Dataset Information

Psychophysical Validation of a Novel Active Learning Approach for Measuring the Visual Acuity Behavioral Function.

ABSTRACT:

Purpose

To evaluate the performance of the quantitative visual acuity (qVA) method in measuring the visual acuity (VA) behavioral function.

Methods

We evaluated qVA performance in terms of the accuracy, precision, and efficiency of the estimated VA threshold and range in Monte Carlo simulations and a psychophysical experiment. We also compared the estimated VA threshold from the qVA method with that from the Electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) and Freiburg Visual Acuity Text (FrACT) methods. Four repeated measures with all three methods were conducted in four Bangerter foil conditions in 14 eyes.

Results

In both simulations and psychophysical experiment, the qVA method quantified the full acuity behavioral function with two psychometric parameters (VA threshold and VA range) with virtually no bias and with high precision and efficiency. There was a significant correlation between qVA estimates of VA threshold and range in the psychophysical experiment. In addition, qVA threshold estimates were highly correlated with those from the E-ETDRS and FrACT methods.

Conclusions

The qVA method can provide an accurate, precise, and efficient assessment of the full acuity behavioral function with both VA threshold and range.

Translational relevance

The qVA method can accurately, precisely, and efficiently assess the full VA behavioral function. Further research will evaluate the potential value of these rich measures for both clinical research and patient care.

SUBMITTER: Zhao Y

PROVIDER: S-EPMC7794273 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Psychophysical Validation of a Novel Active Learning Approach for Measuring the Visual Acuity Behavioral Function.

Zhao Yukai Y Lesmes Luis Andres LA Dorr Michael M Bex Peter J PJ Lu Zhong-Lin ZL

Translational vision science & technology 20210104 1

<h4>Purpose</h4>To evaluate the performance of the quantitative visual acuity (qVA) method in measuring the visual acuity (VA) behavioral function.<h4>Methods</h4>We evaluated qVA performance in terms of the accuracy, precision, and efficiency of the estimated VA threshold and range in Monte Carlo simulations and a psychophysical experiment. We also compared the estimated VA threshold from the qVA method with that from the Electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) and Freib ...[more]

PMID: 33505768

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Project description:PurposeThe recent exponential growth in teleophthalmology has been limited in part by the lack of a validated method to measure visual acuity (VA) remotely. We investigated the validity of a self-administered Early Treatment Diabetic Retinopathy Study (ETDRS) home VA test. We hypothesized that a home VA test with a printout ETDRS chart is equivalent to a standard technician-administered VA test in clinic.DesignProspective cohort study.ParticipantsTwo hundred nine eyes from 108 patients who had a scheduled in-person outpatient ophthalmology clinic visit at an academic medical center.MethodsEnrolled patients were sent a .pdf document consisting of instructions and a printout ETDRS vision chart calibrated for 5 feet. Patients completed the VA test at home before the in-person appointment, where their VA was measured by an ophthalmic technician using a standard ETDRS chart. Survey questions about the ease of testing and barriers to completion were administered. For the bioequivalence test with a 5% nominal level, the 2 1-sided tests procedure was used, and an equivalent 90% confidence interval (CI) was constructed and compared with the prespecified 7-letter equivalence margin.Main outcome measuresThe primary outcome was the mean adjusted letter score difference between the home and clinic tests. Secondary outcomes included the unadjusted letter difference, absolute letter difference, and survey question responses.ResultsThe mean adjusted VA letter score difference was 4.1 letters (90% CI, 3.2-4.9 letters), well within the 7-letter equivalence margin. Average unadjusted VA scores in clinic were 3.9 letters (90% CI, 3.1-4.7 letters) more than scores at home. The absolute difference was 5.2 letters (90% CI, 4.6-5.9 letters). Ninety-eight percent of patients agreed that the home test was easy to perform.ConclusionsAn ETDRS VA test self-administered at home following a standardized protocol was equivalent to a standard technician-administered VA test in clinic in the examined population.

Project description:Introduction: Patients suffering from bilateral vestibular hypofunction (BVH) often experience ataxia as well as visual instability. Even though progress has been made in vestibular testing, insights regarding vestibular deficit in BVH remain incomplete since no method allows evaluation of frequency ranges of vestibular sensors in a continuous way. The aim of our study was to give a detailed description of the level of vestibular deficit in different ranges of vestibular stimulation and an exhaustive evaluation of the functional impact including dynamic visual acuity (DVA) in a cohort of BVH patients in different etiologies. Methods: We prospectively included 20 patients with chronic BVH. All patients underwent clinical evaluation and functional assessment including evaluation of their symptoms related to BVH, quality of life questionnaire and DVA in the horizontal and vertical plane. Patients underwent vestibulo-ocular reflex (VOR) testing using rotatory chair, caloric stimulation and video head impulse (vHIT) in the plane of the 6 canals, and cervical and ocular Vestibular evoked myogenic potentials. Results: Mean rotatory VOR gain was 0.07 (SD = 0.07). Mean rotatory VOR gain during vHIT for the lateral, anterior and posterior canals was respectively < 0.28, < 0.34, and < 0.20. Mean loss of DVA in the 4 directions was >0.30 LogMAR. In our population fall frequency was significantly higher in patients with lower UniPedal Stance Test (UPST), higher Dizziness Handicap Inventory and Ataxia Numeric Scale (ANS) scores, as well as greater loss of upwards DVA. Patients with ototoxic BVH had a significantly higher residual VOR gain during vHIT in the anterior canal plane and lower DHI than other patients. In the general population anterior canal function was significantly higher than lateral or posterior canal function. Conclusions: This study gives extensive descriptive results of residual vestibular function, DVA and quality of life in a population of patients suffering from severe BVH. UPST and ANS are good indicators for fall risk in case of BVH. Gentamicin induced BVH seems to have a lesser impact on quality of life than other etiologies.Anterior semi-circular canal function seems less deteriorated than lateral and posterior function.

Project description:IMPORTANCE:Visual acuity is the most frequently performed measure of visual function in clinical practice and most people worldwide living with visual impairment are living in low- and middle-income countries. OBJECTIVE:To design and validate a smartphone-based visual acuity test that is not dependent on familiarity with symbols or letters commonly used in the English language. DESIGN, SETTING, AND PARTICIPANTS:Validation study conducted from December 11, 2013, to March 4, 2014, comparing results from smartphone-based Peek Acuity to Snellen acuity (clinical normal) charts and the Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart (reference standard). This study was nested within the 6-year follow-up of the Nakuru Eye Disease Cohort in central Kenya and included 300 adults aged 55 years and older recruited consecutively. MAIN OUTCOMES AND MEASURES:Outcome measures were monocular logMAR visual acuity scores for each test: ETDRS chart logMAR, Snellen acuity, and Peek Acuity. Peek Acuity was compared, in terms of test-retest variability and measurement time, with the Snellen acuity and ETDRS logMAR charts in participants' homes and temporary clinic settings in rural Kenya in 2013 and 2014. RESULTS:The 95% CI limits for test-retest variability of smartphone acuity data were ±0.033 logMAR. The mean differences between the smartphone-based test and the ETDRS chart and the smartphone-based test and Snellen acuity data were 0.07 (95% CI, 0.05-0.09) and 0.08 (95% CI, 0.06-0.10) logMAR, respectively, indicating that smartphone-based test acuities agreed well with those of the ETDRS and Snellen charts. The agreement of Peek Acuity and the ETDRS chart was greater than the Snellen chart with the ETDRS chart (95% CI, 0.05-0.10; P?=?.08). The local Kenyan community health care workers readily accepted the Peek Acuity smartphone test; it required minimal training and took no longer than the Snellen test (77 seconds vs 82 seconds; 95% CI, 71-84 seconds vs 73-91 seconds, respectively; P?=?.13). CONCLUSIONS AND RELEVANCE:The study demonstrated that the Peek Acuity smartphone test is capable of accurate and repeatable acuity measurements consistent with published data on the test-retest variability of acuities measured using 5-letter-per-line retroilluminated logMAR charts.

Dataset Information

Psychophysical Validation of a Novel Active Learning Approach for Measuring the Visual Acuity Behavioral Function.

Purpose

Methods

Results

Conclusions

Translational relevance

Publications

Psychophysical Validation of a Novel Active Learning Approach for Measuring the Visual Acuity Behavioral Function.

Similar Datasets

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