The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Alfredo A Sadun - One of the best experts on this subject based on the ideXlab platform.
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PROSPECTIVE THREE-DIMENSIONAL ANALYSIS OF STRUCTURE AND FUNCTION IN VITREOMACULAR ADHESION CURED BY PHARMACOLOGIC VITREOLYSIS
2016Co-Authors: Kevin R. Tozer, Wolfgang Fink, Alfredo A SadunAbstract:Purpose: To prospectively characterize macular structure and function as assessed by combined three-dimensional spectral-domain optical coherence tomography and scanning laser ophthalmoscopy and 3D computer-automated threshold Amsler Grid, respectively, in a patient undergoing pharmacologic vitreolysis for vitreomacular adhesion with tractional cysts. Methods: Combined 3D optical coherence tomography and scanning laser ophthal-moscopy measured macular volume and 3D computer-automated threshold Amsler Grid quantified central visual field function by determining the absolute percent magnitude lost (cumulative value of total visual field loss over all tested levels) before and for a period of 6 months after pharmacologic vitreolysis for vitreomacular adhesion with a single intravitreal injection of microplasmin (125 mg; ThromboGenics). Results: Ocriplasmin pharmacologic vitreolysis released vitreomacular adhesion by 2 weeks and decreased macular volume from 0.32 mL to 0.15 mL by 1 year after injection. There was a concomitant 4-fold improvement in visual function as measured by 3D computer-automated threshold Amsler Grid (percent of central visual field lost) and Snellen visual acuity improved from 20/200 to 20/40
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First author and corresponding author:
2015Co-Authors: Alfredo A Sadun, Wolfgang Fink, Ph. DAbstract:Purpose: To introduce a novel 3D computerized threshold Amsler Grid test, developed by Fink and Sadun, that allows for a novel characterization of the structure of visual field defects in three dimensions (se
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SCOTOMAS OF AGE-RELATED MACULAR DEGENERATION DETECTED AND CHARACTERIZED BY MEANS OF A NOVEL THREE-DIMENSIONAL COMPUTER-AUTOMATED VISUAL FIELD TEST
2014Co-Authors: Paul P Nazemi, Wolfgang Fink, Jennifer I. Lim, Alfredo A SadunAbstract:Purpose: We used the recently devised three-dimensional computer-based threshold Amsler Grid test to acquire and identify typical patterns of visual field defects (scotomas) caused by age-related macular degeneration (AMD). Methods: Patients with AMD traced on a computer touch screen the borders of those areas on an Amsler Grid that were missing from their field of vision. Scotomas were repeatedly outlined and recorded at different Grid contrast levels. The resulting three-dimensional “hole ” in the central 25 ° of the visual field was further characterized by its slope, location, shape, and depth. The results were compared with fundus photographs and fluorescein angiograms. Results: Twenty-five patients and 41 eyes were examined. The three-dimensional depictions consistently demonstrated central scotomas with “scallop”-shaped borders and steplike patterns, with either steep slopes or a combination of steep and shallow slopes. The steep slopes corresponded to nonexudative AMD, while the shallow slopes indicated exudative AMD. Conclusion: The three-dimensional computer-automated threshold Amsler Grid tes
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RETINAL DISORDERS
2014Co-Authors: Renu V. Jivrajka, Alfredo A Sadun, Wolfgang Fink, Janet K. Kim, J. SebagAbstract:Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler Grid testin
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Prospective three-dimensional analysis of structure and function in vitreomacular adhesion cured by pharmacologic vitreolysis.
Retinal cases & brief reports, 2013Co-Authors: Kevin R. Tozer, Alfredo A Sadun, Wolfgang Fink, J. SebagAbstract:Purpose: To prospectively characterize macular structure and function as assessed by combined three-dimensional spectral-domain optical coherence tomography and scanning laser ophthalmoscopy and 3D computer-automated threshold Amsler Grid, respectively, in a patient undergoing pharmacologic vitreolysis for vitreomacular adhesion with tractional cysts. Methods: Combined 3D optical coherence tomography and scanning laser ophthalmoscopy measured macular volume and 3D computer-automated threshold Amsler Grid quantified central visual field function by determining the absolute percent magnitude lost (cumulative value of total visual field loss over all tested levels) before and for a period of 6 months after pharmacologic vitreolysis for vitreomacular adhesion with a single intravitreal injection of microplasmin (125 μg; ThromboGenics). Results: Ocriplasmin pharmacologic vitreolysis released vitreomacular adhesion by 2 weeks and decreased macular volume from 0.32 μL to 0.15 μL by 1 year after injection. There was a concomitant 4-fold improvement in visual function as measured by 3D computer-automated threshold Amsler Grid (percent of central visual field lost) and Snellen visual acuity improved from 20/200 to 20/40. Conclusion: For assessing macular function improvement in conjunction with structural reintegration after pharmacologic vitreolysis for vitreomacular adhesion, 3D computer-automated threshold Amsler Grid is a useful tool. Both 3D measurements quantitatively characterized the resolution of this patient's vitreomacular adhesion, suggesting that this is a useful approach to quantifying macular structure and function as indices of the severity of disease and the response to therapy.
Wolfgang Fink - One of the best experts on this subject based on the ideXlab platform.
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PROSPECTIVE THREE-DIMENSIONAL ANALYSIS OF STRUCTURE AND FUNCTION IN VITREOMACULAR ADHESION CURED BY PHARMACOLOGIC VITREOLYSIS
2016Co-Authors: Kevin R. Tozer, Wolfgang Fink, Alfredo A SadunAbstract:Purpose: To prospectively characterize macular structure and function as assessed by combined three-dimensional spectral-domain optical coherence tomography and scanning laser ophthalmoscopy and 3D computer-automated threshold Amsler Grid, respectively, in a patient undergoing pharmacologic vitreolysis for vitreomacular adhesion with tractional cysts. Methods: Combined 3D optical coherence tomography and scanning laser ophthal-moscopy measured macular volume and 3D computer-automated threshold Amsler Grid quantified central visual field function by determining the absolute percent magnitude lost (cumulative value of total visual field loss over all tested levels) before and for a period of 6 months after pharmacologic vitreolysis for vitreomacular adhesion with a single intravitreal injection of microplasmin (125 mg; ThromboGenics). Results: Ocriplasmin pharmacologic vitreolysis released vitreomacular adhesion by 2 weeks and decreased macular volume from 0.32 mL to 0.15 mL by 1 year after injection. There was a concomitant 4-fold improvement in visual function as measured by 3D computer-automated threshold Amsler Grid (percent of central visual field lost) and Snellen visual acuity improved from 20/200 to 20/40
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First author and corresponding author:
2015Co-Authors: Alfredo A Sadun, Wolfgang Fink, Ph. DAbstract:Purpose: To introduce a novel 3D computerized threshold Amsler Grid test, developed by Fink and Sadun, that allows for a novel characterization of the structure of visual field defects in three dimensions (se
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SCOTOMAS OF AGE-RELATED MACULAR DEGENERATION DETECTED AND CHARACTERIZED BY MEANS OF A NOVEL THREE-DIMENSIONAL COMPUTER-AUTOMATED VISUAL FIELD TEST
2014Co-Authors: Paul P Nazemi, Wolfgang Fink, Jennifer I. Lim, Alfredo A SadunAbstract:Purpose: We used the recently devised three-dimensional computer-based threshold Amsler Grid test to acquire and identify typical patterns of visual field defects (scotomas) caused by age-related macular degeneration (AMD). Methods: Patients with AMD traced on a computer touch screen the borders of those areas on an Amsler Grid that were missing from their field of vision. Scotomas were repeatedly outlined and recorded at different Grid contrast levels. The resulting three-dimensional “hole ” in the central 25 ° of the visual field was further characterized by its slope, location, shape, and depth. The results were compared with fundus photographs and fluorescein angiograms. Results: Twenty-five patients and 41 eyes were examined. The three-dimensional depictions consistently demonstrated central scotomas with “scallop”-shaped borders and steplike patterns, with either steep slopes or a combination of steep and shallow slopes. The steep slopes corresponded to nonexudative AMD, while the shallow slopes indicated exudative AMD. Conclusion: The three-dimensional computer-automated threshold Amsler Grid tes
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RETINAL DISORDERS
2014Co-Authors: Renu V. Jivrajka, Alfredo A Sadun, Wolfgang Fink, Janet K. Kim, J. SebagAbstract:Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler Grid testin
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Prospective three-dimensional analysis of structure and function in vitreomacular adhesion cured by pharmacologic vitreolysis.
Retinal cases & brief reports, 2013Co-Authors: Kevin R. Tozer, Alfredo A Sadun, Wolfgang Fink, J. SebagAbstract:Purpose: To prospectively characterize macular structure and function as assessed by combined three-dimensional spectral-domain optical coherence tomography and scanning laser ophthalmoscopy and 3D computer-automated threshold Amsler Grid, respectively, in a patient undergoing pharmacologic vitreolysis for vitreomacular adhesion with tractional cysts. Methods: Combined 3D optical coherence tomography and scanning laser ophthalmoscopy measured macular volume and 3D computer-automated threshold Amsler Grid quantified central visual field function by determining the absolute percent magnitude lost (cumulative value of total visual field loss over all tested levels) before and for a period of 6 months after pharmacologic vitreolysis for vitreomacular adhesion with a single intravitreal injection of microplasmin (125 μg; ThromboGenics). Results: Ocriplasmin pharmacologic vitreolysis released vitreomacular adhesion by 2 weeks and decreased macular volume from 0.32 μL to 0.15 μL by 1 year after injection. There was a concomitant 4-fold improvement in visual function as measured by 3D computer-automated threshold Amsler Grid (percent of central visual field lost) and Snellen visual acuity improved from 20/200 to 20/40. Conclusion: For assessing macular function improvement in conjunction with structural reintegration after pharmacologic vitreolysis for vitreomacular adhesion, 3D computer-automated threshold Amsler Grid is a useful tool. Both 3D measurements quantitatively characterized the resolution of this patient's vitreomacular adhesion, suggesting that this is a useful approach to quantifying macular structure and function as indices of the severity of disease and the response to therapy.
J. Sebag - One of the best experts on this subject based on the ideXlab platform.
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RETINAL DISORDERS
2014Co-Authors: Renu V. Jivrajka, Alfredo A Sadun, Wolfgang Fink, Janet K. Kim, J. SebagAbstract:Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler Grid testin
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Prospective three-dimensional analysis of structure and function in vitreomacular adhesion cured by pharmacologic vitreolysis.
Retinal cases & brief reports, 2013Co-Authors: Kevin R. Tozer, Alfredo A Sadun, Wolfgang Fink, J. SebagAbstract:Purpose: To prospectively characterize macular structure and function as assessed by combined three-dimensional spectral-domain optical coherence tomography and scanning laser ophthalmoscopy and 3D computer-automated threshold Amsler Grid, respectively, in a patient undergoing pharmacologic vitreolysis for vitreomacular adhesion with tractional cysts. Methods: Combined 3D optical coherence tomography and scanning laser ophthalmoscopy measured macular volume and 3D computer-automated threshold Amsler Grid quantified central visual field function by determining the absolute percent magnitude lost (cumulative value of total visual field loss over all tested levels) before and for a period of 6 months after pharmacologic vitreolysis for vitreomacular adhesion with a single intravitreal injection of microplasmin (125 μg; ThromboGenics). Results: Ocriplasmin pharmacologic vitreolysis released vitreomacular adhesion by 2 weeks and decreased macular volume from 0.32 μL to 0.15 μL by 1 year after injection. There was a concomitant 4-fold improvement in visual function as measured by 3D computer-automated threshold Amsler Grid (percent of central visual field lost) and Snellen visual acuity improved from 20/200 to 20/40. Conclusion: For assessing macular function improvement in conjunction with structural reintegration after pharmacologic vitreolysis for vitreomacular adhesion, 3D computer-automated threshold Amsler Grid is a useful tool. Both 3D measurements quantitatively characterized the resolution of this patient's vitreomacular adhesion, suggesting that this is a useful approach to quantifying macular structure and function as indices of the severity of disease and the response to therapy.
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distinguishing wet from dry age related macular degeneration using three dimensional computer automated threshold Amsler Grid testing
British Journal of Ophthalmology, 2011Co-Authors: Craig D. Robison, Alfredo A Sadun, Wolfgang Fink, Renu V. Jivrajka, Simon R. Bababeygy, J. SebagAbstract:Background/aims With the increased efficacy of current therapy for wet age-related macular degeneration (AMD), better ways to detect wet AMD are needed. This study was designed to test the ability of threedimensional contrast threshold Amsler Grid (3D-CTAG) testing to distinguish wet AMD from dry AMD. Methods Conventional paper Amsler Grid and 3D-CTAG tests were performed in 90 eyes: 63 with AMD (34 dry, 29 wet) and 27 controls. Qualitative comparisons were based upon the three-dimensional shapes of central visual field (VF) defects. Quantitative analyses considered the number and volume of the three-dimensional defects. Results 25/34 (74%) dry AMD and 6/29 (21%) wet AMD eyes had no distortions on paper Amsler Grid. Of these, 5/25 (20%) dry and 6/6 (100%) wet (p¼0.03) AMD eyes exhibited central VF defects with 3D-CTAG. Wet AMD displayed stepped defects in 16/28 (57%) eyes, compared with only 2/34 (6%) of dry AMD eyes (p¼0.002). All three volumetric indices of VF defects were two- to four-fold greater in wet than dry AMD (p<0.006). 3D-CTAG had 83.9% positive and 90.6% negative predictive values for wet AMD. Conclusions 3D-CTAG has a higher likelihood of detecting central VF defects than conventional Amsler Grid, especially in wet AMD. Wet AMD can be distinguished from dry AMD by qualitative and quantitative 3D-CTAG criteria. Thus, 3D-CTAG may be useful in screening for wet AMD, quantitating disease severity, and providing a quantitative outcome measure of therapy.
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Distinguishing wet from dry age-related macular degeneration using three-dimensional computer-automated threshold Amsler Grid testing
The British journal of ophthalmology, 2011Co-Authors: Craig D. Robison, Alfredo A Sadun, Wolfgang Fink, Renu V. Jivrajka, Simon R. Bababeygy, J. SebagAbstract:Background/aims With the increased efficacy of current therapy for wet age-related macular degeneration (AMD), better ways to detect wet AMD are needed. This study was designed to test the ability of threedimensional contrast threshold Amsler Grid (3D-CTAG) testing to distinguish wet AMD from dry AMD. Methods Conventional paper Amsler Grid and 3D-CTAG tests were performed in 90 eyes: 63 with AMD (34 dry, 29 wet) and 27 controls. Qualitative comparisons were based upon the three-dimensional shapes of central visual field (VF) defects. Quantitative analyses considered the number and volume of the three-dimensional defects. Results 25/34 (74%) dry AMD and 6/29 (21%) wet AMD eyes had no distortions on paper Amsler Grid. Of these, 5/25 (20%) dry and 6/6 (100%) wet (p¼0.03) AMD eyes exhibited central VF defects with 3D-CTAG. Wet AMD displayed stepped defects in 16/28 (57%) eyes, compared with only 2/34 (6%) of dry AMD eyes (p¼0.002). All three volumetric indices of VF defects were two- to four-fold greater in wet than dry AMD (p
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Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler Grid testing
Graefe's Archive for Clinical and Experimental Ophthalmology, 2009Co-Authors: Renu V. Jivrajka, Alfredo A Sadun, Wolfgang Fink, Janet K. Kim, J. SebagAbstract:Purpose To evaluate the central visual field (CVF) with specialized Amsler Grid testing methods that include contrast sensitivity evaluation, in an attempt to detect abnormalities not identified with standard methods and to define new patterns of CVF deficits in two different diseases. Methods 3D computer-automated threshold Amsler Grid testing (3D-CTAG) was performed at five levels of contrast in one eye of 37 patients with diabetic macular edema (DME, n = 16) and exudative age-related macular degeneration (AMD, n = 21). Results 3D-CTAG abnormalities were detected in six patients (16%) who had no abnormalities with conventional Amsler Grid testing. DME patients had more foci of CVF deficits (3.56 ± 2.92 defects/eye), than AMD patients (1.24 ± 0.89 defects/eye; P
Sung Chul Park - One of the best experts on this subject based on the ideXlab platform.
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assessment of patient perception of glaucomatous visual field loss and its association with disease severity using Amsler Grid
PLOS ONE, 2017Co-Authors: Kenji Fujitani, Robert Ritch, Joseph L Simonson, Jeffrey M Liebmann, Mark P Ghassibi, Sung Chul ParkAbstract:PURPOSE To investigate patients' perception of glaucomatous VF loss and its association with glaucoma severity using the Amsler Grid test. METHODS In this prospective cross-sectional study, glaucoma patients with abnormal 10-2 Humphrey Swedish Interactive Threshold Algorithm-standard VF tests were enrolled consecutively. All patients underwent a black-on-white Amsler Grid test for each eligible eye. They were asked to outline any perceived scotomas (areas with abnormal Grid lines) on the Grid and then describe verbally their perception of the scotomas. Examiners asked patients to clarify their descriptions. All descriptions used by patients were recorded in their own words, which were then sorted into descriptor categories according to similar themes. The number of descriptor categories was counted for each eye. 10-2 VF mean deviation (MD) was compared among eyes that reported different number of descriptor categories. The mean 10-2 VF MD values were compared among different descriptor categories. RESULTS Fifty glaucoma patients (88 eyes) were included. Patients used a total of 44 different descriptors for their scotomas. Patients' descriptors were classified into categories that incorporated similar themes, resulting in 4 overarching descriptor categories: Missing/White, Blurry/Gray, Black, and Not Aware. Fifty-two eyes reported one descriptor category and 19 eyes reported two descriptor categories (mean number of descriptor categories = 1.27±0.45). Eyes that reported two descriptor categories had worse VF MD than those that reported one (-17.86±10.31 dB vs. -12.08±7.53 dB; p = 0.012). When eyes were organized according to its combination of descriptor categories, each eye naturally sorted into one of the following 5 groups, in frequency order: Missing/White (27 eyes; 31%), Blurry/Gray (21 eyes; 24%), combined Missing/White and Blurry/Gray (19 eyes; 21%), Not Aware (17 eyes; 19%), and Black (4 eyes; 5%). The mean 10-2 VF MD severity order was Black (-21.18±10.59 dB), combined Missing/White and Blurry/Gray (-17.86±10.31 dB), Missing/White (-11.92±6.76 dB), Blurry/Gray (-10.55±7.03 dB), and Not Aware (-3.91±4.05 dB) (p<0.001). CONCLUSION Paracentral vision loss in glaucoma is perceived by patients. As the perception of scotomas and the variety of terms to describe scotomas are related to glaucoma severity, clinicians should pay attention to patients' subjective descriptions of their glaucomatous VF loss. The historical notion that glaucoma patients lose their peripheral vision first and eventually look through a black tunnel needs to be updated to reflect the true perception of glaucoma.
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Assessment of patient perception of glaucomatous visual field loss and its association with disease severity using Amsler Grid.
PloS one, 2017Co-Authors: Kenji Fujitani, Robert Ritch, Joseph L Simonson, Jeffrey M Liebmann, Mark P Ghassibi, Sung Chul ParkAbstract:PURPOSE To investigate patients' perception of glaucomatous VF loss and its association with glaucoma severity using the Amsler Grid test. METHODS In this prospective cross-sectional study, glaucoma patients with abnormal 10-2 Humphrey Swedish Interactive Threshold Algorithm-standard VF tests were enrolled consecutively. All patients underwent a black-on-white Amsler Grid test for each eligible eye. They were asked to outline any perceived scotomas (areas with abnormal Grid lines) on the Grid and then describe verbally their perception of the scotomas. Examiners asked patients to clarify their descriptions. All descriptions used by patients were recorded in their own words, which were then sorted into descriptor categories according to similar themes. The number of descriptor categories was counted for each eye. 10-2 VF mean deviation (MD) was compared among eyes that reported different number of descriptor categories. The mean 10-2 VF MD values were compared among different descriptor categories. RESULTS Fifty glaucoma patients (88 eyes) were included. Patients used a total of 44 different descriptors for their scotomas. Patients' descriptors were classified into categories that incorporated similar themes, resulting in 4 overarching descriptor categories: Missing/White, Blurry/Gray, Black, and Not Aware. Fifty-two eyes reported one descriptor category and 19 eyes reported two descriptor categories (mean number of descriptor categories = 1.27±0.45). Eyes that reported two descriptor categories had worse VF MD than those that reported one (-17.86±10.31 dB vs. -12.08±7.53 dB; p = 0.012). When eyes were organized according to its combination of descriptor categories, each eye naturally sorted into one of the following 5 groups, in frequency order: Missing/White (27 eyes; 31%), Blurry/Gray (21 eyes; 24%), combined Missing/White and Blurry/Gray (19 eyes; 21%), Not Aware (17 eyes; 19%), and Black (4 eyes; 5%). The mean 10-2 VF MD severity order was Black (-21.18±10.59 dB), combined Missing/White and Blurry/Gray (-17.86±10.31 dB), Missing/White (-11.92±6.76 dB), Blurry/Gray (-10.55±7.03 dB), and Not Aware (-3.91±4.05 dB) (p
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efficacy of the Amsler Grid test in evaluating glaucomatous central visual field defects
Ophthalmology, 2016Co-Authors: Daniel Su, Robert Ritch, Andrew Greenberg, Joseph L Simonson, Christopher C Teng, Jeffrey M Liebmann, Sung Chul ParkAbstract:Purpose To investigate the efficacy of the Amsler Grid test in detecting central visual field (VF) defects in glaucoma. Design Prospective, cross-sectional study. Participants Patients with glaucoma with reliable Humphrey 10-2 Swedish Interactive Threshold Algorithm standard VF on the date of enrollment or within the previous 3 months. Methods Amsler Grid tests were performed for each eye and were considered "abnormal" if there was any perceived scotoma with missing or blurry Grid lines within the central 10 degrees ("Amsler Grid scotoma"). An abnormal 10-2 VF was defined as ≥3 adjacent points at P 0.01 with at least 1 point at P 0.005 in the same hemifield on the pattern deviation plot. Sensitivity, specificity, and positive and negative predictive values of the Amsler Grid scotoma area were calculated with the 10-2 VF as the clinical reference standard. Among eyes with an abnormal 10-2 VF, regression analyses were performed between the Amsler Grid scotoma area and the 10-2 VF parameters (mean deviation [MD], scotoma extent [number of test points with P 0.01 in total deviation map] and scotoma mean depth [mean sensitivity of test points with P 0.01 in total deviation map]). Main Outcome Measures Sensitivity, specificity, and positive and negative predictive values of the Amsler Grid scotoma area. Results A total of 106 eyes (53 patients) were included (mean ± standard deviation age, 24-2 MD and 10-2 MD = 66±12 years, −9.61±8.64 decibels [dB] and −9.75±9.00 dB, respectively). Sensitivity, specificity, and positive and negative predictive values of the Amsler Grid test were 68%, 92%, 97%, and 46%, respectively. Sensitivity was 40% in eyes with 10-2 MD better than −6 dB, 58% in eyes with 10-2 MD between −12 and −6 dB, and 92% in eyes with 10-2 MD worse than −12 dB. The area under the receiver operating characteristic curve of the Amsler Grid scotoma area was 0.810 (95% confidence interval, 0.723–0.880, P 0.001). The Amsler Grid scotoma area had the strongest relationship with 10-2 MD (quadratic R 2 =0.681), followed by 10-2 scotoma extent (quadratic R 2 =0.611) and 10-2 scotoma mean depth (quadratic R 2 =0.299) (all P 0.001). Conclusions The Amsler Grid can be used to screen for moderate to severe central vision loss from glaucoma.
Renu V. Jivrajka - One of the best experts on this subject based on the ideXlab platform.
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RETINAL DISORDERS
2014Co-Authors: Renu V. Jivrajka, Alfredo A Sadun, Wolfgang Fink, Janet K. Kim, J. SebagAbstract:Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler Grid testin
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distinguishing wet from dry age related macular degeneration using three dimensional computer automated threshold Amsler Grid testing
British Journal of Ophthalmology, 2011Co-Authors: Craig D. Robison, Alfredo A Sadun, Wolfgang Fink, Renu V. Jivrajka, Simon R. Bababeygy, J. SebagAbstract:Background/aims With the increased efficacy of current therapy for wet age-related macular degeneration (AMD), better ways to detect wet AMD are needed. This study was designed to test the ability of threedimensional contrast threshold Amsler Grid (3D-CTAG) testing to distinguish wet AMD from dry AMD. Methods Conventional paper Amsler Grid and 3D-CTAG tests were performed in 90 eyes: 63 with AMD (34 dry, 29 wet) and 27 controls. Qualitative comparisons were based upon the three-dimensional shapes of central visual field (VF) defects. Quantitative analyses considered the number and volume of the three-dimensional defects. Results 25/34 (74%) dry AMD and 6/29 (21%) wet AMD eyes had no distortions on paper Amsler Grid. Of these, 5/25 (20%) dry and 6/6 (100%) wet (p¼0.03) AMD eyes exhibited central VF defects with 3D-CTAG. Wet AMD displayed stepped defects in 16/28 (57%) eyes, compared with only 2/34 (6%) of dry AMD eyes (p¼0.002). All three volumetric indices of VF defects were two- to four-fold greater in wet than dry AMD (p<0.006). 3D-CTAG had 83.9% positive and 90.6% negative predictive values for wet AMD. Conclusions 3D-CTAG has a higher likelihood of detecting central VF defects than conventional Amsler Grid, especially in wet AMD. Wet AMD can be distinguished from dry AMD by qualitative and quantitative 3D-CTAG criteria. Thus, 3D-CTAG may be useful in screening for wet AMD, quantitating disease severity, and providing a quantitative outcome measure of therapy.
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Distinguishing wet from dry age-related macular degeneration using three-dimensional computer-automated threshold Amsler Grid testing
The British journal of ophthalmology, 2011Co-Authors: Craig D. Robison, Alfredo A Sadun, Wolfgang Fink, Renu V. Jivrajka, Simon R. Bababeygy, J. SebagAbstract:Background/aims With the increased efficacy of current therapy for wet age-related macular degeneration (AMD), better ways to detect wet AMD are needed. This study was designed to test the ability of threedimensional contrast threshold Amsler Grid (3D-CTAG) testing to distinguish wet AMD from dry AMD. Methods Conventional paper Amsler Grid and 3D-CTAG tests were performed in 90 eyes: 63 with AMD (34 dry, 29 wet) and 27 controls. Qualitative comparisons were based upon the three-dimensional shapes of central visual field (VF) defects. Quantitative analyses considered the number and volume of the three-dimensional defects. Results 25/34 (74%) dry AMD and 6/29 (21%) wet AMD eyes had no distortions on paper Amsler Grid. Of these, 5/25 (20%) dry and 6/6 (100%) wet (p¼0.03) AMD eyes exhibited central VF defects with 3D-CTAG. Wet AMD displayed stepped defects in 16/28 (57%) eyes, compared with only 2/34 (6%) of dry AMD eyes (p¼0.002). All three volumetric indices of VF defects were two- to four-fold greater in wet than dry AMD (p
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Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler Grid testing
Graefe's Archive for Clinical and Experimental Ophthalmology, 2009Co-Authors: Renu V. Jivrajka, Alfredo A Sadun, Wolfgang Fink, Janet K. Kim, J. SebagAbstract:Purpose To evaluate the central visual field (CVF) with specialized Amsler Grid testing methods that include contrast sensitivity evaluation, in an attempt to detect abnormalities not identified with standard methods and to define new patterns of CVF deficits in two different diseases. Methods 3D computer-automated threshold Amsler Grid testing (3D-CTAG) was performed at five levels of contrast in one eye of 37 patients with diabetic macular edema (DME, n = 16) and exudative age-related macular degeneration (AMD, n = 21). Results 3D-CTAG abnormalities were detected in six patients (16%) who had no abnormalities with conventional Amsler Grid testing. DME patients had more foci of CVF deficits (3.56 ± 2.92 defects/eye), than AMD patients (1.24 ± 0.89 defects/eye; P
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quantitative analysis of central visual field defects in macular edema using three dimensional computer automated threshold Amsler Grid testing
Graefes Archive for Clinical and Experimental Ophthalmology, 2009Co-Authors: Renu V. Jivrajka, Alfredo A Sadun, Wolfgang Fink, Janet K. Kim, J. SebagAbstract:Purpose To evaluate the central visual field (CVF) with specialized Amsler Grid testing methods that include contrast sensitivity evaluation, in an attempt to detect abnormalities not identified with standard methods and to define new patterns of CVF deficits in two different diseases. Methods 3D computer-automated threshold Amsler Grid testing (3D-CTAG) was performed at five levels of contrast in one eye of 37 patients with diabetic macular edema (DME, n=16) and exudative age-related macular degeneration (AMD, n=21). Results 3D-CTAG abnormalities were detected in six patients (16%) who had no abnormalities with conventional Amsler Grid testing. DME patients had more foci of CVF deficits (3.56±2.92 defects/eye), than AMD patients (1.24± 0.89 defects/eye; P<0.0002). The shape of the 3D-CTAG abnormality in DME was an inverted cone, while the deficits in AMD were always cylindrical. All eyes showed significant increases in CVF deficit surface area at minimum contrast levels when compared to maximum contrast (295% greater with DME, P<0.02 and 150% greater with AMD, P<0.03). Conclusion 3D-CTAG detected CVF abnormalities not identified with conventional Amsler Grid testing in 16% of subjects. Low-contrast conditions elicited a larger defect in both DME (3-fold) and AMD (1.5-fold). DME and AMD have unique 3D-CTAG profiles, enabling diagnostic discrimination. Measuring CVF defects with 3D-CTAG can quantitatively index disease severity and may be useful in longitudinal studies of the natural history of disease, as well as providing a quantitative outcome measure of the response to therapy.