July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Improved estimation of subtle, but noticeable changes in functional vision using new tests of visual acuity and contrast sensitivity
Author Affiliations & Notes
  • Emma Flor
    College of Optometry, Nova Southeastern University , Davie, Florida, United States
  • Andrea M Janoff
    College of Optometry, Nova Southeastern University , Davie, Florida, United States
  • Luis Andres Lesmes
    Adaptive Sensory Technology, California, United States
  • Manonmani Murugappan
    College of Osteopathic Medicine, Nova Southeastern University, Davie, Florida, United States
  • Maryn JaNet Barnes
    College of Optometry, Nova Southeastern University , Davie, Florida, United States
  • Ava K Bittner
    College of Optometry, Nova Southeastern University , Davie, Florida, United States
    Ophthalmology, University of California, Los Angeles, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Emma Flor, Adaptive Sensory Technology (F), Adaptive Sensory Technology (R); Andrea Janoff, Adaptive Sensory Technology (F); Luis Lesmes, Adaptive Sensory Technology (I), Adaptive Sensory Technology (E), Adaptive Sensory Technology (P); Manonmani Murugappan, Adaptive Sensory Technology (F), Adaptive Sensory Technology (R); Maryn Barnes, Adaptive Sensory Technology (F); Ava Bittner, Adaptive Sensory Technology (F)
  • Footnotes
    Support  an investigator initiated award from Adaptive Sensory Technology
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3630. doi:https://doi.org/
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      Emma Flor, Andrea M Janoff, Luis Andres Lesmes, Manonmani Murugappan, Maryn JaNet Barnes, Ava K Bittner; Improved estimation of subtle, but noticeable changes in functional vision using new tests of visual acuity and contrast sensitivity. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3630. doi: https://doi.org/.

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

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Abstract

Purpose : True changes in central visual function that are small in magnitude but subjectively appreciated may not necessarily be documented as being statistically significant due to potential measurement-related issues with existing chart-based tests of visual acuity (VA ) and contrast sensitivity (CS). We determined optical intervention-related changes in VA and CS for existing tests compared to two novel tests.

Methods : The ETDRS trans-illuminated VA chart, Pelli-Robson CS, and active learning adaptive tests of VA (i.e., quantitative VA) and CS function (i.e., quantitative CSF) were repeated at two visits in 50 eyes of 25 normally-sighted, pre-presbyopic adults without ocular disease. Subjects were randomized and masked to perform these tests at 3-4m while wearing daily disposable Acuvue or Alcon contact lenses with distance-only and multifocal correction.

Results : All except two subjects (92%) were accurately able to identify which contact lens was the multifocal, based on subjective visual disturbances. The qVA test measured a significantly greater VA loss with the multifocal on average when compared to the ETDRS chart (0.18±0.10 vs . 0.14±0.12 log units; p=0.03). The qCSF test measured a slightly greater CS loss at 3cpd with the multifocal on average when compared to the Pelli-Robson chart (-0.13±0.15 vs. -0.09±0.11 log units; p=0.12). Hypothesis testing for detecting VA loss of >7.5 letters with the multifocal with the qVA test was marginally significant (p=0.028; one-sided), but not significant for the ETDRS chart (p>0.50). For detecting CS degradations of >0.20 logCS with the multifocal lens, the measured changes were significant at 3, 6, and 12 cpd with the qCSF (p<0.025; one-sided), but not significant for Pelli-Robson (p>0.50).

Conclusions : The definition of clinically meaningful changes in vision is constrained by what is clinically measurable, thus it is important to build better tools to detect subtle changes in visual function that are noted by patients. Our findings support that enhanced test design can reveal significant visual changes that have perceptual correlates.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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