Validation of an automated‐ETDRS near and intermediate visual acuity measurement

Abstract

Background The aim of this study was to determine the repeatability of an automated‐ETDRS (Early Treatment Diabetic Retinopathy Study) near and intermediate visual acuity measurement in subjects with normal visual acuity and subjects with reduced visual acuity. The agreement of automated‐ETDRS with gold standard chart‐based visual acuity measurement was also studied. Methods Fifty‐one subjects were tested (aged 23 to 91 years; 33 subjects with normal visual acuity: 6/7.5 or better; 18 subjects with reduced visual acuity: 6/9 to 6/30). Near and intermediate visual acuity of one eye from each subject was measured with an automated tablet‐computer system (M&S Technologies, Inc.) and Precision Vision paper chart in a random sequence. Subjects were retested one week later. Repeatability was evaluated using the 95 per cent limits of agreement (LoA) between the two visits. Results Average difference between automated‐ETDRS near visual acuity and near visual acuity by paper chart was 0.02 ± 0.10 logMAR (p > 0.05). Agreement of near visual acuity between automated‐ETDRS and paper chart was good, with 95 per cent LoA of ±0.19 logMAR. Furthermore, automated‐ETDRS near visual acuity showed good repeatability (95 per cent LoA of ±0.20). Mean difference between automated‐ETDRS intermediate visual acuity and intermediate visual acuity by paper chart was 0.02 ± 0.10 logMAR (p > 0.05). Agreement of intermediate visual acuity between automated‐ETDRS and paper chart was good, with 95 per cent LoA of ±0.20 logMAR. In addition, automated‐ETDRS intermediate visual acuity had good repeatability (95 per cent LoA of ±0.16). Conclusion Automated‐ETDRS near and intermediate visual acuity measurement showed good repeatability and agreement with the gold standard chart‐based visual acuity measurement. The findings of this study indicate the automated visual acuity measurement system may have potential for use in both patient care and clinical trials.

Minimum Detectable Change of Visual Acuity Measurements Using ETDRS Charts (Early Treatment Diabetic Retinopathy Study)

“…These values strengthen the high reliability of the ETDRS test, as referred to by other authors who measured only its repeatability [8][9][10]17,26]. Within the future research of lines, a new approach with an automated-ETDRS in near and intermediate distance [28] or a comparative assessment between Snellen scale and ETDRS [29] could improve scientific literature about ETDRS.…”

Novel clusters of newly-diagnosed type 2 diabetes and their association with diabetic retinopathy: a 3-year follow-up study

“…The strengths of our study included a prospective cohort design and the use of ETDRS protocol -the gold standard approach for accurate visual acuity measurement to assess diabetic retinopathy [16]. However, our study has several limitations.…”

“…To address this issue, we firstly conducted cluster analysis based on the Study on Evaluation of iNnovated Screening tools and determination of optimal diagnostic cutoff points for type 2 diaBetes in Chinese muLti-Ethnic (SENSIBLE) and SENSIBLE-Addition studies. Secondly, we assessed whether the derived clusters were associated with diabetic retinopathy ascertained by the gold-standard approach for visual acuity measurement -the Early Treatment of Diabetic Retinopathy Study (ETDRS) protocol [16], in SENSIBLE-cohort study.…”

Repeatability of an automated ETDRS contrast threshold measurement

“…If test distance, luminance and contrast of the test screen are carefully calibrated and external glare is limited, computerised equipment can generate results similar to gold standard charts. 1 Several computer-based automated contrast sensitivity tests have become available commercially, including the Freiburg Visual Acuity and Contrast Test, 2 the iPad test of letter contrast sensitivity, 3 a smartphone-based Peek Contrast Sensitivity test, 4 and the Spaeth/Richman Contrast Sensitivity Test. 5 The commercially available automated Early Treatment Diabetic Retinopathy Study contrast threshold (ETDRS-CT) test is one of the newer computerised tests.…”

“…With recent advances in technology, computerised tests are commonly used to measure visual function. If test distance, luminance and contrast of the test screen are carefully calibrated and external glare is limited, computerised equipment can generate results similar to gold standard charts 1 . Several computer‐based automated contrast sensitivity tests have become available commercially, including the Freiburg Visual Acuity and Contrast Test, 2 the iPad test of letter contrast sensitivity, 3 a smartphone‐based Peek Contrast Sensitivity test, 4 and the Spaeth/Richman Contrast Sensitivity Test 5 …”