Comparison of Snellen and Early Treatment Diabetic Retinopathy Study charts using a computer simulation

Shamir, Reuben R.; Friedman, Yael; Joskowicz, Leo; Blumenthal, Eytan Z.

doi:10.18240/ijo.2016.01.20

Cited by 17 publications

(15 citation statements)

References 24 publications

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“…Unlike microperimetry, which uses decibels, visual acuity has no standardised measurement as distances can be measured in feet or metres. In addition, there are several different methods of visual acuity examination in clinical use [ 6 , 31 , 32 ], making it difficult to directly compare results from different clinics and research centres. Visual acuity measures a person’s ability to discriminate between stimuli when presented on a highly contrasted background [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies recommend the ETDRS method of visual acuity measurement in patients with AMD because it has better accuracy and reproducibility than Snellen, particularly in patients with advanced disease [ 6 , 31 , 33 ]. This is especially relevant as visual acuity may not be affected in patients with AMD until the disease has progressed into the late stage [ 3 , 9 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Correlation of macular sensitivity measures and visual acuity to vision-related quality of life in patients with age-related macular degeneration

2021

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Background Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant. Methods Fifty-one consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity. Results There was a higher correlation between vision-related quality of life and macular sensitivity (r = 0.458; p = 0.014) than between vision-related quality of life and visual acuity (r = 0.446; p = 0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r = 0.542; p = 0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r = 0.469; p = 0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r = 0.652; p < 0.001) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated with the nasal outer macular sub-region in these patients (r = 0.469; p = 0.012). Conclusions Macular sensitivity as measured using microperimetry correlates with vision-related quality of life in early AMD and in late AMD, showing it to be a patient-relevant outcome measure. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD. (338 words)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Correlation of macular sensitivity measures and visual acuity to vision-related quality of life in patients with age-related macular degeneration

2021

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“…Impairment of the optic nerve was assessed by VA in each eye separately using ETDRS logMAR charts presented with standard illumination [ 20 ]. Visual acuity was performed at 100 and 5% contrast at screening, baseline, and every 3 months.…”

Section: Methodsmentioning

confidence: 99%

“…Patients with optic nerve injury represent a good target group to evaluate the efficacy of drugs aimed at restoring neurological function in patients with MS, as the optic nerves are accessible to precise and quantitative measures. Visual function can readily be assessed using ETDRS (Early Treatment Diabetic Retinopathy Study) logarithm of the minimum angle of resolution (logMAR) charts at high and low contrast to determine VA [ 20 ] and automated perimetry to examine visual field defects [ 21 ]. Optic nerve function can be assessed by recording visual evoked potentials (VEPs) [ 22 ] and the pathological changes seen in the thickness of the retinal nerve fiber layer (RNFL) can be accurately quantified via optical coherence tomography (OCT).…”

Section: Introductionmentioning

confidence: 99%

MD1003 (High-Dose Pharmaceutical-Grade Biotin) for the Treatment of Chronic Visual Loss Related to Optic Neuritis in Multiple Sclerosis: A Randomized, Double-Blind, Placebo-Controlled Study

et al. 2018

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BackgroundChronic visual loss is a disabling feature in patients with multiple sclerosis (MS). It was recently shown that MD1003 (high-dose pharmaceutical-grade biotin or hdPB) may improve disability in patients with progressive MS.ObjectiveThe aim of this study was to evaluate whether MD1003 improves vision compared with placebo in MS patients with chronic visual loss.MethodsThe MS-ON was a 6-month, randomized, double-blind, placebo-controlled study with a 6-month open-label extension phase. Adult patients with MS-related chronic visual loss of at least one eye [visual acuity (VA) below 0.5 decimal chart] were randomized 2:1 to oral MD1003 300 mg/day or placebo. The selected eye had to show worsening of VA within the past 3 years following either acute optic neuritis (AON) or slowly progressive optic neuropathy (PON). The primary endpoint was the mean change from baseline to month 6 in VA measured in logarithm of the minimum angle of resolution (logMAR) at 100% contrast of the selected eye. Visually evoked potentials, visual field, retinal nerve fiber layer (RNFL) thickness, and health outcomes were also assessed.ResultsNinety-three patients received MD1003 (n = 65) or placebo (n = 28). The study did not meet its primary endpoint, as the mean change in the primary endpoint was nonsignificantly larger (p = 0.66) with MD1003 (− 0.061 logMAR, + 3.1 letters) than with placebo (− 0.036 logMAR, + 1.8 letters). Pre-planned subgroup analyses showed that 100% contrast VA improved by a mean of + 2.8 letters (− 0.058 logMAR) with MD1003 and worsened by − 1.5 letters (+ 0.029 logMAR) with placebo (p = 0.45) in the subgroup of patients with PON. MD1003-treated patients also had nonsignificant improvement in logMAR at 5% contrast and in RNFL thickness and health outcome scores when compared with placebo-treated patients. There was no superiority of MD1003 vs placebo in patients with AON. The safety profile of MD1003 was similar to that of placebo.ConclusionsMD1003 did not significantly improve VA compared with placebo in patients with MS experiencing chronic visual loss. An interesting trend favoring MD1003 was observed in the subgroup of patients with PON. Treatment was overall well tolerated.Trial registrationEudraCT identifier 2013-002112-27. ClinicalTrials.gov Identifier: NCT02220244FundingMedDay Pharmaceuticals.Electronic supplementary materialThe online version of this article (10.1007/s40263-018-0528-2) contains supplementary material, which is available to authorized users.

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“…Visual acuity testing with the ETDRS chart generally requires a 4-meter distance and its use may be limited by its relatively high cost, large chart size, poor availability and applicability. [8][9][10][11] Consequently, other methods of visual acuity measurement are still necessary in general ophthalmic offices (eg Snellen chart and Rosenbaum near vision card).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Visual Acuity Measurement Using Three Methods: Standard ETDRS Chart, Near Chart and a Smartphone-Based Eye Chart Application

Tiraset¹,

Poonyathalang²,

Padungkiatsagul³

et al. 2021

OPTH

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Purpose To validate the Rosenbaum near vision card (Near Chart) and a smartphone-based visual acuity (VA) test (Eye Chart) against a standard retro-illuminated Early Treatment Diabetic Retinopathy Study (ETDRS) chart within participants. Materials and Methods A cross-sectional study of participants aged ≥18 years was conducted. VA was measured in all participants using the ETDRS chart, Near Chart and smartphone-based Eye Chart application, respectively. VA was converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Eyes with ETDRS VA worse than 1.0 logMAR (20/200) were excluded. The main outcome measures were levels of agreement between VA measured using the Near Chart or Eye Chart application vs the ETDRS chart. Results A total of 295 eyes of 151 participants were included. One hundred participants (66.2%) were female and the mean age was 64.3 ± 12.5 years. Educational level was high school or below for 49% of participants and at Bachelor’s degree or above for 51%. The median logMAR VAs of all eyes tested using the ETDRS chart, Near Chart and Eye Chart application were 0.1, 0.0 and 0.1, respectively. The median VA difference between the Near Chart vs ETDRS chart and Eye Chart application vs ETDRS chart was 0.0 logMAR in both cases for both the right eye (OD) and left eye (OS). Intraclass correlation coefficient (ICC) demonstrated a strong positive correlation between VA tested with the Near Chart vs ETDRS chart (OD: ICC=0.85; p <0.001, OS: ICC=0.77; p <0.001) and Eye Chart application vs ETDRS chart (OD: ICC=0.88; p <0.001, OS: ICC=0.74; p <0.001). Conclusion VA measurements with the Near Chart and smartphone-based Eye Chart application corresponded well to the standard ETDRS chart, suggesting potential utility of alternative portable VA tests for in-office or remote vision monitoring, particularly during periods of physical distancing such as the Coronavirus disease 2019 (COVID-19) era.

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Comparison of Snellen and Early Treatment Diabetic Retinopathy Study charts using a computer simulation

Cited by 17 publications

References 24 publications

Correlation of macular sensitivity measures and visual acuity to vision-related quality of life in patients with age-related macular degeneration

Correlation of macular sensitivity measures and visual acuity to vision-related quality of life in patients with age-related macular degeneration

MD1003 (High-Dose Pharmaceutical-Grade Biotin) for the Treatment of Chronic Visual Loss Related to Optic Neuritis in Multiple Sclerosis: A Randomized, Double-Blind, Placebo-Controlled Study

Comparison of Visual Acuity Measurement Using Three Methods: Standard ETDRS Chart, Near Chart and a Smartphone-Based Eye Chart Application

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