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  • Diagnostic Accuracy of the Amsler Grid for AMD

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, April 2023

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    In a systematic review and meta-anal­ysis, Bjerager et al. reviewed data on the diagnostic accuracy of the Amsler grid test when used by patients for self-assessment of signs of age-related macular degeneration (AMD). They found low sensitivity and moderate specificity.

    After a search of 12 databases, the researchers found 10 studies eligible for their review. The studies were clinic-based and took place between 2003 and 2015, and they collectively included 425 eyes with neovascular AMD, 1,262 eyes with dry AMD, and 203 healthy control eyes. Participants’ age ranged from 62 to 83 years. Main outcomes were sensitivity and specificity of the Amsler grid for detecting neo­vascular AMD, with comparators being either healthy control eyes or eyes with dry AMD.

    Sensitivity and specificity to diag­nose neovascular AMD were 67% and 99%, respectively, when compared to healthy control participants—and were 71% and 63%, respectively, when com­pared to eyes with dry AMD.

    These findings indicate that the Amsler grid test should be used with caution for detecting neovascular AMD, the researchers wrote. They acknowledged that the test continues to appeal to patients, as it is inexpensive, readily available, easy to use, and does not require any electronics or devices. However, they wrote, “Although the Amsler grid may perform well in some cases, it may also provide a false sense of security in others.” As a result, they said, patients should be encouraged to have regular ophthalmic exams, regard­less of their self-assessment results.

    The original article can be found here.