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Amsler Grid test's effectiveness for wet AMD is under question

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A recent systemic review and meta-analysis study published in JAMA Ophthalmology evaluated the sensitivity and specificity of the Amsler grid test for monitoring neovascular age-related macular degeneration (AMD).

Tell me about the study.

The meta-analysis screened 523 records, including 10 studies, for a total of 1890 eyes. Of these, 425 eyes had wet AMD  and 1,262 eyes were at risk of wet AMD (early/dry AMD). The mean participant age ranged from 62 to 83 years old.

What were the results?

Researchers found that the sensitivity and specificity for diagnosing wet AMD were 67% (95% confidence interval [CI], 51%-79%) and 99% (95% CI, 49%-51%), respectively, when compared to healthy control participants.

What else?

Compared to non-neovascular AMD control participants, the sensitivity of the Amsler grid test was 71% (95% CI, 60%-80%), and the specificity was 63% (95% CI, 49%-51%).

Investigators noted that the overall potential sources of bias were low across all 10 studies.

Let’s dissect this.

The Amsler grid test was positive in 2 of 3 cases with wet AMD when performed under close supervision and in the best possible conditions. For patients at risk of wet AMD, the test was positive in 1 of 3 cases.


While the Amsler grid test offers eyecare practitioners an easy-to-use and affordable self-test to monitor wet AMD progression, investigators said the study shows its “sensitivity may be at levels usually not recommended for monitoring.”

Paired with the moderate specificity for identifying neovascular AMD in at-risk patients, the study results suggest that such patients “should undergo regular ophthalmic examinations, regardless of the results of the Amsler grid self-assessment.”