Regional Variations and Intra-/Intersession Repeatability for Scotopic Sensitivity in Normal Controls and Patients With Inherited Retinal Degenerations

Invest Ophthalmol Vis Sci. 2019 Mar 1;60(4):1122-1131. doi: 10.1167/iovs.18-25473.

Abstract

Purpose: Dark-adapted visual fields were obtained from patients with inherited retinal degeneration (IRD) and controls to evaluate the effect that age, retinal region, and disease had on scotopic sensitivity. Intra- and intersession test-retest repeatabilities for patients and controls were measured to establish significant change for longitudinal studies.

Methods: A total of 41 patients with IRD and 30 controls had one eye dilated and dark-adapted for 40 minutes. Scotopic sensitivity was measured with a Medmont dark-adapted chromatic (DAC) perimeter (size V stimulus, 200-ms duration, background luminance < 0.0001 cd/m2, dynamic range 0-75 decibel [dB]). Mixed effects analysis was performed to analyze age, retinal eccentricity, and sensitivity. The intra-/intersession coefficients of repeatability (CR) were calculated for controls and patients with IRD.

Results: Each additional year was associated with lower sensitivity (-0.22 dB) per year in normal controls over age 50 compared to younger controls (12-49 years). The superior field had lower sensitivity than the inferior, but the nasal field was not different compared to the temporal field in normal controls. The CR for intra- and intersession testing on mean sensitivity (MS)/pointwise sensitivity (PWS) were ±1.5/±8.5 and ±3.3/±9.8 dB, respectively, for patients with IRD. Control MS/PWS CR were ±1.5/±6.1 dB for intrasession and ±1.7/±6.8 dB for intersession DAC perimetry.

Conclusions: The DAC perimeter is an important asset because it tests a wide field of scotopic vision. The CR are comparable to those of other perimetry devices. Effects of age and retinal region should be considered when assessing scotopic sensitivity measured with the DAC perimeter.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Dark Adaptation / physiology
  • Female
  • Follow-Up Studies
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Night Vision / physiology*
  • Observer Variation
  • Reproducibility of Results
  • Retina / physiopathology*
  • Retinal Degeneration / genetics
  • Retinal Degeneration / physiopathology*
  • Scotoma / genetics
  • Scotoma / physiopathology*
  • Visual Acuity
  • Visual Field Tests / methods
  • Visual Fields / physiology*
  • Young Adult