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The Thai logarithmic visual acuity chart.

OBJECTIVE: To evaluate visual acuity scores from the Thai and the standard logarithmic visual acuity chart. DESIGN: Comparative non-randomized clinical study. PARTICIPANTS AND METHOD: 153 subjects, calculated from sample size estimation, without any ocular disease and aged between 18 and 80 years old who could read English and at least 3 out of 5 letters of the largest line of both charts were enrolled to use only their right eyes to read the Thai and the standard logarithmic visual acuity chart without any refractive correction. 27 subjects came back for second measurements of visual acuity in the same manner as the first a week later. MAIN OUTCOME MEASUREMENT: The visual acuity scores were divided into the Snellen or the whole line score and the ETDRS or the letter-by-letter score. The former was compared by weighted Kappa and the latter was compared by the paired t-test. RESULTS: There was high agreement in weighted Kappa between the Snellen scores from the Thai and standard chart (k = 0.7375). There was also high agreement in weighted Kappa between the Snellen scores from the first and second reading of the Thai chart (k = 0.7304) and the standard chart (k = 0.7282). A high correlation was observed between the ETDRS scores from the Thai and standard charts (r = 0.947). Also there was a high correlation between the ETDRS scores of the first and second reading of both the Thai chart (r = 0.962) and the standard chart (r = 0.952). There was a significant difference between the ETDRS scores from the Thai and standard chart (p<0.0001). There was no significant difference between the ETDRS scores from the first and second reading of either the Thai chart (p = 0.794) or the standard chart (p = 0.62). CONCLUSION: The Snellen visual acuity score from the Thai chart is comparable to the standard chart. Although the ETDRS score from the Thai chart is different statistically from the standard chart, its test-retest variability tends to be low. This suggests the possibility of using the Thai chart for monitoring of the ETDRS score in research studies.

Adolescent↗

Impaired visual acuity as a risk factor for visual hallucinations in Parkinson's disease.

Pathophysiology of hallucinations in Parkinson's disease is poorly understood. This study investigated relationships between visual hallucinations and visual acuity. Twenty-six consecutive patients with Parkinson's disease participated in this study. Patients were divided into two groups: patients with visual hallucinations (VH group) and those without visual hallucinations (no-VH group). Unaided and corrected eyesight was evaluated in all patients, and if frequent use of prescription glasses or contact lenses was involved, eyesight using these lenses was also measured as the patient's own best eyesight. If a patient did not use prescription glasses or contact lenses, the patient's own best eyesight was defined as the unaided eyesight. Multivariate regression analysis demonstrated that agonist use and best eyesight were different after the backward elimination method. Visual hallucinations were closely related not to uncorrected eyesight or unaided eyesight but to the patient's best eyesight. It is suggested that impaired visual acuity is a risk factor for visual hallucinations.

Aged↗

[Initial results of studies on stereo-visual acuity for moving objects].

Besides dynamic visual acuity, dynamic stereo visual acuity can also be interesting in ergophthalmology. This was investigated in 11 test persons by means of two synchronously rotating prisms simulating circular motion. The dynamic stereo visual acuity decreases more steeply with increasing speed than dynamic visual acuity. The interindividual standard deviation is considerable, especially in cases of reduced vision. Bilateral good vision or good stereopsis does not always result in good dynamic stereo visual acuity, because of differences in the ability to achieve stereopsis and to follow to object by rolling the eyes.

Adolescent↗

[Computer-based assessment of visual acuity--technical realization].

Testing of visual acuity for distant vision can be computerized by using monitor screens to present optotypes. Because of the limited spatial resolution of conventional monitors, measurement of visual acuity for near vision is not possible. This paper describes a new computer-aided method for the measurement of both near and distant visual acuity. Our approach to the assessment of visual acuity for near vision is based on a recently developed liquid crystal display (a screen, LCD) measuring 10.5 mm x 15 mm. The LCD permits the presentation of optotypes for the measurement of visual acuity between 0.063 and 1.25 at a viewing distance of 40 cm (near/distant). The presentation of optotypes for the assessment of the acuity of distant vision uses a standard 17" monitor that permits visual acuity figures of between 0.032 and 1.6 to be assessed.

Diagnosis, Computer-Assisted↗

Prospective comparison of the Heine retinometer with the Mentor Guyton-Minkowski potential acuity meter for the assessment of potential visual acuity before cataract surgery.

Various techniques and devices have been developed to aid in the assessment of potential visual acuity prior to cataract surgery. We report a prospective comparison of two such assessments, one made using a new instrument, the hand-held Heine retinometer (HR) (Heine Instruments, Germany), and the other using the Mentor Guyton-Minkowski potential acuity meter (PAM) (Mentor, Inc, Norwell, Mass). A total of 37 eyes were assessed using both instruments just before cataract surgery. Three eyes were excluded from analysis due to postoperative complications affecting visual acuity that could not have been predicted with either instrument. The false-negative rate was 44% for the PAM and 32% for the HR. There were no false-positive results with either instrument. Neither instrument was particularly accurate in predicting actual final visual acuity (r2 = 0.290 and 0.144 for the PAM and HR, respectively). The HR was deemed easier to use.

Cataract↗

Subnormal visual acuity in children: prognosis and visual evoked cortical potential findings.

Seventy-one children, age 4-12 years, with subnormal visual acuity (VA) in at least one eye (0.7 or less) were examined using visual evoked cortical potentials (VECPs) to pattern-reversal stimulation. Twenty-eight children with squint had mean VA 0.3 in squinting and 0.7 in non-squinting eyes. Thirty-one children had unexplained subnormal VA, mean 0.6. Twelve children with mild unclassifiable fundus abnormalities had mean VA 0.5. In the squinting eyes and the eyes with fundus abnormalities the mean latency of the VECP was significantly prolonged. In squinters the mean amplitude to stimulation of the squinting eyes and to binocular stimulation was significantly reduced. Statistically significant increase in the mean VA was observed in all groups except in the cases with visible fundus abnormalities. There was no statistically significant correlation between VECP parameters and final VA. In conclusion, VA prognosis could not be predicted from VECP data in individual cases.

Child↗

[Correlation of letter optotypes with Landholt ring for different degrees of visual acuity].

BACKGROUND: According to the German visual acuity standard DIN 58220 part 2 we compared in 1990 a set of 10 capital letters (C, D, E, F, K, N, P, U, V, Z; type DIN 1451; Serifless Linear-Antiqua) with the Landolt Ring regarding their legibility. The measurements at that time had been accomplished with young adults whose visual acuity was around 2.0. The results showed that the letters at the same height as the Landolt-Ring are easier to see. The difference of legibility was 4.7%. So the set of letters in comparison to the Landolt Ring was equivalent within the required tolerance of +/- 0.05 log units of visual acuity as defined in the standard. For visual acuity measurements which need only eight instead of ten different letters, the set C, D, E, K, N, P, U, Z has been suggested. MATERIALS AND METHODS: With this set the experiments were repeated on 48 subjects. Nine of these had a reduced visual acuity from 0.32 to 0.6. Twenty subjects had amblyopia with a visual acuity of 0.02 to 0.2. The last nineteen subjects had a normal visual acuity, but 10 persons hereof had been artificially made ametropic by a plus-overcorrection and 9 by holding a frosted glass disk in front of their eyes. These subjects then had a visual acuity of about 0.1. RESULTS: The results of the measurements showed that in this visual acuity range the letters are easier to see than a Landolt Ring of the same size. The difference in legibility of the letters in comparison to the Landolt Ring was up to 0.3 log units of the viewing angle. CONCLUSIONS: To achieve an equivalence with the Landolt Ring even in this visual acuity range, the height of the letters have to be reduced at a higher percentage.

Adolescent↗

Cytidine-5'-diphosphocholine improves visual acuity, contrast sensitivity and visually-evoked potentials of amblyopic subjects.

PURPOSE: Cytidine-5'-diphosphocholine (CDP-choline) therapy is currently used to improve the consciousness level in patients with brain lesions and as a complement to levodopa therapy in Parkinson's disease. Recently, the substance has been shown to improve the visual acuity (VA) of both eyes of adults with amblyopia. This study aims at establishing whether Contrast Sensitivity (CS) and visually-evoked potentials (VEPs) also change after CDP-choline treatment. METHODS: VA, CS, and VEPs were measured in a group of amblyopic volunteers (n = 10, mean age 24.8 years) before treatment with Neuroton (CDP-choline, 1 g/day intramuscularly [IM] for 15 days) and the day after termination of the same. CS was evaluated, using a forced-choice, automatic procedure (QUEST: Watson and Pelli, 1983). Steady-state VEPs were recorded in response to counterphased (8 Hz) sinusoidal gratings (2 c/deg) of different contrasts. RESULTS: On average, after treatment, VA improved 1.4-1.5 lines in the amblyopic eyes and 0.4 lines in the normal eyes. CSs improved in both dominant and amblyopic eyes by about 3 dB. VEPs increased in amplitude (about 30%) and advanced in phase (about 0.2 pi rad). Amplitude and phase changes were not correlated. CONCLUSIONS: Treating adult amblyopes with CDP-choline has the effect of improving their VA, CS and VEPs. Changes occur in both eyes, although to different extents, and resemble those previously reported for levodopa treatment.

Adolescent↗

Iris pigmentation and photopic visual acuity: a preliminary study.

Visual acuity under varying conditions of light stress was tested in four human populations. It was found that the density of iris pigmentation had no significant effect on visual acuity under conditions of bright light. While some acclimatization to local light levels was observed, significant population differences in visual acuity were obtained. A hypothesis is advanced at to the adaptive value of varying densities of pigmentation of the iris based on the known heat absorption properties of melanin granules.

Anthropology, Physical↗

[Variables that influence visual acuity after macular hole surgery].

PURPOSE: To evaluate the variables that influence visual acuity and visual improvement after macular hole surgery. METHODS: Our study included 421 eyes in which maculor holes were successfully closed after surgery and followed up at least 1 year after the last surgery. Surgical techniques were conventional methods (Group 1: 350 eyes) with retinal pigment scalping of the macular hole basis added in the refractory cases (Group 2: 71 eyes). The variables used for the multiple regression were gender, age, preoperative visual acuity, hole stage, duration of symptoms, hole size, and axial length. RESULTS: The variables that most influenced postoperative visual acuity were as follows: Group 1: gender (r = -0.011, p = 0.016), age (r = -0.17, p = 0.005), preoperative visual acuity (r = 0.51, p < 0.0001), duration of symptoms (r = -0.015, p < 0.0001), and axial length (r = -0.090, p = 0.045). Group 2: age (r = -0.18, p = 0.047), and preoperative visual acuity (r = 0.47, p < 0.0001). CONCLUSIONS: The variables that influenced visual acuity and visual improvement after macular hole surgery were common. In Group 1: gender, age, preoperative visual acuity, duration of symptoms, and axial length; in Group 2: age and preoperative visual acuity.

Adult↗

Perinatal characteristics may influence the outcome of visual acuity.

Visual-evoked potential (VEP) acuity has been used to assess the effects of dietary fats on the integrity of the visual pathway of infants. We investigated prognostic determinants of VEP acuity at 16 wk of age. The results of two randomized dietary intervention trials designed to assess the effect of dietary fatty acids on the visual development of term infants were combined. At entry to both trials (approximately day 5 of life), a blood sample to assess polyunsaturated fatty acid (PUFA) status was collected along with sociodemographic and perinatal characteristics. At 16 +/- 0.9 wk of age, infants underwent VEP testing to measure acuity. There was no effect of dietary treatment on these outcomes within or between trials. Multiple linear regression models were constructed to investigate the effect of perinatal and nutritional variables at study entry on VEP acuity of 185 infants. Higher birth weight was associated with an ability to resolve smaller checkerboard patterns [r2 = 0.05; 95% confidence interval (Cl), -0.10, -0.04 log units]. Male gender (r2 = 0.03; 95% Cl, 0.01, 0.07 log units), day 5 plasma 22:5n-6 (r2 = 0.04; 95% Cl, 0.02, 0.20 log units), day 5 red cell membrane 20:3n-9 (r2 = 0.03; 95% Cl, 0.03, 0.13 log units), and the number of smokers in the household (r2 = 0.02; 95% Cl, 0.00, 0.04 log units) were all associated with poorer VEP acuity scores. It is possible that a combination of perinatal factors could accumulate to either mask or enhance effects of diet on VEP acuity, given the relatively modest effects of long-chain PUFA on visual outcome.

Birth Weight↗

[Prediction of curative effect of amblyopia by laser interference fringe visual acuity].

Laser interference fringe visual acuities (IVAs) and E visual acuities (EVAs) of 116 cases 171 amblyopic eyes were examined. All cases were treated by various therapies and the average follow-up was 2.5 years. Before treatment, the IVAs of 86.5% eyes were better than their EVAs and the IVAs of 13.5% eyes were equal to their EVAs. After treatment, the EVAs of all the eyes were raised to their IVA levels (P < 0.0001, r = 0.8218). The results show that the IVA examination can predict the curative effect and monitor the treatment of amblyopia. The relationships between the IVA and the character of visual fixation, the type and degree of amblyopia, elder child and adult amblyopia, etc. were discussed.

Adolescent↗

Variables That Influence Visual Acuity After Macular Hole Surgery.

Purpose: To evaluate the variables that influence visual acuity and visual improvement after macular hole surgery.Methods: Our study included 421 eyes in which macular holes were successfully closed after surgery and followed up at least 1 year after the last surgery. Surgical techniques were conventional methods (Group 1: 350 eyes) with retinal pigment scalping of the macular hole basis added in the refractory cases (Group 2: 71 eyes). The variables used for the multiple regression were gender, age, preoperative visual acuity, hole stage, duration of symptoms, hole size, and axial length.Results: The variables that most influenced postoperative visual acuity were as follows: Group 1: gender (r = -0.011, P =.016), age (r = -0.17, P =.005), preoperative visual acuity (r = 0.51, P <.0001), duration of symptoms (r = -0.015, P <.0001), and axial length (r = -0.090, P =.045). Group 2: age (r = -0.18, P =.047), and preoperative visual acuity (r = 0.47, P <.0001).Conclusions: The variables that influenced visual acuity and visual improvement after macular hole surgery were common. In Group 1: gender, age, preoperative visual acuity, duration of symptoms, and axial length; in Group 2: age and preoperative visual acuity.

Journal Article↗

[Usefulness of visual evoked potentials in visual acuity examination].

Determination of visual acuity by means of VEP is carried out usually by the calculation of the amplitude function response from the value of pattern single element. That purpose is achieved by carrying out several tests of transient VEP performed each time with stimulation, using the pattern of different size of individual elements or changing sweep the following sizes of the pattern single element. Concentration of a patient is necessary during any examination and therefore in clinical practise the second of the listed methods is preferred because of its short duration. Correlation factor of visual acuity, determined by means of VEP and Snellen tests, differs depending on the examined group from about 0.4 to 0.9 and it is the lowest in case of ophthalmological disorders connected with optic nerve. Fixing of VEP optimal parameters when evaluating the visual acuity remains an open matter.

Evoked Potentials, Visual↗

Snellen visual acuity versus pattern reversal visual-evoked response acuity in clinical applications.

We compared the best-corrected Snellen acuity (SA) and the pattern reversal visual-evoked response (PVER) acuity in normal subjects and patients. Forty-two eyes of 42 normal subjects were controls; 457 eyes of 329 patients comprised the patient group. A steady-state stimulus with five check sizes ranging from 160 to 10 min in 1.0-octave steps was used. The PVER acuity was derived from the best-fit linear function relating the amplitude to the log-adjusted check size. Three intercepts of 0, 1 and 2 microV were used in both groups, and the PVER acuities were called P0, P1 and P2. The SAs in normal subjects ranged from 20/15 to 20/20 (mean, 20/18.3) and in patients from 20/15 to 20/1,600 (mean, 20/56.9). In normals, the P0 showed the best agreement with the SA (mean acuity difference, +0.34 octave). The SA and P0 agreed within +/- 2.0 octaves in 33/42 (78.6%) eyes. In patients, the P0 also showed the best agreement with the SA; 306/457 (67.0%) eyes showed an acuity difference within +/- 2.0 octaves. Unlike normals, 83/457 (18.2%) eyes showed an acuity difference > -3.0 octaves. These eyes mostly had optic nerve disease with a flattened PVER amplitude-check size function curve. The P0 seems to correlate better with SA than P1 and P2, but this analytical method may be less effective in the presence of certain pathologic conditions.

Adolescent↗

Assessment of the Catford drum in visual acuity testing and its use as a measurement of visual performance in low-vision patients.

Objective measurements of visual acuity were determined with the Catford drum in 82 eyes of patients in our Low-Vision Clinic who typically suffered from visual loss due to macular disease. The results were compared with subjective measurements of visual acuity by the Snellen chart. The findings indicated a significant overestimation of Snellen visual acuities by the Catford drum in 90.2% of eyes tested by a factor of 1.05 to 20.0, average 4.73. The correlation coefficient for the study was +0.40. This differs from the original results of Catford and Oliver in 1971. In addition, the Catford drum was used on follow-up visits in the same patients to assess 'visual performance'. The initial results showed an improvement in visual acuities when the Catford drum was used in 12 of 15 patients, while the Snellen acuities remained stable when retested after one month of basic instruction and use of standard low-vision aids. This improvement in 'Catford' acuity was by a factor of 0.3 to 10.0, average 4.08. This is thought to represent the patient's ability to learn the use of eccentric viewing or parafoveal retinal areas for vision. It confirms previous intuitive findings and helps to explain why low-vision patients seem to function at a higher level than expected from their Snellen visual acuities.

Follow-Up Studies↗