Benchmarking test-retest variability in microperimetry for intermediate age-related macular degeneration using MP-3 and MAIA

• Published in: Canadian journal of ophthalmology
• Main Authors: Schweighofer, Jakob, Birner, Klaudia, Mohamed, Hamza, Schrittwieser, Johannes, Bogunovic, Hrvoje, Reiter, Gregor S., Schmidt-Erfurth, Ursula
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 12.06.2025
• ISSN: 0008-4182; 1715-3360; 1715-3360
• DOI: 10.1016/j.jcjo.2025.05.002

Microperimetry (MP) has emerged as a clinical functional endpoint in nonexudative age-related macular degeneration (AMD). In this study, we aim to provide reference values for test-retest outcomes on two MP devices in intermediate AMD (iAMD). Prospective, cross-sectional study. 3 600 stimuli from 20 eyes in 20 subjects. Patients diagnosed with iAMD underwent consecutive testing on MP-3 (NIKED, Gamagori, Japan) and MAIA (CenterVue Icare, Padova, Italy). The obtained point-wise sensitivity (PWS) measurements were superimposed with optical coherence tomography (OCT) (Spectralis, Heildelberg Engineering) acquired. Hyperreflective foci (HRF), drusen volume, ellipsoid zone (EZ)-thickness and outer nuclear layer (ONL)-thickness were quantified with deep-learning algorithms. Subretinal drusenoid deposits (SDD) were manually annotated. We assessed test–retest repeatability at the location of these biomarkers using Bland–Altmann coefficients of repeatability. Furthermore, interdevice correlation, fixation stabilities, and examination durations were evaluated. Comparable overall point-wise retest variances were detected for MP-3 (±4.54 dB) and MAIA (±5.24 dB). SDDs led to significantly worse repeatability in the MAIA device (p = 0.03). Drusen, HRF, EZ-thickness, and ONL thickness had no significant impact on test–retest variance. A good intradevice correlation (MP-3: 0.869 [0.851 – 0.886] MAIA 0.848 [0.827 – 0.867]), and a good mean interdevice correlation (0.841 [0.819 – 0.861]) was observed. Intradevice and interdevice repeatability for MP examinations with MP-3 and MAIA in patients with iAMD can be considered as good. Biomarkers except for SDD show no significant impact in repeatability in both devices. This supports MP as a reliable functional endpoint in clinical trials in iAMD.