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Zhong-Lin Lu, Yukai Zhao, Luis A Lesmes, Michael Dorr, Peter J. Bex; Accuracy in detecting vision changes with visual acuity and contrast sensitivity tests. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4943. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Accurate detection of vision change is important in diagnosing and monitoring visual disease progression and treatment effects. In this study, we evaluated the accuracy of three tests in detecting vision changes: the e-ETDRS (Beck et al., 2003), a new Bayesian visual acuity test (Lesmes, 2017), and qCSF assessment of the contrast sensitivity function (Lesmes, et al, 2010; Hou, et al, 2015).
Monocular visual acuities and contrast sensitivities were measured with the three tests in both eyes of six subjects with normal or corrected-to-normal vision in four simulated vision conditions (no foil and three different levels of Bangerter foil that degraded vision). Each session tested one foil condition. Subjects were tested monocularly with both the new Bayesian visual acuity and e-ETDRS methods 4 times, with random test order of the two methods and two eyes in different blocks. At the end of each session, the contrast sensitivity function of each eye was measured with the qCSF method. An ROC analysis (Hou et al., 2016) was conducted to evaluate the accuracy of the methods in detecting changes in visual acuity and area under the log CSF (AULCSF) associated with different foil conditions. The analysis consisted of computing (1) the average acuity from repeated e-ETDRS measures in each eye and foil condition for each subject; (2) posterior distributions of the estimated VA from the new visual acuity and e-ETDRS tests and AULCSF from the qCSF, (3) the accuracy of detecting acuity changes (averaged across all 16 possible combinations of the four repeats in each condition) and AULCSF changes between each pair of foil conditions; (4) the average accuracy in three ranges of mean acuity changes: 0.02-0.05, 0.05-0.10, and 0.10-0.20 logMAR.
For detection of visual function change, the qCSF with 50 trials had the highest accuracy (0.996 ± 0.008, 0.996 ± 0.007, and 0.987 ± 0.020 in the three ranges), followed by the new Bayesian visual acuity test with 45 trials or 135 letters (0.874 ± 0.038, 0.910 ± 0.047, and 0.971 ± 0.036), and lastly by the e-ETDRS test with 30.8 ± 5.4 letters (0.826 ± 0.036, 0.808 ± 0.029, and 0.0.905 ± 0.042).
Bangerter foils produce deficits in visual function beyond visual acuity. The qCSF was the most accurate test for these deficits, and the new Bayesian VA test is more accurate than e-ETDRS in detecting associated visual acuity changes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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