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Published in: International Ophthalmology 8/2019

01-08-2019 | Original Paper

The optokinetic response is effective to assess objective visual acuity in patients with cataract and age-related macular degeneration

Authors: Carlo Aleci, Gabriele Cossu, Elena Belcastro, Lorenzo Canavese

Published in: International Ophthalmology | Issue 8/2019

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Abstract

Purpose

To estimate objective visual acuity in subjects suffering from cataract and age-related macular degeneration via the optokinetic response evoked by a non-conventional induction method (oktotype); in addition, to compare such objective outcome with the subjective acuity based on the ETDRS charts.

Methods

Patients were presented with 13 sequences of symbols arranged horizontally to form a serial pattern, moving from left to right at a constant rate. In each sequence, the size of the stimuli was reduced progressively, while the operator checked for the disappearance of the optokinetic response via a small video camera mounted on the test lens frame. The minimum angular size of the serial pattern able to evoke the optokinetic response (MAER) was referred to as the objective visual acuity of the subject.

Results

Correlation between logMAER and logMAR was significant in the cataract and macular degeneration group (\(R_{\text{cat}}^{2}\) = 0.70, p < .0001; \(R_{\text{AMD}}^{2}\) = 0.63, p < .0007). In the two samples, the correspondence between subjective and objective visual acuity (as, respectively, decimal units and arbitrary decimal units) was satisfactory (concordance correlation coefficient: cataract group = 0.91 and AMD group = 0.93). Test–retest reliability of the oktotype was good for the cataract group and moderate for the AMD sample (Κ 0.81 and 0.59, respectively).

Conclusion

The oktotype seems a promising tool to objectively assess visual acuity in noncooperating subjects with cataract or macular degeneration. Further research on other clinical conditions is needed to clarify the suitability of the procedure in the clinical setting.
Footnotes
1
We are grateful to the anonymous reviewer for this valuable suggestion.
 
Literature
1.
go back to reference Teller DY (1979) The forced-choice preferential looking procedure: a psychophysical technique for use with human infants. Infant Behav Dev 2:135–153CrossRef Teller DY (1979) The forced-choice preferential looking procedure: a psychophysical technique for use with human infants. Infant Behav Dev 2:135–153CrossRef
2.
go back to reference McDonald MA, Dobson V, Sebris L, Baitch L, Varber D, Teller DY (1985) The acuity card procedure: a rapid test of infant acuity. Invest Ophthalmol Vis Sci 26:1158–1162PubMed McDonald MA, Dobson V, Sebris L, Baitch L, Varber D, Teller DY (1985) The acuity card procedure: a rapid test of infant acuity. Invest Ophthalmol Vis Sci 26:1158–1162PubMed
3.
go back to reference McDonald M, Sebris SL, Mohn G, Teller DY, Dobson V (1986) Monocular acuity in normal infants: the acuity card procedure. Am J Optom Physiol Opt 63:127–134CrossRefPubMed McDonald M, Sebris SL, Mohn G, Teller DY, Dobson V (1986) Monocular acuity in normal infants: the acuity card procedure. Am J Optom Physiol Opt 63:127–134CrossRefPubMed
4.
go back to reference Courage ML, Adams RJ (1990) Visual acuity assessment from birth to three years using the acuity card procedure: cross-sectional and longitudinal samples. Optom Vis Sci 67:713–718CrossRefPubMed Courage ML, Adams RJ (1990) Visual acuity assessment from birth to three years using the acuity card procedure: cross-sectional and longitudinal samples. Optom Vis Sci 67:713–718CrossRefPubMed
5.
go back to reference Fielder AR, Dobson V, Moseley MJ, Mayer DL (1992) Preferential looking-clinical lessons. Ophthalmic Paediatr Genet 13:101–110CrossRefPubMed Fielder AR, Dobson V, Moseley MJ, Mayer DL (1992) Preferential looking-clinical lessons. Ophthalmic Paediatr Genet 13:101–110CrossRefPubMed
6.
go back to reference Tyler CW, Apkarian P, Levi DM, Nakayama K (1979) Rapid assessment of visual function: an electronic sweep technique for the pattern visual evoked potential. Invest Ophthalmol Vis Sci 18:703–713PubMed Tyler CW, Apkarian P, Levi DM, Nakayama K (1979) Rapid assessment of visual function: an electronic sweep technique for the pattern visual evoked potential. Invest Ophthalmol Vis Sci 18:703–713PubMed
7.
go back to reference Bach M, Maurer JP, Wolf ME (2008) Visual evoked potential-based acuity assessment in normal vision, artificially degraded vision, and in patients. Br J Ophthalmol 92:396–403CrossRefPubMed Bach M, Maurer JP, Wolf ME (2008) Visual evoked potential-based acuity assessment in normal vision, artificially degraded vision, and in patients. Br J Ophthalmol 92:396–403CrossRefPubMed
8.
go back to reference Steele M, Seiple WH, Carr RE, Klug R (1989) The clinical utility of visual-evoked potential acuity testing. Am J Ophthalmol 108:572–577CrossRefPubMed Steele M, Seiple WH, Carr RE, Klug R (1989) The clinical utility of visual-evoked potential acuity testing. Am J Ophthalmol 108:572–577CrossRefPubMed
10.
go back to reference Quinn GE, Berlin JA, James M (1993) The Teller acuity card procedure. Three testers in a clinical setting. Ophthalmology 100:488–494CrossRefPubMed Quinn GE, Berlin JA, James M (1993) The Teller acuity card procedure. Three testers in a clinical setting. Ophthalmology 100:488–494CrossRefPubMed
11.
go back to reference Millodot M, Harper P (1969) Measure of visual acuity by means of eye movements. Optom Vis Sci 46:938–944CrossRef Millodot M, Harper P (1969) Measure of visual acuity by means of eye movements. Optom Vis Sci 46:938–944CrossRef
12.
go back to reference Kim MS, Choi YS, Lu WN, Lee K, Hwang GM, Wee WR, Lee JH (2000) The development of an objective test for visual acuity assessment using optokinetic nystagmus stimuli presented head-mounted display: Sreohan objective visual acuity test. J Korean Ophthalmol Soc 41:871–878 Kim MS, Choi YS, Lu WN, Lee K, Hwang GM, Wee WR, Lee JH (2000) The development of an objective test for visual acuity assessment using optokinetic nystagmus stimuli presented head-mounted display: Sreohan objective visual acuity test. J Korean Ophthalmol Soc 41:871–878
13.
go back to reference Shin YJ, Park KH, Hwang JM, Wee WR, Lee JH, Lee IB (2006) Objective measurement of visual acuity by optokinetic response determination in patients with ocular diseases. Am J Ophthalmol 141:327–332CrossRefPubMed Shin YJ, Park KH, Hwang JM, Wee WR, Lee JH, Lee IB (2006) Objective measurement of visual acuity by optokinetic response determination in patients with ocular diseases. Am J Ophthalmol 141:327–332CrossRefPubMed
14.
go back to reference Wester ST, Rizzo JF, Balkwill MD, Wall C (2007) Optokinetic nystagmus as a measure of visual function in severely visually impaired patients. Invest Ophthalmol Vis Sci 48:4542–4548CrossRefPubMed Wester ST, Rizzo JF, Balkwill MD, Wall C (2007) Optokinetic nystagmus as a measure of visual function in severely visually impaired patients. Invest Ophthalmol Vis Sci 48:4542–4548CrossRefPubMed
15.
go back to reference Hyon JY, Yeo HE, Seo JM, Lee IB, Lee JH, Hwang JM (2010) Objective measurement of distance visual acuity determined by computerized optokinetic nystagmus test. Invest Ophthalmol Vis Sci 51:752–755CrossRefPubMed Hyon JY, Yeo HE, Seo JM, Lee IB, Lee JH, Hwang JM (2010) Objective measurement of distance visual acuity determined by computerized optokinetic nystagmus test. Invest Ophthalmol Vis Sci 51:752–755CrossRefPubMed
16.
go back to reference Han SB, Yang HK, Hyon JY, Seo J, Lee JH, Lee IB, Hwang J (2011) Efficacy of a computerized optokinetic nystagmus test in prediction of visual acuity of better than 20/200. Invest Ophthalmol Vis Sci 52:7492–7497CrossRefPubMed Han SB, Yang HK, Hyon JY, Seo J, Lee JH, Lee IB, Hwang J (2011) Efficacy of a computerized optokinetic nystagmus test in prediction of visual acuity of better than 20/200. Invest Ophthalmol Vis Sci 52:7492–7497CrossRefPubMed
17.
go back to reference Han SB, Han ER, Hyon JY, Seo JM, Lee JH, Hwang JM (2011) Measurement of distance objective visual acuity with the computerized optokinetic nystagmus test in patients with ocular diseases. Graefes Arch Clin Exp Ophthalmol 249:1379–1385CrossRefPubMed Han SB, Han ER, Hyon JY, Seo JM, Lee JH, Hwang JM (2011) Measurement of distance objective visual acuity with the computerized optokinetic nystagmus test in patients with ocular diseases. Graefes Arch Clin Exp Ophthalmol 249:1379–1385CrossRefPubMed
18.
go back to reference Millodot M, Miller D, Jernigan ME (1973) Evaluation of an objective acuity device. Arch Ophthalmol 90:449–452CrossRefPubMed Millodot M, Miller D, Jernigan ME (1973) Evaluation of an objective acuity device. Arch Ophthalmol 90:449–452CrossRefPubMed
19.
go back to reference Khan SG, Chen KF, Frenkel M (1976) Subjective and objective visual acuity testing techniques. Arch Ophthalmol 94:2086–2091CrossRefPubMed Khan SG, Chen KF, Frenkel M (1976) Subjective and objective visual acuity testing techniques. Arch Ophthalmol 94:2086–2091CrossRefPubMed
21.
go back to reference Altman DG (1991) Practical statistics for medical research. Chapman and Hall, London, p 1991 Altman DG (1991) Practical statistics for medical research. Chapman and Hall, London, p 1991
22.
go back to reference Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRef Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRef
23.
go back to reference Gorman JJ, Cogan DG, Gellis SS (1957) An apparatus for grading the visual acuity of infants on the basis of optokinetic nystagmus. Pediatrics 19:1088–1092PubMed Gorman JJ, Cogan DG, Gellis SS (1957) An apparatus for grading the visual acuity of infants on the basis of optokinetic nystagmus. Pediatrics 19:1088–1092PubMed
24.
go back to reference Geer I, Robertson KM (1993) Measurement of central and peripheral dynamic visual acuity thresholds during ocular pursuit of a moving target. Optom Vis Sci 70:552–560CrossRefPubMed Geer I, Robertson KM (1993) Measurement of central and peripheral dynamic visual acuity thresholds during ocular pursuit of a moving target. Optom Vis Sci 70:552–560CrossRefPubMed
25.
go back to reference Abadi RV, Pascal E (1991) The effects of simultaneous central and peripheral field motion on the optokinetic response. Vis Res 31:2219–2225CrossRefPubMed Abadi RV, Pascal E (1991) The effects of simultaneous central and peripheral field motion on the optokinetic response. Vis Res 31:2219–2225CrossRefPubMed
26.
go back to reference Miyoshi T (1984) Role of the central and peripheral retina upon optokinetic nystagmus: foveal and peripheral nystagmus. Acta Otolaryng Suppl 419:53–61 Miyoshi T (1984) Role of the central and peripheral retina upon optokinetic nystagmus: foveal and peripheral nystagmus. Acta Otolaryng Suppl 419:53–61
27.
go back to reference Ludvigh E, Miller JW (1953) A study of dynamic visual acuity. U.S. Naval School of Aviation Medicine. Research Report No. NM 001 075.01.01 Ludvigh E, Miller JW (1953) A study of dynamic visual acuity. U.S. Naval School of Aviation Medicine. Research Report No. NM 001 075.01.01
28.
go back to reference Towle VL, Harter MR (1977) Objective determination of human visual acuity: pattern evoked potentials. Invest Ophthalmol Vis Sci 16:1073–1076PubMed Towle VL, Harter MR (1977) Objective determination of human visual acuity: pattern evoked potentials. Invest Ophthalmol Vis Sci 16:1073–1076PubMed
Metadata
Title
The optokinetic response is effective to assess objective visual acuity in patients with cataract and age-related macular degeneration
Authors
Carlo Aleci
Gabriele Cossu
Elena Belcastro
Lorenzo Canavese
Publication date
01-08-2019
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 8/2019
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-018-1001-4

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