Development and validation of functional based grading for macular diseases

Age-related Macular Degeneration (AMD) is the leading cause of legal blindness and central vision loss in the 50 above age group among both developed and developing countries. In India, the prevalence of early late ARMD is similar to that observed in Western populations in the age group of 60-79 years. The standard practice for the diagnosis of AMD is by Amsler test conducted by an eye professional. It is a simple procedure but suffers from poor recall and requires trained clinician to interpret. Current digital solutions are inadequate to provide a unified visual functional deficiency report for the grading and monitoring of the disease. The proposed work presents a novel functional vision screening algorithm ideal for the detection and grading of AMD and other macular diseases with the help of severity scoring, which is integral part of our developed software called Manipal E-Amsler (ME Amsler). The software is validated through clinical trials conducted on 134 subjects out of which 72 subjects are affected by AMD. A sensitivity of 90.2% and specificity of 84.4% and area under receiver operating characteristics curve (AUC) of about 92% are obtained.