Scotopic microperimetry: evolution, applications and future directions

ABSTRACT

For many inherited and acquired retinal diseases, reduced night vision is a primary symptom. Despite this, the clinical testing options for spatially resolved scotopic vision have until recently been limited. Scotopic microperimetry is a relatively new visual function test that combines two-colour perimetry with fundus-controlled perimetry performed in scotopic luminance conditions. The technique enables spatially resolved mapping of central retinal sensitivity alongside the ability to distinguish between rod and cone photoreceptor sensitivities. Two companies produce commercially available scotopic microperimeters – Nidek (Nidek Technologies Srl, Padova, Italy) and CenterVue (CenterVue S.p.A., Padova, Italy). Scotopic microperimetry is a promising technology capable of detecting changes in retinal sensitivity before changes in other measures of visual function. Scotopic microperimetry is a promising functional biomarker that has the potential as a useful clinical trial outcome measure. This review summarises the evolution and applications of scotopic microperimetry, and discusses testing options, including testing grid selection, dark-adaptation time and threshold sensitivity analyses.

KEYWORDS:

• Dark-adaptation
• Fundus-controlled perimetry
• microperimetry
• rods
• Scotopic microperimetry

Disclosure statement

The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The sponsor and funding organization had no role in the design or conduct of this research. No authors have a conflict of interest.

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Funding

This study is supported by the kind donation made by Jean Williams (known as the Winstanley donation) to the University of Oxford for research into inherited macular diseases, and the NIHR Oxford Biomedical Research Centre.