® . Invest Ophthalmol Vis Sci 2016; 57: 31
• 28 DOG. Leitlinie 21: Altersabhängige Makuladegeneration AMD. 2015 Accessed October 2, 2020 at: https://augeninfo.de/leit/leit21.pdf
• 29 Wirtz M, Caspar F. Beurteilerübereinstimmung und Beurteilerreliabilität. Göttingen: Hogrefe; 2002
• 30 Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15: 155-163 doi:10.1016/j.jcm.2016.02.012
• 31 Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979; 86: 420-428
• 32 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-310
• 33 Bach M, Kommerell G. Sehschärfebestimmung nach Europäischer Norm, Wissenschaftliche Grundlagen und Möglichkeiten der automatischen Messung. Klin Monbl Augenheilkd 1998; 212: 190-195
• 34 Ku JY, Milling AF, Pitrelli Vazquez N. et al. Performance, usability and comparison of two versions of a new macular vision test: the handheld Radial Shape Discrimination test. PeerJ 2016; 4: e2650 doi:10.7717/peerj.2650
• 35 Arimura E, Matsumoto C, Okuyama S. et al. Quantification of metamorphopsia in a macular hole patient using M-CHARTS. Acta Ophthalmol Scand 2007; 85: 55-59 doi:10.1111/j.1600-0420.2006.00729.x
• 36 Kinoshita T, Imaizumi H, Miyamoto H. et al. Changes in metamorphopsia in daily life after successful epiretinal membrane surgery and correlation with M-CHARTS score. Clin Ophthalmol 2015; 9: 225-233 doi:10.2147/OPTH.S76847
• 37 Ho CYD, Wu Z, Turpin A. et al. A tablet-based retinal function test in neovascular age-related macular degeneration eyes and at-risk fellow eye. Transl Vis Sci Technol 2018; 7: 2 doi:10.1167/tvst.7.2.2
• 38 Coco-Martin RM, Pichel-Mouzo M, Fernandez I. et al. Reliability of colour perimetry to assess macular pigment optical density in age-related macular degeneration. Eur J Ophthalmol 2019;
• 39 Welker SG, Pfau M, Heinemann M. et al. Retest reliability of mesopic and dark-adapted microperimetry in patients with intermediate age-related macular degeneration and age-matched controls. Invest Ophthalmol Vis Sci 2018; 59: AMD152-AMD159 doi:10.1167/iovs.18-23878
• 40 Chaikitmongkol V, Nanegrungsunk O, Patikulsila D. et al. Test-retest-reliability and agreement of visual acuity using the ETDRS number chart, Landolt c chart, or ETDRS alphabet chart in eyes with or without sight-threatening diseases. JAMA Ophthalmol 2018; 136: 286-290 doi:10.1001/jamaophthalmol.2017.6290
• 41 Patel PJ, Chen FK, Rubin GS. et al. Intersession test-retest-reliability of visual acuity scores in age-related macular degeneration. Invest Ophthalmol Vis Sci 2008; 49: 4347-4352 doi:10.1167/iovs.08-1935
• 42 Aslam T, Mahmood S, Balaskas K. et al. Test-retest-reliability of visual function measures in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2014; 252: 201-206 doi:10.1007/s00417-013-2421-5
• 43 Amsler M. Die Untersuchung des qualitativen Sehens mit dem quadratischen Netz. Anweisung zum Gebrauch der Testtafeln. London: Theodore Hamblin LTD; 1958
• 44 Wall M, Sadun AA. Threshold Amsler grid testing. Cross-polarizing lenses enhance yield. Arch Ophthalmol 1986; 104: 520-523
• 45 Matsumoto C, Arimura E, Okuyama S. et al. Quantification of metamorphopsia in patients with epiretinal membranes. Invest Ophthalmol Vis Sci 2003; 44: 4012-4016
• 46 Claessens D, Schuster AK. [Correlation of quantitative metamorphopsia measurement and central retinal thickness in diabetic macular edema and age-related exsudative macular degeneration]. Klin Monbl Augenheilkd 2019; 236: 877-884 doi:10.1055/s-0043-125080