The Macular Mapping Test
1. Purpose
The size and extent of still intact areas of the retina in maculopathies vary from patient to patient. Hence, an individual assessment of each patient’s remaining vision is necessary for successful rehabilitation. This assessment can be done by our The MMT gives the eye care specialist a tool to assess remaining vision in patients/clients with macular vision loss. One goal is to find intact areas of the retina that can be used for eccentric viewing. Another goal is the detection of early signs of a beginning disease of the macula that is not apparent in everyday life yet.
2. Source
The test was developed by Manfred MacKeben, Ph.D. and August Colenbrander, M.D., with programming by Alexander Gofen.
3. Implementation
The test consists of custom software that runs on IBM PCs and compatible computers under any version of Windows (incl. Vista) and requires no hardware modifications. The MMT has been used on hundreds of subjects in our laboratory, many of them patients with central field loss. It is commercially available (go to www.macularmapping.com for details) and is now used in offices and laboratories in 9 countries on 3 continents.
4. Advantages
The MMT is fast, inexpensive, and can be run by anyone with minimal computer skills. One round of testing (36 trials) takes about 3 minutes, on average. It builds and maintains a data base that allows immediate access to all past and present data. Results can be sent by email to other MMT installations and printed out in 3 different formats. Besides the gain of information for the eye care specialist, the MMT is a valuable tool for teaching those patients whose rehabilitative progress is held back because they are unaware of their scotoma. MMT results can be used as a first step to further patient education through self-exploration of the visual field (link to page 8).
Legend: The left picture shows a target (letter H) that is shown to the patient for ¼ second. The background “wagon wheel” pattern helps the keep the tested person’s gaze stable. The right picture shows all 33 used test positions. Note that this is a picture the tested person never gets to see.
Legend: The picture shows the results of one round of testing with the MMT. The symbols mean: Black = not seen, half black = detected, but not recognized, clear = recognized. The square with radial beams to the lower right indicates that this spot could be recommended as a locus to be used for eccentric viewing. The results of every test run like this can also be expressed as a single number.
Publications:
MacKeben, M and Colenbrander, A. (1994) “Mapping the topography of residual vision after macular vision loss.” In: Low Vision-Research and New Developments in Rehabilitation, Kooijman AC et al. (Eds.), IOS Press, Amsterdam, pp. 59-67.
MacKeben, M., Colenbrander, A. and Gofen, A. (1999) Use you PC to quickly map remaining vision after foveal vision loss. Perimetry Update 1998/1999 (M. Wall & J.M. Wild, eds.), Kugler Publications, The Hague, Netherlands.
MacKeben, M. & Colenbrander, A. (2000) Topographic measurements of low contrast letter recognition as a tool for diagnosis and vision rehabilitation. Vision Rehabilitation (C.Stuen et al., eds), Swets & Zeitlinger, Lisse, p. 158-160
Trauzettel-Klosinski S, Biermann P, Hahn G, Weismann M. (2003) Assessment of parafoveal function in maculopathy: a comparison between the Macular Mapping Test and kinetic Manual Perimetry. Graefes Arch Clin Exp Ophthalmol. Dec; 241(12):988-95 (pubmed)
MacKeben M. (2008) Topographic mapping of residual vision by computer. Journal of Visual Impairment & Blindness (Special Issue on AMD), October, Vol. 102, No.10, 649-655. (afb.org)
Hahn G A, Messias A, Mackeben M, Dietz K, Horwath K, Hyvärinen L, Leinonen M, Trauzettel-Klosinski S (2009) Parafoveal letter recognition at reduced contrast in normal aging and in patients with risk factors for AMD. Graefes Arch Clin Exp Ophthalmol. Jan; 247(1):43-51 (pubmed)