Multicenter normative data for mesopic microperimetry

ABSTRACT

Purpose To provide a large, multi-center normative dataset for the Macular Integrity Assessment (MAIA) microperimeter and compare the goodness-of-fit and prediction interval calibration-error for a panel of hill-of-vision models.

Methods Microperimetry examinations from five independent study groups and one previously available dataset were included. Linear mixed models (LMMs) were fitted to the data to obtain interpretable hill-of-vision models. For predicting age-adjusted normative values, an array of regression models were compared using cross-validation with site-wise splits. The mean absolute error (MAE) and miscalibration area (area between the calibration curve and the ideal diagonal) were evaluated as the performance measures.

Results 1,052 tests from 531 eyes of 432 participants were included. Based on the parameters ‘participant age’, ‘eccentricity from the fovea’, ‘overlap with the central fixation target’ and ‘eccentricity along the four principal meridians’, a Bayesian mixed model had the lowest MAE (2.13 dB; 95% confidence interval [CI] = 1.86, 2.40 dB) and miscalibration area (0.14; 95% CI = 0.07, 0.20). However, a parsimonious linear model provided a comparable MAE (2.16 dB; 95% CI = 1.89, 2.43 dB) and a similar miscalibration area (0.14; 95% CI = 0.08, 0.20).

Conclusions Normal variations in visual sensitivity on mesopic microperimetry can be effectively explained by a linear model that includes age and eccentricity. The dataset and a code vignette are provided for estimating normative values across a large range of retinal locations, applicable to customized testing patterns.

Competing Interest Statement

Maximilian Pfau: Novartis (R), Janssen Pharmaceutica (C), Apellis (F,C) Jasleen K. Jolly: GenSight (C). OKKO (C), CRF (S) Jason Charng: None Leon von der Emde: None Philipp L. Muller: Apellis (C), Bayer (R), Novartis (R, C), Roche/Genentech (R, C) Georg Ansari: None Kristina Pfau: Daiichi Sankyo (C) Fred K Chen: PYC Therapeutics (C), Novartis (C), Apellis (C) Zhichao Wu: None

Funding Statement

This study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The ethics committees of the University of Bonn, CERA, and Oxford University gave ethical approval for this work.

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced will be published at Zenodo.org upon acceptance of the manuscript.

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