Abstract
Purpose :
We sought to test the repeatability of HOTV visual acuity test with black and white optotypes in children. In addition, visual acuity with black optotype on a white background (B-on-W) was compared to white optotype on a black background (W-on-B) in myopic children as compared to non-myopic children aged 4-7 years.
Methods :
11 children (9 girls, 1 boy, 1 unspecified) aged 4-7 years were tested utilizing an electronic automated ATS surrounded HOTV distance acuity chart (M&S Technologies Inc) with both B-on-W and W-on-B testing conditions. Participants were tested monocularly at a 3 meter viewing distance. The testing screen was calibrated to a luminance of 90-100 lux. Participants were retested after a 30-minute break (± 15 minutes). Only right eye data was used for statistical analysis. We conducted Bland-Altman analysis with a 95% limit of agreement (LoA) to compare test conditions. Paired T-Tests were implemented to evaluate test and retest. Independent T-tests were utilized to compare LogMAR acuity in myopic (n=3) and non-myopic (n=8) eyes with both B-on-W and W-on-B optotypes.
Results :
Agreement of repeatability showed a 95% LoA between test and retest was ± 0.21 LogMAR for black optotype (upper LoA = 0.22 and lower LoA = –0.20, mean difference = 0.01, P > 0.05) and was ± 0.10 LogMAR for white optotype (upper LoA = 0.06 and lower LoA = –0.14, mean difference = -0.04, P=0.04). The average acuity difference between white optotype and black optotype was –0.03 LogMAR (P > 0.05, Cohen’s
d = -0.29). The agreement of white optotype and black optotype test conditions results in a 95% LoA of ± 0.17 (upper LoA = 0.13 and lower LoA = -0.20, mean difference = -0.03, P > 0.05). When comparing myopic with non-myopic children, the myopic group habitual visual acuity was poorer than non-myopic patients in the black optotype condition (mean difference = -0.13 LogMAR, P = 0.02), but there was no significant difference in the white optotype condition (mean difference = -0.04 LogMAR, P > 0.05).
Conclusions :
When using the ATS-HOTV method, the white optotype visual acuity testing is more repeatable than black optotype visual acuity testing in children aged 4-7 years.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.