Establishing Fully-Automated Fundus-Controlled Dark Adaptometry: A Validation and Retest-Reliability Study

Abstract

Purpose The purpose of this study was to establish and validate a novel fundus-controlled dark-adaptometry method. Methods We developed a custom dark-adaptometry software for the S-MAIA device using the open-perimetry-interface. In the validation-substudy, participants underwent dark-adaptometry testing with a comparator device (MonCvONE, 59% rhodopsin bleach, cyan and red stimuli centered at 2 degrees, 4 degrees, and 6 degrees eccentricity). Following a brief break (approximately 5 minutes), the participants were bleached again and underwent dark-adaptometry testing with the S-MAIA device (same loci). In the retest reliability-substudy, participants were tested twice with the S-MAIA device (same loci as above). Nonlinear curve fitting was applied to extract dark-adaptation curve parameters. Validity and repeatability were summarized in terms of the mean bias and 95% limits of agreement (LoAs). Results In the validation-substudy ( N = 20 participants, median age interquartile range [IQR] 31.5 years [IQR = 25.8, 62.0]), measures of rod-mediated dark-adaptation showed little to no between method differences for the cone-rod-break-time (bias 95% confidence interval [95% CI] of +0.1 minutes [95% CI = −0.6 to 0.8]), rod-intercept-time (−0.23 minutes [95% CI = −1.38 to 0.93]), and S2 slope (−0.01 LogUnits/minutes [95% CI = −0.02 to −0.01]). In the retest reliability-substudy ( N = 10 participants, 32.0 years [95% CI = 27.0, 57.5]), the corresponding LoAs were (cone-rod-break-time) −3.94 to 2.78 minutes, (rod-intercept-time) −4.55 to 3.11 minutes, and (S2 slope [rate-limited component of rod recovery]) −0.03 to 0.03 LogUnits/minutes. The LoAs for the steady-state cone and rod thresholds were −0.28 to 0.33 LogUnits and −0.34 to 0.28 LogUnits. Conclusions The devised fundus-controlled dark-adaptometry method yields valid and reliable results. Translational Relevance Fundus-controlled dark-adaptometry solves the critical need for localized testing of the visual cycle and retinoid transfer in eyes with unstable fixation.

Assessing visual performance during intense luminance changes in virtual reality

“…Dark adaptometry can be useful as an early indicator of e.g., age-related macular degeneration 34 or other retinal diseases related to systemic vitamin A deficiency, where impaired dark adaptation leads to a complete dark-adapted rod sensitivity. 35,36…”