The Effect of Attention on Fixation Stability During Dynamic Fixation Testing in Stargardt Disease.

Autor: Schönbach EM; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Ophthalmology, Case Western Reserve University, Cleveland, Ohio, USA., Strauss RW; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Moorfields Eye Hospital, London, United Kingdom; Department of Ophthalmology, Johannes Kepler Universität, Linz, Austria; Department of Ophthalmology, Medizinische Universität Graz, Graz, Austria., Ibrahim MA; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Byers Eye Institute, Stanford University, Palo Alto, California, USA., Janes JL; University Hospitals Clinical Research Center, Cleveland Medical Center, Cleveland, Ohio, USA., Cideciyan AV; Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Birch DG; Retina Foundation of the Southwest, Dallas, Texas, USA., Sunness JS; Hoover Low Vision Rehabilitation Services, Greater Baltimore Medical Center, Baltimore, Maryland, USA., Zrenner E; Zentrum für Augenheilkunde, Eberhard Karls Universität, Tübingen, Germany., Ip MS; Doheny Eye Institute, UCLA David Geffen School of Medicine, Los Angeles, California, USA., Kong X; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Sadda SR; Doheny Eye Institute, UCLA David Geffen School of Medicine, Los Angeles, California, USA., Scholl HPN; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Ophthalmology, University of Basel, Basel, Switzerland; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland. Electronic address: Hendrik.Scholl@usb.ch.
Jazyk: angličtina
Zdroj: American journal of ophthalmology [Am J Ophthalmol] 2020 Sep; Vol. 217, pp. 305-316. Date of Electronic Publication: 2020 May 11.
DOI: 10.1016/j.ajo.2020.05.002
Abstrakt: Purpose: Sensitive, reproducible visual function biomarkers are necessary to evaluate the efficacy of emerging treatments for Stargardt disease type 1 in clinical trials. We previously demonstrated that fixation stability may serve as a secondary outcome parameter for visual function loss. However, the test duration and protocol have an unknown effect on the assessment of fixation stability. Here, we hypothesize that separate fixation testing with a single target is different from combined fixation testing using the same target with simultaneous perimetry testing.
Design: International, multicenter, prospective, cross-sectional study.
Methods: Microperimetry data from the international, multicenter, prospective Progression of Atrophy Secondary to Stargardt Disease (ProgStar, NCT01977846) study were analyzed. Patients underwent various types of fixation testing including static testing and dynamic testing, and a duration-corrected dynamic test was generated (30sEpoch).
Results: A total of 437 eyes from 235 patients were included (mean age, 33.8 ± 15.1 years; 55.3% female). The mean 1SD-BCEA (bivariate contour ellipse area), which is the smallest ellipse encompassing 1 standard deviation of all fixation events, was smaller for the static fixation test compared to the 30sEpoch (4.5 ± 6.9 deg 2 vs 5.3 ± 7.0 deg 2 ; P = .02) and the number of points within both the 2-degree and 4-degree circles was larger (P < .0001).
Conclusions: Our results suggest that differences in static and dynamic assessment of fixation stability are dependent not only on different test durations but also on the testing protocol of a single fixation target vs fixation target plus simultaneous perimetry testing and provide information on the conduct of fixation testing for clinical trials.
(Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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