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Xoana Barcala, Maria Vinas, enrique Gambra, Susana Marcos, Carlos Dorronsoro; Perceptual differences across binocular corrections for presbyopia. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6469. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
A binocular simultaneous vision simulator and a multidimensional metric (Multifocal Acceptance Score to Evaluate Vision;MAS-2EV) were used to assess perceived visual quality of different binocular presbyopic corrections in cyclopleged young subjects and presbyopic subjects
A wearable simulator (SimVisGekko,2EyesVision) operating under the principle of temporal multiplexing was used to simulate four binocular presbyopic corrections: Monofocal-far(FF); Bifocal(BB); Monovision far(dominant eye)/near(FN); Modified monovision far(dominant eye)/bifocal(FB).Near add was +2.50D. Tests were performed on 10 subjects:5 cyclopleged young subjects(22-38 yo;SE:-2.45±2.11D) and 5 non-cyclopleged presbyopes(57-68 yo;SE:+1.05±0.45D; accommodation amplitude 1.4±0.2D from PowerRefractor II,PlusoptiX). MAS-2EV is a multicomponent vector comprising stereoscopic vision and 4 perceptual scores (PS,0-10 range) of image quality at far/near distance of day/night using multi-image stimuli presented on a HDR monitor(far at 4m) and a tablet(iPad-retina at 40cm),respectively.Subjects judged the perceived quality (PS) of the images with the 4 corrections (10 repetitions).Results from MAS-2EV were graphically represented as a polygon,numerically summarized by its modulus (0-10).
MAS-2EV was 6.26 PS on average(avg), and varied across subjects, corrections and conditions, covering a higher range in cyclopleged subjects (PS difference=8.0±1.4) than in presbyopic (6.3±1.9). MAS-2EV was highly repetitive across the 10 repetitions (avg std across subjects and conditions: 1.0). For each binocular correction, the PS difference across subjects and conditions ranged from 6.3 to 10. For Far, FF produced the best PS in all subjects (PSF=9.31±0.62), followed by FB (PSF=8.03±0.68)-highest in 8/10 subjects- and FN (PSF=7.57±1.04)–highest in 2/10-. PS for Near (PSN) was lower than for Far, with best PS for FN (PSN=7.01±2.20)–best in 7/10-and BB (PSN=5.36±1.81)–best in 3/10-. On avg PS(near/far;day/night) was highest for FN (PS=7.29±1,70)–best in 7/10- and BB (PS=5.25±1.65 )–best in 3/10-. However,stereopsis was lowest for FN in all subjects (80” on avg), compared to the other corrections (40”). The best balance between Near and Far vision for all subjects was provided by BB correction (PSF-PSN=0.22).
The combination of visual simulators and MAS-2EV metric is a promising tool for non-invasive selection of presbyopic corrections in the clinic.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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