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E Eugenie Hartmann, Lindreth DuBois, Michael Lynn, Scott R Lambert, ; Relationship between monocular grating acuity at 12-months and recognition acuity at 4.5-years in the Infant Aphakia Treatment Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4394.
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To determine the relationship between grating acuity measured at 12-months and recognition acuity at 4.5-years of age in the treated eyes of infants enrolled in the Infant Aphakia Treatment Study (IATS).
IATS is a multi-center, randomized clinical trial sponsored by NEI to compare contact lenses (CL) and intraocular lenses (IOL) for initial correction of unilateral aphakia in patients with an infantile cataract whose surgery was performed from 1 to <7 months of age. Patients were enrolled in IATS at 12 sites (2004-2009;n=57 per treatment). Grating acuity was tested at 12 months of age (Teller Acuity Cards) and recognition acuity at 4.5 years of age (ATS-HOTV protocol) by a traveling tester masked to the treatment groups. Visual acuity (VA) was obtained on all 114 patients at 12-months and 112 patients at 4.5-years. The relationship between VA at the two ages in the treated eye was evaluated using the Spearman rank correlation coefficient.
There was no significant difference in logMAR VA at either age between the two treatment groups. A comparison of logMAR VA at the two ages for all patients is shown in the scatter plot. Correlation was 0.47 (p<0.001). This plot shows that almost equal numbers of patients demonstrated improved versus worsened VA. When the data are categorized relative to norms for grating VA and specific ranges of recognition VA, it is apparent that infants whose grating VA was >20/150 (lower 95th% predictive limit of normal) were more likely to have >20/200 recognition VA. More infants whose grating acuity was <20/150 at age 12 months were able to maintain a reasonable level of acuity, with only 32% of these patients having VA of >20/200 at age 4.5 years.
Our results suggest that grating VA at 12 months can provide some indication of long-term recognition VA. While there is not a strict predictive relationship between the two measures, as expected, infants whose VA was within the 95% predictive limits for normal at 12 months were more likely to demonstrate recognition VA up to 20/80 in the treated eye compared with infants whose grating acuity was below this level (48% vs 26%). Thus, a grating VA within normal limits at 12 months is reason for cautious optimism. On the contrary, a grating VA below normal limits cannot be conclusively interpreted as an eye that will ultimately be considered legally blind.
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