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Frequently Asked Questions

AMD and Dark Adaptation

What is Dark Adaptation?

Dark adaptation is the ability of our eyes to adjust from light to darkness. Learn more about dark adaptation.

What is Rod Intercept (RI)?

Rod Intercept™ is the amount of time it takes for eyes to adapt to darkness. It is measured in minutes using the AdaptDx Pro automated dark adaptometer. If a patient’s RI is below 6.5 minutes, the patient has normal dark adaptation function. If the RI is equal to or above 6.5 minutes, the patient has impaired dark adaptation.

What is the connection between AMD and dark adaptation?

Research has shown that impaired dark adaptation is the first biomarker of AMD and indicates subclinical AMD at least three years before structural changes are visible with imaging or clinical exam. Learn more about the science behind dark adaptation testing.

What is subclinical AMD?

Subclinical AMD is the earliest stage of the disease. Even though no structural changes can be observed at this point, AMD has already impaired the function of the macula, specifically the dark adaptation function. Learn more about subclinical AMD.

What is the value in detecting AMD at a subclinical stage?

AMD has an extended subclinical phase lasting five years or more. During this time there is little or no loss of vision, but it is followed by a precipitous loss of vision if a patient transitions to an advanced stage of the disease. Detecting AMD at a subclinical stage will allow eye care physicians to help patients take proactive measures that can slow progression of the disease.

How accurate is dark adaptation testing using the AdaptDx Pro?

AdaptDx Pro is 90.6% sensitive in identifying AMD cases and 90.5% specific in identifying normal cases. The overall accuracy of 90.6% makes AdaptDx Pro more accurate than a visual field test. Read more about the sensitivity and specificity research.

Compare AdaptDx Pro to Other AMD Tests

How is AdaptDx Pro different from other AMD testing tools?

Other devices and tests look at structure of the macula (OCT, fundus photography, etc.) or risk factors of AMD (contrast sensitivity, macular pigment optical density, genetics, etc.). AdaptDx Pro is the only device that measures the function of the macula and provides objective and easy-to-interpret results. Learn more about AMD testing.

What is the difference between AdaptDx Pro and the MPOD?

MPOD (macular pigment optical density) devices measure a risk factor for AMD, not a physiological indicator of the disease. The AdaptDx Pro dark adaptometer measures a biomarker of the disease with 90% specificity and sensitivity. Impaired dark adaptation results from an AdaptDx Pro test signal that AMD is already present. Research has shown that there is no correlation between low MPOD levels and impaired dark adaptation.

Unlike MPOD devices, AdaptDx Pro testing is reimbursable under CPT code 92284 at a national average of $64.08.

Is the AdaptDx Pro test more or less accurate than the AdaptDx test?

As both devices use the same dark adaptation science, they have the same level of accuracy. Both the AdaptDx Pro and the AdaptDx are 90.6% sensitive in identifying AMD cases and 90.5% specific in identifying normal cases.

Testing with AdaptDx Pro

Is the AdaptDx Pro testing reimbursable?

Yes. The CPT code for dark adaptation testing is CPT 92284 and reimburses at a national average of $60.63. There are also numerous applicable ICD-10 codes, including H53.62 for acquired night blindness.

Download a Complete List of ICD-10 Codes

Who should take the AdaptDx Pro test?

The AdaptDx Pro test is indicated for patients with symptoms or risk factors. It is also used to monitor disease progression.

Patients with issues seeing or driving at night:

Since night vision difficulty is the first symptom of AMD, all patients who have issues seeing or driving at night should be tested for dark adaptation impairment. Acquired night blindness (ICD-10 H53.62) is a billable reason for performing a dark adaptation test (CPT 92284). Simply add the following question to your intake form: “Have you experienced problems seeing or driving at night?”

Patients who are at risk of AMD:

Patients over 50 who are at high risk of developing AMD should be tested on an annual basis, even if they do not experience night vision problems. Risk factors include age, family history, smoking, obesity and overall cardiovascular health (heart disease, high blood pressure or high cholesterol). You can use this helpful Risk and Symptom Assessment Form.

Patients with AMD to monitor disease progression:

Patients with diagnosed AMD should take the AdaptDx Pro Extended Test every six months or more to monitor disease progression. There are several ICD-10 codes that can be used to justify an extended dark adaptation test.

Download a Complete List of ICD-10 Codes

Are there any risks in taking the dark adaptation test?

No. The test is non-invasive, which means that nothing touches the patient’s eye. The lights used are very dim. Even the conditioning flash at the beginning of the test is milder than a normal camera flash.

How do I phase the AdaptDx Pro testing into my practice workflow?

Every eye care practice is different and the way you’ll incorporate the AdaptDx Pro testing into your workflow depends on your current practice for specialty testing. As part of the AMD Excellence Program™ , our team of experienced Practice Management Consultants will work with you to integrate the AdaptDx Pro test into your existing flow and optimize it to reach your goals.

Should I test both eyes?

Since AMD is a bilateral disease and there is a 92% concordance of dark adaptation status between eyes, the AdaptDx can be used unilaterally in both the Rapid Test (for disease detection) and Extended Test (for disease staging and monitoring) protocols. Some eye care professionals alternate eyes from test to test. For reimbursement, CPT 92284 can be used whether one or both eyes are tested, without the use of code modifiers for laterality.

Interpreting AdaptDx Pro Results

How do you interpret AdaptDx Pro results?

The AdaptDx Pro test results are objective and very easy to interpret. By looking at a single number from the test results (the Rod Intercept™ or RI), you will be able to determine whether the patient has impaired dark adaptation.

  • An RI below 6.5 minutes indicates normal dark adaptation function, consistent with normal retinal function.
  • An RI equal to or above 6.5 minutes indicates impaired dark adaptation, consistent with AMD.

Example of test results from AdaptDx Pro.

Do cataracts affect the AdaptDx Pro test results?

No. Dark adaptation measured by AdaptDx Pro is not affected by cataracts.  

Does amblyopia affect the AdaptDx Pro test results?

Amblyopia does not affect the test results because it is not correlated with AMD. The results will not be affected as long as the patient is capable of fixating on the light and can concentrate.

Does color vision deficiency influence the results of an AdaptDx Pro test?

Color vision deficiency has no impact on dark adaptation test results. The only special consideration would be to precisely explain the test without reference to the color of the fixation target and stimulus light.

Dark adaptation testing has been a great addition to my office. This device helps me find patients with AMD much sooner than we've ever been able to do. We know that 1 out of 3 Americans over the age of 75 has some form of AMD. But why wait until it's obvious to start therapy?

Jacob Olding, OD Jacob Olding, OD View all testimonials

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