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. 2005 Aug 10:5:18.
doi: 10.1186/1471-2415-5-18.

The macular mapping test: a reliability study

Hannah Bartlett  1 , Leon N Davies, Frank Eperjesi
Affiliations

The macular mapping test: a reliability study

Hannah Bartlett et al. BMC Ophthalmol. .

Abstract

Background: Age-related macular degeneration (ARMD) is the leading cause of visual disability in people over 60 years of age in the developed world. The success of treatment deteriorates with increased latency of diagnosis. The purpose of this study was to determine the reliability of the macular mapping test (MMT), and to investigate its potential as a screening tool.

Methods: The study population comprised of 31 healthy eyes of 31 participants. To assess reliability, four macular mapping test (MMT) measurements were taken in two sessions separated by one hour by two practitioners, with reversal of order in the second session. MMT readings were also taken from 17 age-related maculopathy (ARM), and 12 AMD affected eyes.

Results: For the normal cohort, average MMT scores ranged from 85.5 to 100.0 MMT points. Scores ranged from 79.0 to 99.0 for the ARM group and from 9.0 to 92.0 for the AMD group. MMT scores were reliable to within +/- 7.0 points. The difference between AMD affected eyes and controls (z = 3.761, p = < 0.001) was significant. The difference between ARM affected eyes and controls was not significant (z = -0.216, p = 0.829).

Conclusion: The reliability data shows that a change of 14 points or more is required to indicate a clinically significant change. This value is required for use of the MMT as an outcome measure in clinical trials. Although there was no difference between MMT scores from ARM affected eyes and controls, the MMT has the advantage over the Amsler grid in that it uses a letter target, has a peripheral fixation aid, and it provides a numerical score. This score could be beneficial in office and home monitoring of AMD progression, as well as an outcome measure in clinical research.

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Figures

Figure 1
Figure 1
Subject view of the MMT results. Black squares indicate letters that were not seen, half-shaded squares indicate those that were seen but not correctly identified, and white squares indicate letters that were correctly identified.
Figure 2
Figure 2
Difference in MMT score between HB1 and HB2 compared with the mean (n = 31 eyes). The mean bias is represented by the solid line and the 95 % confidence limits are represented by the dotted lines.
Figure 3
Figure 3
Difference in MMT score between HB1 and LD1 compared with the mean (n = 31 eyes). The mean bias is represented by the solid line and the 95 % confidence limits are represented by the dotted lines.
Figure 4
Figure 4
Difference in Macular Mapping Test (MMT) value between LD1 and LD2, compared with the mean (N = 30 eyes). The mean bias is represented by the solid line, and the 95% confidence limits are known by the dashed lines.
Figure 5
Figure 5
Difference in Macular Mapping Test (MMT) value between LD2 and HB2, compared with the mean (N = 30 eyes). The mean bias is represented by the solid line, and the 95% confidence limits are known by the dashed lines.
Figure 6
Figure 6
Difference in Macular Mapping Test (MMT) value between HB1 and LD2, compared with the mean (N = 30 eyes). The mean bias is represented by the solid line, and the 95% confidence limits are known by the dashed lines.
Figure 7
Figure 7
First MMT scores taken from normal (over 50 years), ARM and AMD participants plotted against age.
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