Jason Turuwhenua, Zaw LinTun, Mohammad Norouzifard, Misty Edmonds, Rebecca Findlay, Joanna Black, Benjamin Thompson
{"title":"使用阶梯扫频刺激，通过光动眼震自动估算视力。","authors":"Jason Turuwhenua, Zaw LinTun, Mohammad Norouzifard, Misty Edmonds, Rebecca Findlay, Joanna Black, Benjamin Thompson","doi":"10.1111/opo.13391","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To describe an automatic system for objective measurement of visual acuity (VA) using optokinetic nystagmus (OKN). This pilot study tested the system's sensitivity and specificity for detecting reduced VA in healthy adults by comparing VA-OKN to VA with an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart (VA-ETDRS).</p><p><strong>Methods: </strong>Adult participants (age 30 ± 12 years) with either reduced VA (n = 11, VA-ETDRS > 0.20 logMAR) or normal VA (n = 12, VA-ETDRS ≤ 0.20 logMAR) completed monocular VA-OKN measurements in each eye. The VA-OKN stimulus was an array of drifting (5°/s) vanishing discs presented in descending/ascending size order (0.00-1.00 logMAR in 0.10 steps). The stimulus was stepped every 2 s, and 10 sweeps were shown per eye (five ascending and five descending). Eye-tracking data determined when OKN activity ceased (descending sweep) or began (ascending sweep), which was used to determine VA-OKN for each sweep. The estimates were averaged across sweeps to produce an automated VA-OKN. The automated sweeps were then provided in randomised order to a reviewer blinded to the VA-ETDRS findings who determined a final VA-OKN for an eye.</p><p><strong>Results: </strong>A single randomly selected eye from each observer was used for analysis. The sensitivity and specificity of VA-OKN using the same 0.20 logMAR threshold as VA-ETDRS was 100%. Comparisons between the VA-OKN and VA-ETDRS measures were made for participants in the reduced VA group. There was no significant difference between VA-OKN and VA-ETDRS (p = 0.55) and the two measures produced comparable values (r<sup>2</sup> = 0.84, 95% limits of agreement = 0.19 logMAR, intra-class correlation coefficient = 0.90 [95% CI:0.68-0.97]).</p><p><strong>Conclusions: </strong>Visual acuity using optokinetic nystagmus correctly identified a VA deficit in adults and for those with a VA deficit, VA-OKN was strongly correlated with the gold-standard clinical measure of VA. OKN is a promising method which has the potential for use in cognitively impaired adults and pre-verbal children.</p>","PeriodicalId":19522,"journal":{"name":"Ophthalmic and Physiological Optics","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Automated visual acuity estimation by optokinetic nystagmus using a stepped sweep stimulus.\",\"authors\":\"Jason Turuwhenua, Zaw LinTun, Mohammad Norouzifard, Misty Edmonds, Rebecca Findlay, Joanna Black, Benjamin Thompson\",\"doi\":\"10.1111/opo.13391\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To describe an automatic system for objective measurement of visual acuity (VA) using optokinetic nystagmus (OKN). This pilot study tested the system's sensitivity and specificity for detecting reduced VA in healthy adults by comparing VA-OKN to VA with an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart (VA-ETDRS).</p><p><strong>Methods: </strong>Adult participants (age 30 ± 12 years) with either reduced VA (n = 11, VA-ETDRS > 0.20 logMAR) or normal VA (n = 12, VA-ETDRS ≤ 0.20 logMAR) completed monocular VA-OKN measurements in each eye. The VA-OKN stimulus was an array of drifting (5°/s) vanishing discs presented in descending/ascending size order (0.00-1.00 logMAR in 0.10 steps). The stimulus was stepped every 2 s, and 10 sweeps were shown per eye (five ascending and five descending). Eye-tracking data determined when OKN activity ceased (descending sweep) or began (ascending sweep), which was used to determine VA-OKN for each sweep. The estimates were averaged across sweeps to produce an automated VA-OKN. The automated sweeps were then provided in randomised order to a reviewer blinded to the VA-ETDRS findings who determined a final VA-OKN for an eye.</p><p><strong>Results: </strong>A single randomly selected eye from each observer was used for analysis. The sensitivity and specificity of VA-OKN using the same 0.20 logMAR threshold as VA-ETDRS was 100%. Comparisons between the VA-OKN and VA-ETDRS measures were made for participants in the reduced VA group. There was no significant difference between VA-OKN and VA-ETDRS (p = 0.55) and the two measures produced comparable values (r<sup>2</sup> = 0.84, 95% limits of agreement = 0.19 logMAR, intra-class correlation coefficient = 0.90 [95% CI:0.68-0.97]).</p><p><strong>Conclusions: </strong>Visual acuity using optokinetic nystagmus correctly identified a VA deficit in adults and for those with a VA deficit, VA-OKN was strongly correlated with the gold-standard clinical measure of VA. OKN is a promising method which has the potential for use in cognitively impaired adults and pre-verbal children.</p>\",\"PeriodicalId\":19522,\"journal\":{\"name\":\"Ophthalmic and Physiological Optics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmic and Physiological Optics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/opo.13391\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic and Physiological Optics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/opo.13391","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/11 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Automated visual acuity estimation by optokinetic nystagmus using a stepped sweep stimulus.
Purpose: To describe an automatic system for objective measurement of visual acuity (VA) using optokinetic nystagmus (OKN). This pilot study tested the system's sensitivity and specificity for detecting reduced VA in healthy adults by comparing VA-OKN to VA with an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart (VA-ETDRS).
Methods: Adult participants (age 30 ± 12 years) with either reduced VA (n = 11, VA-ETDRS > 0.20 logMAR) or normal VA (n = 12, VA-ETDRS ≤ 0.20 logMAR) completed monocular VA-OKN measurements in each eye. The VA-OKN stimulus was an array of drifting (5°/s) vanishing discs presented in descending/ascending size order (0.00-1.00 logMAR in 0.10 steps). The stimulus was stepped every 2 s, and 10 sweeps were shown per eye (five ascending and five descending). Eye-tracking data determined when OKN activity ceased (descending sweep) or began (ascending sweep), which was used to determine VA-OKN for each sweep. The estimates were averaged across sweeps to produce an automated VA-OKN. The automated sweeps were then provided in randomised order to a reviewer blinded to the VA-ETDRS findings who determined a final VA-OKN for an eye.
Results: A single randomly selected eye from each observer was used for analysis. The sensitivity and specificity of VA-OKN using the same 0.20 logMAR threshold as VA-ETDRS was 100%. Comparisons between the VA-OKN and VA-ETDRS measures were made for participants in the reduced VA group. There was no significant difference between VA-OKN and VA-ETDRS (p = 0.55) and the two measures produced comparable values (r2 = 0.84, 95% limits of agreement = 0.19 logMAR, intra-class correlation coefficient = 0.90 [95% CI:0.68-0.97]).
Conclusions: Visual acuity using optokinetic nystagmus correctly identified a VA deficit in adults and for those with a VA deficit, VA-OKN was strongly correlated with the gold-standard clinical measure of VA. OKN is a promising method which has the potential for use in cognitively impaired adults and pre-verbal children.
期刊介绍：
Ophthalmic & Physiological Optics, first published in 1925, is a leading international interdisciplinary journal that addresses basic and applied questions pertinent to contemporary research in vision science and optometry.
OPO publishes original research papers, technical notes, reviews and letters and will interest researchers, educators and clinicians concerned with the development, use and restoration of vision.
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