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      MacuFix® versus Amsler grid for metamorphopsia categorization for macular diseases

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          Abstract

          Purpose

          Macular diseases often lead to metamorphopsia, which is traditionally tested using the Amsler grid. This study evaluates a novel method for assessing metamorphopsia, based on the software AMD-A Metamorphopsia Detector, application MacuFix®.

          Methods

          In this observational study, the usability of a new smartphone-based testing method to assess metamorphopsia was evaluated in 45 patients experiencing metamorphopsia in at least one eye using the questionnaire “System Usability Score (SUS).” Additionally, the diagnostic adherence of self-monitoring with the Amsler grid was compared to self-monitoring with the novel software MacuFix®.

          Results

          The average score of the SUS questionnaire in this study was 76.7 ± 15.5, corresponding to the “good” score on the grading scale. The average interval between two home administered tests was significantly shorter (6 days) when the application was used as compared to using the Amsler grid (19 days). The odds ratio of the frequency of patients using the application to the patients using the home test was 4.

          Conclusion

          MacuFix® application can help in effective home monitoring of macular function as high user satisfaction and increased testing frequency was observed in its use in patients with macular diseases.

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          Most cited references27

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          An Empirical Evaluation of the System Usability Scale

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            Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration.

            Two similarly designed, phase-3 studies (VEGF Trap-Eye: Investigation of Efficacy and Safety in Wet AMD [VIEW 1, VIEW 2]) of neovascular age-related macular degeneration (AMD) compared monthly and every-2-month dosing of intravitreal aflibercept injection (VEGF Trap-Eye; Regeneron, Tarrytown, NY, and Bayer HealthCare, Berlin, Germany) with monthly ranibizumab. Double-masked, multicenter, parallel-group, active-controlled, randomized trials. Patients (n = 2419) with active, subfoveal, choroidal neovascularization (CNV) lesions (or juxtafoveal lesions with leakage affecting the fovea) secondary to AMD. Patients were randomized to intravitreal aflibercept 0.5 mg monthly (0.5q4), 2 mg monthly (2q4), 2 mg every 2 months after 3 initial monthly doses (2q8), or ranibizumab 0.5 mg monthly (Rq4). The primary end point was noninferiority (margin of 10%) of the aflibercept regimens to ranibizumab in the proportion of patients maintaining vision at week 52 (losing <15 letters on Early Treatment Diabetic Retinopathy Study [ETDRS] chart). Other key end points included change in best-corrected visual acuity (BCVA) and anatomic measures. All aflibercept groups were noninferior and clinically equivalent to monthly ranibizumab for the primary end point (the 2q4, 0.5q4, and 2q8 regimens were 95.1%, 95.9%, and 95.1%, respectively, for VIEW 1, and 95.6%, 96.3%, and 95.6%, respectively, for VIEW 2, whereas monthly ranibizumab was 94.4% in both studies). In a prespecified integrated analysis of the 2 studies, all aflibercept regimens were within 0.5 letters of the reference ranibizumab for mean change in BCVA; all aflibercept regimens also produced similar improvements in anatomic measures. Ocular and systemic adverse events were similar across treatment groups. Intravitreal aflibercept dosed monthly or every 2 months after 3 initial monthly doses produced similar efficacy and safety outcomes as monthly ranibizumab. These studies demonstrate that aflibercept is an effective treatment for AMD, with the every-2-month regimen offering the potential to reduce the risk from monthly intravitreal injections and the burden of monthly monitoring. Proprietary or commercial disclosure may be found after the references. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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              Compulsory averaging of crowded orientation signals in human vision.

              A shape can be more difficult to identify when other shapes are near it. For example, when several grating patches are viewed parafoveally, observers are unable to report the orientation of the central patch. This phenomenon, known as 'crowding,' has historically been confused with lateral masking, in which one stimulus attenuates signals generated by another stimulus. Here we show that despite their inability to report the orientation of an individual patch, observers can reliably estimate the average orientation, demonstrating that the local orientation signals are combined rather than lost. Our results imply that crowding is distinct from ordinary masking, and is perhaps related to texture perception. Under crowded conditions, the orientation signals in primary visual cortex are pooled before they reach consciousness.
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                Author and article information

                Contributors
                daniela.claessens@gmx.de
                parul77@rediffmail.com
                Journal
                Int Ophthalmol
                Int Ophthalmol
                International Ophthalmology
                Springer Netherlands (Dordrecht )
                0165-5701
                1573-2630
                22 August 2021
                : 1-10
                Affiliations
                [1 ]Augenheilkunde Lindenthal, Dürener Str. 251, 50931 Cologne, Germany
                [2 ]GRID grid.413220.6, ISNI 0000 0004 1767 2831, Department of Ophthalmology, , Government Medical College & Hospital, ; Chandigarh, India
                [3 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Ophthalmology, Massachusetts and Ear and Ear, , Harvard Medical School, ; Boston, MA USA
                [4 ]GRID grid.10419.3d, ISNI 0000000089452978, Department of Ophthalmology, , Leiden University Medical Center, ; Leiden, The Netherlands
                Author information
                http://orcid.org/0000-0001-6256-4002
                Article
                2017
                10.1007/s10792-021-02017-3
                8380298
                34420124
                d2ea8db2-3da0-4b7c-8cf8-36c67fec4152
                © The Author(s), under exclusive licence to Springer Nature B.V. 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 26 March 2021
                : 13 August 2021
                Categories
                Original Paper

                Ophthalmology & Optometry
                metamorphopsia,usability,adherence,age-related macular degeneration,diabetic macular edema,smartphone-based application

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