Feasibility of Macular Integrity Assessment (MAIA) microperimetry in children: Sensitivity, reliability, and fixation stability in healthy observers

Jones, P.R.; Yasoubi, N.; Nardini, M.; Rubin, G.S.

Abstract

Purpose: To assess the feasibility of macular integrity assessment (MAIA) microperimetry (MP) in children. Also to establish representative outcome measures (differential light sensitivity, fixation stability, test–retest reliability) for children without visual impairment. Methods: Thirty-three adults and 33 children (9–12 years) were asked to perform three monocular MAIA examinations within a single session (dominant eye only). Results: Children exhibited poorer test–retest reliability than adults for measures of both mean sensitivity (95% coefficient of repeatability [CoR95] = 2.7 vs. 2.3 dB, P = 0.036) and pointwise sensitivity (CoR95 = 6.2 vs. 5.7 dB, P < 0.001). Mean sensitivity was lower in children (27.6 vs. 29.5 dB, P < 0.001), and fixation stability was poorer (95% bivariate contour ellipse area [BCEA95] = 4.58 vs. 1.14, P < 0.001). Mean sensitivity was negatively correlated with fixation stability (r = −0.44, P < 0.001). Both children and adults exhibited substantial practice effects, with mean sensitivity improving by 0.5 dB (adults) and 0.9 dB (children) between examinations 1 and 2 (P ≤ 0.017). There were no significant differences between examinations 2 and 3 (P ≥ 0.374). Conclusions: Microperimetry is feasible in 9- to 12-year-old children. However, systematically lower sensitivities mean that the classification boundary for “healthy” performance should be lowered in children, pending development of techniques to improve attentiveness/fixation that may reduce or remove this difference. High measurement variability suggests that the results of multiple tests should be averaged when possible. Learning effects are a potential confound, and it is recommended that the results of the first examination be discarded.

Citation

Jones, P., Yasoubi, N., Nardini, M., & Rubin, G. (2016). Feasibility of Macular Integrity Assessment (MAIA) microperimetry in children: Sensitivity, reliability, and fixation stability in healthy observers. Investigative Ophthalmology & Visual Science, 57(14), 6349-6359. https://doi.org/10.1167/iovs.16-20037

• Journal Article Type: Article
• Acceptance Date: Sep 9, 2016
• Online Publication Date: Nov 29, 2016
• Publication Date: Nov 29, 2016
• Deposit Date: Sep 9, 2016
• Publicly Available Date: Dec 8, 2016
• Journal: Investigative Ophthalmology & Visual Science
• Print ISSN: 0146-0404
• Electronic ISSN: 1552-5783
• Publisher: Association for Research in Vision and Ophthalmology
• Peer Reviewed: Peer Reviewed
• Volume: 57
• Issue: 14
• Pages: 6349-6359
• DOI: https://doi.org/10.1167/iovs.16-20037
• Public URL: https://durham-repository.worktribe.com/output/1405131