Background: Torpedo maculopathy is a rare condition with a twofold clinical significance. Firstly, it is a differential of atypical congenital hypertrophy of the retinal pigment epithelium. Secondly, visual field loss has been reported. We demonstrate the spectrum of structural abnormality of torpedo maculopathy as seen on optical coherence tomography, and correlate this with age of presentation, fundus autofluorescence, retinal sensitivity loss and visual field abnormality.

PurposeTo investigate the intersession test–retest variability (TRV) of topography- and threshold-based parameters derived from the Nidek MP-1.DesignProspective observational study.MethodsSixteen participants with and without central scotoma underwent microperimetry in one eye over three sessions at 1-month intervals in a single institution. We calculated 95% coefficient of repeatability (CR) for the number of normal-suspect (NS) loci, relative scotoma (RS) and dense scotoma (DS), median macular sensitivity (MS), mean sensitivity of responding loci (RLS), perilesional loci (PLS), and extralesional loci (ELS). Topographical agreement score of mapping NS and DS loci (TASNS and TASDS) were also calculated for each patient.ResultsMean (range) age was 50 (21–86) years. The CR (95% confidence intervals) for NS, RS, and DS were 9.9 (6.5–13.3), 9.5 (6.2–12.7), and 3.0 (1.1–4.1) respectively. CR (95% CIs) for median MS, mean RLS, PLS, and ELS were 3.4 (2.3–4.5), 1.6 (1.1–2.2), 1.8 (0.9–2.6), and 2.8 (1.5–4.0) dB. We found significant change in thresholds between Test 1, and Tests 2 and 3 (both P=0.03), but not between Tests 2 and 3 (P=0.8). Medians (range) TASNS and TASDS were 74% (39%–100%) and 77% (0%–97%), respectively, between Tests 2 and 3.ConclusionWe recommend the use of four DS loci (upper limit of CR) as the limit of TRV for assessing change. There was large interindividual variability in NS or DS mapping agreement. We recommend discarding the first microperimetry test and caution the use of a change in spatial distribution to determine disease progression.

PurposeTo determine the intersession test–retest variability (TRV) of CenterVue Macular Integrity Assessment (MAIA) microperimeter in glaucoma patients with fixation-threatening field defects.MethodsThis is a prospective case–control study of 27 participants consisting of 13 patients with stable primary open-angle glaucoma and 14 control subjects including 5 healthy individuals and 9 retinal patients (5 with non-neovascular age-related macular degeneration and 4 with inherited retinal disease). Each participant underwent three microperimetry tests in one eye at 1-month intervals. Each test used an identical test strategy of 10-2 Cartesian grid and 4-2 staircase algorithm. We investigated TRV by calculating the coefficient of repeatability (CR) for mean sensitivity (MS) and point-wise sensitivity (PWS) for glaucomatous subjects and retinal and normal subjects. 95% confidence intervals (CIs) for CRs were calculated.ResultsThere was no significant change in MS, and the median durations of microperimetry sessions were 9′26″, 8′52″, and 8′46″ across the three study visits. The intersession CRs for MS were 1.1, 2.5, and 1.8 dB, and the average CRs for PWS were 3.5, 7.4, and 8.6 dB for healthy controls and retinal and glaucoma patients, respectively. For test loci with 25–34 dB at baseline, CRs for PWS were 8.2 (95% CI: 7.5–8.9) and 4.3 (95% CI: 4.0–4.6) dB for glaucoma and control subjects, respectively.ConclusionWe found differences in TRV of test loci depending on the baseline sensitivity value. Glaucoma patients had significantly worse TRV for loci that had sensitivity values within the normal range at baseline. The estimated CR has implications for sample size calculation in future glaucoma treatment trials using microperimetry as a clinical endpoint.