June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Quick and easy light sensitivity assessment of the dark adapted eye: The Tuebingen Scotopic Threshold Test (TSTT)
Author Affiliations & Notes
  • Torsten Strasser
    Institute for Ophthalmic Research, Centre for Ophthalmology, Tuebingen, Germany
  • Hana Langrová
    Institute for Ophthalmic Research, Centre for Ophthalmology, Tuebingen, Germany
  • Anne Kurtenbach
    Institute for Ophthalmic Research, Centre for Ophthalmology, Tuebingen, Germany
  • Ditta Zobor
    Institute for Ophthalmic Research, Centre for Ophthalmology, Tuebingen, Germany
  • Dominic Hillerkuss
    Institute for Ophthalmic Research, Centre for Ophthalmology, Tuebingen, Germany
  • Eberhart Zrenner
    Institute for Ophthalmic Research, Centre for Ophthalmology, Tuebingen, Germany
  • Footnotes
    Commercial Relationships Torsten Strasser, None; Hana Langrová, None; Anne Kurtenbach, None; Ditta Zobor, None; Dominic Hillerkuss, None; Eberhart Zrenner, Retina Implant AG (F), Retina Implant AG (I), Retina Implant AG (C), Retina Implant AG (P), QLT Inc (C), Servier, Paris (C), Steinbeis GmbH&CoKG, Stuttgart (I), Steinbeis GmbH&CoKG, Stuttgart (C), Neurotech, USA (C), Pfizer, USA (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3015. doi:
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      Torsten Strasser, Hana Langrová, Anne Kurtenbach, Ditta Zobor, Dominic Hillerkuss, Eberhart Zrenner; Quick and easy light sensitivity assessment of the dark adapted eye: The Tuebingen Scotopic Threshold Test (TSTT). Invest. Ophthalmol. Vis. Sci. 2013;54(15):3015.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Light sensitivity of the dark-adapted eye is a valuable indicator of retinal function. Changes in light sensitivity are observed in many retinal disorders like Retinitis pigmentosa, CSNB, or in vitamin A deficiency. Light sensitivity is usually tested using dark adaptometry: after transient exposition to bright light the dark-adaptation curve and the final threshold are measured. This procedure is time-consuming and uncomfortable, especially for children. Within the EU-project TREATRUSH, we developed a test for assessing the scotopic threshold for early detection of Usher's syndrome.

 
Methods
 

The TSTT has 2 panels for scotopic and photopic stimulation. Each panel has a size of 7×10cm, consisting of 35 individually addressable LED bars, thus allowing to use various stimulus shapes. The centerpiece of the TTST is a microcontroller (ATmega8515, Atmel Corp.), running a self-developed software. Stimulus luminance is tuned by pulse-width modulation and adjustable in 100 steps between -3 to -1 log cd/m2. Using filters, this can be extended from -8 to -1 log cd/m2. The luminance gradually increases until a perception is indicated. The patient names the shape and the examiner confirms or discards the response, thus discriminating correct answers from false-positives. If confirmed, the luminance is decreased and the procedure is repeated. Feasibility and repeatability were tested in 11 subjects (10-68yrs). Monocular and binocular presentation were compared, as well as results obtained with natural or dilated pupil.

 
Results
 

All subjects completed the test successfully. Binocular presentation reduced threshold by ~0.15 log units. Intra-subject repeatability was >90%. We found no difference in the results obtained with natural or dilated pupils. A flickering stimulus did not show advantages over a constant presentation.

 
Conclusions
 

The Tuebingen Scotopic Threshold Test allows for quick and easy assessment of the sensitivity of the dark-adapted eye. The recording takes only 5 minutes (w/o dark adaptation), can be done with natural pupils and is comfortable for the patient. Results obtained with the TSTT show a high correlation to similar tests. This makes the TSTT to a well suited tool for testing children. This project and study is supported through TREATRUSH (HEALTH-F2-2010-242013), a European Collaborative project - supported by the European Commission under the 7th Framework Program.

     
Keywords: 649 photoreceptors: visual performance • 556 infant vision • 612 neuro-ophthalmology: diagnosis  
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