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Loh L, Prem-Senthil M, Constable PA. Visual acuity and reading print size requirements in children with vision impairment. Clin Exp Optom 2024; 107:709-715. [PMID: 37952256 DOI: 10.1080/08164622.2023.2279190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/07/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
CLINICAL RELEVANCE The support of students with a vision impairment throughout education could be enhanced by assessing the functional reading ability of the individual. This visual assessment could inform educators of individualised student needs and potentially improve the academic achievement for these students. BACKGROUND Support for children with a vision impairment within a classroom is typically based on clinical findings of distance visual acuity and visual fields. Therefore, determining optimal print size for reading is essential to ensure best academic outcomes. Secondary aims were to investigate the possible impact of underlying pathology on reading ability. METHODS Forty-seven participants were recruited from a state-wide support service for children with a vision impairment in South Australia. Three visual acuity groups were formed based on World Health Organisation definitions of mild, moderate, and severe vision impairment. Correlation between clinical measures of distance visual acuity using the Freiburg Visual Acuity Test, were compared with reading acuity and critical print size (smallest font before reading speed reduced) using Minnesota low vision reading chart (MNREAD). RESULTS No significant correlations were found for mild (0.20-0.49 logMAR) and severe (1.00-1.52 logMAR) vision impairment groups between distance visual acuity and reading acuity read (p = .64, CI [-.585, .395]/p = .82, CI [-.48, .58]) or critical print size (p = .78, CI [-.57, .45]/p = .43, CI [-.34, .68]. A significant correlation was found for the moderate vision impairment group: 0.50-0.99 logMAR for minimum reading acuity (p < .001, CI [.44, .91]) and critical print size (p = .03, CI [.05, .80]). CONCLUSIONS Standard clinical measures of distance visual acuity are an unpredictable estimate of reading ability in children with mild and severe vision impairment. Additional measures of functional near reading ability could provide a more meaningful indicator of reading ability and help provide optimum support to students through education.
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Affiliation(s)
| | | | - Paul A Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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Bano T, Wolffsohn JS, Sheppard AL. Assessment of visual function using mobile Apps. Eye (Lond) 2024; 38:2406-2414. [PMID: 38509183 PMCID: PMC11306548 DOI: 10.1038/s41433-024-03031-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/19/2024] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
With the advances in smartphone and tablet screens, as well as their processing power and software, mobile apps have been developed reporting to assess visual function. This review assessed those mobile apps that have been evaluated in the scientific literature to measure visual acuity, reading metrics, contrast sensitivity, stereoacuity, colour vision and visual fields; these constitute just a small percentage of the total number of mobile apps reporting to measure these metrics available for tablets and smartphones. In general, research suggests that most of the mobile apps evaluated can accurately mimic most traditionally paper-based tests of visual function, benefitting from more even illumination from the backlit screen and aspects such as multiple tests and versions (to minimise memorisation) being available on the same equipment. Some also utilise the in-built device sensors to monitor aspects such as working distance and screen tilt. As the consequences of incorrectly recording visual function and using this to inform clinical management are serious, clinicians must check on the validity of a mobile app before adopting it as part of clinical practice.
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Affiliation(s)
- Thaiba Bano
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
| | - Amy L Sheppard
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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Loh L, Prem-Senthil M, Constable PA. The impact of using reverse polarity text for children with vision impairment assessed using light-adapted flicker electroretinogram. Clin Exp Optom 2024:1-8. [PMID: 38951809 DOI: 10.1080/08164622.2024.2367631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/09/2024] [Indexed: 07/03/2024] Open
Abstract
CLINICAL RELEVANCE Children with vision impairment can have difficulty accessing classroom reading material and knowledge of which students are likely to have improved performance reading performance with reverse polarity would be of value to educators. BACKGROUND Printed material is typically presented as black text on a white background; however, reversing the polarity to white text on a black background may improve the reading speed for children with vision impairment. This study sought to identify the visual function or pathological features of children with vision impairment where reversing the polarity of text would improve their reading performance. METHODS Forty-eight vision-impaired participants (27 male), aged 5-18 years with binocular visual acuities between 0.18-1.52 logMAR, were included. Reading performance was assessed by changes in Critical Print Size (ΔCPS), Maximum Reading Speed (ΔMRS) in normal and reverse polarity digital print, and numeric reading speed (ΔNRS) with normal and reverse polarity fonts. Correlations were made with 30 Hz flicker electroretinogram amplitude and high/low contrast acuity. Paired nonparametric tests evaluated significance in pathological condition groups. RESULTS Significant negative correlations were only found between the 30 Hz flicker amplitude and ΔMRS (r = -.42, p = .028) and ΔNRS (r = -.46, p = .027). Follow-up pairwise comparisons based on pathology group only showed a significant effect of the retinal dystrophy group and CPS (n = 12, z = -2.24, p = .025). All other pairwise comparisons based on group were non-significant (p > .05). CONCLUSIONS This study did not identify a specific pathological group or visual functional measure that could be used as a clinical marker to predict the impact of reversing polarity. However, significant improvements could be made in reading performance for some children and so a reading performance assessment is recommended for all children with vision impairment.
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Affiliation(s)
- Lynne Loh
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Mallika Prem-Senthil
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Paul A Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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Castet E, Termoz-Masson J, Vizcay S, Delachambre J, Myrodia V, Aguilar C, Matonti F, Kornprobst P. PTVR - A software in Python to make virtual reality experiments easier to build and more reproducible. J Vis 2024; 24:19. [PMID: 38652657 PMCID: PMC11044846 DOI: 10.1167/jov.24.4.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/25/2024] [Indexed: 04/25/2024] Open
Abstract
Researchers increasingly use virtual reality (VR) to perform behavioral experiments, especially in vision science. These experiments are usually programmed directly in so-called game engines that are extremely powerful. However, this process is tricky and time-consuming as it requires solid knowledge of game engines. Consequently, the anticipated prohibitive effort discourages many researchers who want to engage in VR. This paper introduces the Perception Toolbox for Virtual Reality (PTVR) library, allowing visual perception studies in VR to be created using high-level Python script programming. A crucial consequence of using a script is that an experiment can be described by a single, easy-to-read piece of code, thus improving VR studies' transparency, reproducibility, and reusability. We built our library upon a seminal open-source library released in 2018 that we have considerably developed since then. This paper aims to provide a comprehensive overview of the PTVR software for the first time. We introduce the main objects and features of PTVR and some general concepts related to the three-dimensional (3D) world. This new library should dramatically reduce the difficulty of programming experiments in VR and elicit a whole new set of visual perception studies with high ecological validity.
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Affiliation(s)
- Eric Castet
- Aix Marseille Univ, CNRS, CRPN, Marseille, France
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5
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Costa MF, Henriques LD, Souza GS. Validation of a computerized version of the MNREAD chart for children. Int Ophthalmol 2024; 44:127. [PMID: 38466499 DOI: 10.1007/s10792-024-03056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE We aimed the develop and validate a computerized version of the MNREAD for the assessment of reading speed for children. METHODS A computerized version of the MNREAD was built in Psykinematix software using the same parameters as the physical chart. We measured the reading velocity of 104 children (n = 44 of the 3rd grade; n = 60 of the 5th grade). Bland-Altaman analysis was used to quantify agreement between two chart measurements. RESULTS Comparison between the 3rd and 5th-grade children for physical and computerized MNREAD versions showed statistical differences in Maximum Reading Speed (F = 2669.6; p < 0.001), Critical Print Size (F = 17.49; p < 0.001), and Reading Acuity (F = 14.19; p = 0.002) with huge effect size (η2 = 0.930). No differences were found between the versions within grades. Bland-Altman analysis showed 95% of the data points within ± 2 s of the mean difference, suggesting a similarity between versions of the MNREAD parameters. CONCLUSION Our reading speed values for children in the 5th grade were higher than previous studies, suggesting a better quality of the assessment in the computerized version. Tolerance Limits were calculated as normality references for clinical purposes.
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Affiliation(s)
- Marcelo Fernandes Costa
- Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brasil.
- Programa de Pós-Graduação em Neurociências e Comportamento, Depto. Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, Av. Prof. Mello Moraes, 1721, 05508-030, São Paulo, Brasil.
| | - Leonardo Dutra Henriques
- Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brasil
| | - Givago Silva Souza
- Instituto de Ciências Biológicas e Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brasil
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Bittner AK, Kaminski JE, Yoshinaga PD, Shepherd JD, Chan TL, Malkin AG, Deemer A, Gobeille M, Thoene SJ, Rossi A, Ross NC. Outcomes of Telerehabilitation Versus In-Office Training With Magnification Devices for Low Vision: A Randomized Controlled Trial. Transl Vis Sci Technol 2024; 13:6. [PMID: 38214688 PMCID: PMC10790671 DOI: 10.1167/tvst.13.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024] Open
Abstract
Purpose An evidence basis is lacking but needed to compare reading ability outcomes after magnification device training remotely via telerehabilitation versus in office. Methods A multicenter randomized controlled trial at academic centers and vision rehabilitation private practices randomized 61 visually impaired adults to telerehabilitation or in-office training 1 to 4 months after dispensing new portable electronic, hand-held, or stand optical magnifiers. Telerehabilitation included loaner equipment for Zoom videoconferencing with remote control access software. Using a multilevel regression model, changes in Activity Inventory responses using Rasch analysis estimated reading ability in dimensionless log odds units (logits) (0.14-logit change corresponds with ability change expected from a one-line change in visual acuity). Results Across 47 participants who completed the trial, reading ability with new magnifiers improved significantly by 0.61 logits on average (95% confidence interval [CI], 0.36-0.86; P < 0.001) from baseline to 1 month, and by an additional 0.44 logits on average (95% CI, 0.19-0.69; P < 0.001) from 1 to 4months (i.e., after magnifier training), with very similar significant findings for both telerehabilitation (n = 29; mean improvement = 0.44 logits; 95% CI, 0.08-0.80; P = 0.018) and in-office training (n = 18; mean improvement = 0.43 logits; 95% CI, 0.15-0.71; P = .003), and no significant difference between randomized groups across both follow-ups (95% CI, -0.43 to 0.61; P = .73). Vision, demographics, and health factors were nonsignificantly related to reading ability changes from 1 to 4 months. Conclusions Reading ability improved after the provision of newly dispensed magnifiers, with further improvements following additional magnifier training via either telerehabilitation or in-office usual care. Translational Relevance These findings provide support for the use of telerehabilitation to enhance reading ability with newly prescribed magnifiers as an alternative modality of care delivery.
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Affiliation(s)
- Ava K Bittner
- University of California, Los Angeles, Department of Ophthalmology, Stein Eye Institute, Los Angeles, CA, USA
| | | | - Patrick D Yoshinaga
- Marshall B. Ketchum University, Southern California College of Optometry, Fullerton, CA, USA
| | - John D Shepherd
- University of Nebraska Medical Center, Department of Ophthalmology, Truhlsen Eye Institute, Weigel Williamson Center for Visual Rehabilitation, Omaha, NE, USA
| | - Tiffany L Chan
- Chan Family Optometry, Grass Valley, CA, USA
- Frank Stein & Paul S. May Center for Low Vision Rehabilitation, San Francisco, CA, USA
| | | | - Ashley Deemer
- Marshall B. Ketchum University, Southern California College of Optometry, Fullerton, CA, USA
| | | | - Stacy J Thoene
- University of Nebraska Medical Center, Department of Ophthalmology, Truhlsen Eye Institute, Weigel Williamson Center for Visual Rehabilitation, Omaha, NE, USA
| | - Annemarie Rossi
- Frank Stein & Paul S. May Center for Low Vision Rehabilitation, San Francisco, CA, USA
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Wolffsohn JS. 2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management. Optom Vis Sci 2024; 101:12-24. [PMID: 38350054 DOI: 10.1097/opx.0000000000002102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
ABSTRACT Detailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.
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Goddin TL, Yu H, Friedman DS, Owsley C, Kwon M. MNREAD Reading Vision in Adults With Glaucoma Under Mesopic and Photopic Conditions. Invest Ophthalmol Vis Sci 2023; 64:43. [PMID: 38153749 PMCID: PMC10756241 DOI: 10.1167/iovs.64.15.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/02/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose Despite good photopic visual acuity, glaucoma patients report difficulty performing daily activities under dim light such as reading. Here we investigated the impact of mesopic lighting conditions on reading vision of glaucoma patients. Methods The study design included 39 patients with glaucoma and 40 healthy controls. Reading vision was assessed with MNREAD charts under mesopic (2 cd/m2) and photopic (220 cd/m2) conditions. Four reading indexes: maximum reading speed (MRS), critical print size (CPS), reading acuity (RA), and reading accessibility index (ACC) were obtained from the MNREAD test yielding a plot of reading speed versus print size. Results Compared to photopic conditions, reading vision of both healthy controls and glaucoma patients significantly decreased under mesopic conditions (P < 0.05). For glaucoma patients (85% with mild or moderate glaucoma), MRS and ACC decreased by six words per minute and 0.1, respectively under mesopic conditions; CPS and RA increased by 0.25 and 0.18 logMAR, respectively. Moreover, under both photopic and mesopic conditions, reading vision of glaucoma patients was significantly worse than that of healthy controls, but the difference was greater under mesopic conditions (P < 0.05) even after controlling for age and visual acuity. Conclusions Mesopic conditions make reading more challenging for both healthy controls and glaucoma patients. However, reading in dim light appears to be more burdensome for glaucoma patients. Mesopic reading tests mediated by both cone and rod photoreceptor systems likely provide a more sensitive and comprehensive assessment of a patient's reading impairment than testing under photopic conditions.
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Affiliation(s)
- Traci-Lin Goddin
- Department of Psychology, Northeastern University, Boston, Massachusetts, United States
| | - Haojue Yu
- Department of Psychology, Northeastern University, Boston, Massachusetts, United States
| | - David S. Friedman
- Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - MiYoung Kwon
- Department of Psychology, Northeastern University, Boston, Massachusetts, United States
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Kwon M, Owsley C. Reading Vision in Adults With Early and Intermediate Age-Related Macular Degeneration Under Mesopic and Photopic Conditions. Transl Vis Sci Technol 2023; 12:7. [PMID: 37676678 PMCID: PMC10494985 DOI: 10.1167/tvst.12.9.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023] Open
Abstract
Purpose Reading is involved in various daily activities that operate under a wide range of luminance levels. Rod- and cone-mediated mesopic visual function is known to be impaired even in early/intermediate age-related macular degeneration (AMD). It remains unclear whether and to what extent mesopic reading is impaired in early/intermediate AMD. Here, we assessed differences in reading vision between photopic and mesopic conditions in early/intermediate AMD and compared their performance to those in older adults with normal macular health. Methods The study included 30 patients with early/intermediate AMD and 30 healthy controls. Reading performance was tested on the MNREAD iPad app under mesopic (2 cd/m2 with a neural-density filter) and photopic (220 cd/m2) conditions. Four reading indices-maximum reading speed (MRS), critical print size (CPS), reading acuity (RA), and reading accessibility index (ACC)-were obtained from the MNREAD test, yielding a function representing reading speed versus print size. Results Compared to photopic conditions, patients with AMD and healthy controls both exhibited noticeable decreases in reading vision under mesopic conditions (P < 0.001) despite normal photopic visual acuity. This decrease was more pronounced in AMD even after adjusting for age (P < 0.001): Under mesopic conditions, MRS and ACC decreased by 8 words per minute and 0.1, respectively; CPS and RA were enlarged by 0.27 and 0.24 logMAR, respectively. Conclusions Reading vision deteriorates under mesopic conditions compared to photopic conditions in early/intermediate AMD and is accentuated compared to this difference in healthy controls. Translational Relevance A mesopic reading test may provide a more sensitive and comprehensive assessment of a patient's reading impairment.
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Affiliation(s)
- MiYoung Kwon
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Plainis S, Ktistakis E, Tsilimbaris MK. Presbyopia correction with multifocal contact lenses: Evaluation of silent reading performance using eye movements analysis. Cont Lens Anterior Eye 2023; 46:101853. [PMID: 37164776 DOI: 10.1016/j.clae.2023.101853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Many activities of daily living rely on reading, thus is not surprising that complaints from presbyopes originate in reading difficulties rather in visual acuity. Here, the effectiveness of presbyopia correction with multifocal contact lenses (CLs) is evaluated using an eye-fixation based method of silent reading performance. ΜETHODS: Visual performance of thirty presbyopic volunteers (age: 50 ± 5 yrs) was assessed monocularly and binocularly following 15 days of wear of monthly disposable CLs (AIR OPTIX™ plus HydraGlyde™, Alcon Laboratories) with: (a) single vision (SV) lenses - uncorrected for near (b) aspheric multifocal (MF) CLs. LogMAR acuity was measured with ETDRS charts. Reading performance was evaluated using standard IReST paragraphs displayed on a screen (0.4 logMAR print size at 40 cm distance). Eye movements were monitored with an infrared eyetracker (Eye-Link II, SR Research Ltd). Data analysis included computation of reading speed, fixation duration, fixations per word and percentage of regressions. RESULTS Average reading speed was 250 ± 68 and 235 ± 70 wpm, binocularly and monocularly, with SV CLs, improving statistically significantly to 280 ± 67 (p = 0.002) and 260 ± 59 wpm (p = 0.01), respectively, with MF CLs. Moreover, fixation duration, fixations per word and ex-Gaussian parameter of fixation duration, μ, showed a statistically significant improvement when reading with MF CLs, with fixation duration exhibiting the stronger correlation (r = 0.79, p < 0.001) with improvement in reading speed. The correlation between improvement in VA and reading speed was moderate (r = 0.46, p = 0.016), as was the correlation between VA and any eye fixation parameter. CONCLUSION Average silent reading speed in a presbyopic population was found improved with MF compared to SV CL correction and was faster with binocular compared to monocular viewing: this was mainly due to the faster average fixation duration and the lower number of fixations. Evaluating reading performance using eye fixation analysis could offer a reliable outcome of functional vision in presbyopia correction.
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Affiliation(s)
- Sotiris Plainis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Greece; Optometry & Vision Science Research Group, Aston University School of Life and Health Sciences, Birmingham, UK.
| | - Emmanouil Ktistakis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Greece
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Using the C-Read as a Portable Device to Evaluate Reading Ability in Young Chinese Adults: An Observational Study. J Pers Med 2023; 13:jpm13030463. [PMID: 36983645 PMCID: PMC10056310 DOI: 10.3390/jpm13030463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
We evaluated the reading characteristics of normal-sighted young adults using C-Read to provide baseline healthy population values. We also investigated the relationship between the National Eye Institute’s Visual Functioning Questionnaire (VFQ-25) score and reading ability, myopia, and hours of screen use, focusing on the extent to which these factors affect participants’ visual function and, ultimately, their vision-related quality of life (QoL). Overall, 207 young, healthy participants (414 eyes) aged 18–35 years were tested for reading speed using C-Read connected to a smartphone-based application between December 2022 and January 2023. Each participant received a VFQ-25 questionnaire to evaluate vision-related QoL. Data on daily e-screen usage hours were collected. Among the participants, 91 (44.0%) were women; their mean (SD) age was 22.45 (4.01) years. The mean (SD) reading acuity (RA) was 0.242 (0.124), 0.249 (0.120), and 0.193 (0.104) logarithmic minimum angle of resolution (logMAR) for the right, left, and both eyes, respectively. The mean (SD) maximum reading speed (MRS) was 171.65 (46.27), 168.59 (45.68), and 185.16 (44.93) words per minute (wpm) with the right, left, and both eyes, respectively. The mean (SD) critical print size (CPS) was 0.412 (0.647), 0.371 (0.229), and 0.419 (1.05) logMAR per the right, left, and both eyes, respectively. The RA and CPS were significantly different between sexes (p = 0.002 and p = 0.001). MRS was significantly different between the education level (p = 0.005) and myopia level groups (p = 0.010); however, it was not clear whether this difference was confounded by age. The myopic power in diopters significantly affected RA (coefficient, −0.012; 95% CI, −0.018 to −0.006; p = 0.001); screen time significantly affected MRS (coefficient, 0.019; 95% CI, 0.57 to 6.33; p = 0.019). RA (coefficient, −21.41; 95% CI, −33.74 to −9.08; p = 0.001) and duration of screen use (coefficient, -0.86; 95% CI, −1.29 to −0.43; p < 0.001) independently had a significantly negative correlation with VFQ-25 scores. Our findings provide a baseline value for C-Read in normal-sighted young adults. Refractive status significantly affected RA, while screen time significantly affected MRS. Interventions aimed at enhancing RA may have the potential to maximize vision-related QoL and enable older adults with impaired vision to achieve greater outcomes. Future, larger-scale, C-Read experiments will help provide newer, more optimal methods for the early diagnosis of visual impairment.
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Ntonti P, Mitsi C, Chatzimichael E, Panagiotopoulou EK, Bakirtzis M, Konstantinidis A, Labiris G. A systematic review of reading tests. Int J Ophthalmol 2023; 16:121-127. [PMID: 36659955 PMCID: PMC9815988 DOI: 10.18240/ijo.2023.01.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 10/27/2022] [Indexed: 12/29/2022] Open
Abstract
Adequate near and intermediate visual capacity is important in performing everyday tasks, especially after the introduction of smartphones and computers in our professional and recreational activities. Primary objective of this study was to review all available reading tests both conventional and digital and explore their integrated characteristics. A systematic review of the recent literature regarding reading charts was performed based on the PubMed, Google Scholar, and Springer databases between February and March 2021. Data from 11 descriptive and 24 comparative studies were included in the present systematic review. Clinical settings are still dominated by conventional printed reading charts; however, the most prevalent of them (i.e., Jaeger type charts) are not validated. Reliable reading capacity assessment is done only by those that comply with the International Council of Ophthalmology (ICO) recommendations. Digital reading tests are gaining popularity both in clinical and research settings and are differentiated in standard computer-based applications that require installation either in a computer or a tablet (e.g., Advanced VISION Test and web-based ones e.g., Democritus Digital Acuity Reading Test requires no installation). It is evident that validated digital tests will prevail in future clinical or research settings and it is upon ophthalmologists to select the one most compatible with their examination routine.
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Chen EP, Mills M, Gallagher T, Polis A, Blasberg S, Pham P, Gentile RC, Ianchulev T. Remote vision testing of central retinal acuity and comparison with clinic-based Snellen acuity testing in patients followed for retinal conditions. Digit Health 2023; 9:20552076231180727. [PMID: 37325078 PMCID: PMC10265370 DOI: 10.1177/20552076231180727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 05/22/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction The unmet need for remote monitoring of visual function with home-based, patient-centric technologies became increasingly palpable during the COVID-19 pandemic. Many patients with chronic eye conditions lack access to office-based examinations. Here, we evaluate the efficacy of the Accustat® test, a virtual application for measuring near visual acuity on any portable electronic device via telehealth. Materials and methods Thirty-three adult subjects from the telehealth remote monitoring service of a retina practice performed the Accustat® acuity testing at home. All patients underwent in-office general eye examination with additional fundoscopic examination and optical coherence tomography retina imaging. Best corrected visual acuity assessment using a Snellen chart was compared with remote visual acuity assessment with the Accustat® test. Visual acuity was analyzed and compared between the best-corrected near visual acuity potential achieved on the Accustat® and in-office distance best-corrected Snellen visual acuity. Results The mean logarithm of the minimum angle of resolution (logMAR) visual acuities of all eyes tested using the Accustat test was 0.19 ± 024 and for the office Snellen test 0.21 ± 0.21. A linear regression model with 95% confidence intervals reveals that there is a strong linear relationship between Accustat logMAR and office Snellen logMAR. Bland-Altman analysis demonstrated 95.2% significant agreement between Accustat and Office Snellen's best corrected visual acuity. Intraclass correlation coefficient (ICC = 0.94) demonstrated a strong positive correlation between at home versus office visual acuity. Conclusion There was a high correlation between the visual acuity measured with the Accustat near vision digital self-test and the office Snellen acuity test, suggesting the potential utility of scalable remote monitoring of central retinal function via telehealth.
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Affiliation(s)
- Earnest P Chen
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, USA
| | - Michael Mills
- Department of Ophthalmology, Prism Eye Institute, Oakville, ON, Canada
| | - Tara Gallagher
- Department of Ophthalmology, Gentile Retina Practice, New York, USA
| | - Andrew Polis
- Department of Ophthalmology, Gentile Retina Practice, New York, USA
| | - Sophie Blasberg
- Department of Ophthalmology, Gentile Retina Practice, New York, USA
| | - Peter Pham
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, USA
| | - Ronald C Gentile
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, USA
- Department of Ophthalmology, Prism Eye Institute, Oakville, ON, Canada
- Department of Ophthalmology, New York University Long Island School of Medicine, New York, USA
| | - Tsontcho Ianchulev
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, USA
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14
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Development and Validation of the First Smart TV-Based Visual Acuity Test: A Prospective Study. Healthcare (Basel) 2022; 10:healthcare10112117. [PMID: 36360458 PMCID: PMC9691125 DOI: 10.3390/healthcare10112117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/04/2022] Open
Abstract
(1) Background: While smartphones are among the primary devices used in telemedical applications, smart TV healthcare apps are not prevalent despite smart TVs’ penetrance in home settings. The present study’s objective was to develop and validate the first smart TV-based visual acuity (VA) test (Democritus Digital Visual Acuity Test (DDiVAT)) that allows a reliable VA self-assessment. (2) Methods: This is a prospective validation study. DDiVAT introduces several advanced features for reliable VA self-testing; among them: automatic calibration, voice recognition, voice guidance, automatic calculation of VA indexes, and a smart TV-based messaging system. Normal and low vision participants were included in the validation. DDiVAT VA results (VADDiVAT) were compared against the ones from: (a) the gold-standard conventional ETDRS (VAETDRS), and, (b) an independent ophthalmologist who monitored the self-examination testing (VARES). Comparisons were performed by noninferiority test (set at 2.5-letters) and intraclass correlation coefficients (ICCs). DDiVAT’s test-retest reliability was assessed within a 15-day time-window. (3) Results: A total of 300 participants (185 and 115 with normal and low vision, respectively) responded to ETDRS and DDiVAT. Mean difference in letters was −0.05 for VAETDRS–VARES, 0.62 for VARES–VADDiVAT, and 0.67 for VAETDRS–VADDiVAT, significantly lower than the 2.5 letter noninferiority margin. ICCs indicated an excellent level of agreement, collectively and for each group (0.922-0.996). All displayed letters in DDiVAT presented a similar difficulty. The overall accuracy of the voice recognition service was 96.01%. ICC for VADDiVAT test-retest was 0.957. (4) Conclusions: The proposed DDiVAT presented non-significant VA differences with the ETDRS, suggesting that it can be used for accurate VA self-assessment in telemedical settings, both for normal and low-vision patients.
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15
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Almaliotis D, Athanasopoulos GP, Almpanidou S, Papadopoulou EP, Karampatakis V. Design and Validation of a New Smartphone-Based Reading Speed App (GDRS-Test) for the Greek Speaking Population. CLINICAL OPTOMETRY 2022; 14:111-124. [PMID: 35942276 PMCID: PMC9356703 DOI: 10.2147/opto.s370215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To present a novel smartphone-based application (GDRS-test, Greek Digital Reading Speed - test) for the assessment of reading speed, to evaluate, whether this test could be easily and reliably used by patients with visual impairment and normal individuals serving as an adjunctive tool for their visual examination. PATIENTS AND METHODS One hundred and five visually impaired and 32 normal eyes were examined. Depending on existing active ocular pathology, patients were divided into a non-macular and a macular group, We examined the reading performance for continuous text (MNREAD chart) and random unrelated words of the new smartphone-based reading speed app, monocularly. The patients' best-corrected visual acuity ranged from 1.3 to 0.2 logMAR. Examinees were asked to read aloud (at a 40 cm distance) a series of 30 random two-syllable and then 30 three-syllable Greek words, without semantic connection. Reading speed was measured as correct words per minute for critical print size. The individuals were examined twice within 2 weeks for test-retest reliability. Correlations and comparisons concerning each group adjusted for age and visual acuity were performed. RESULTS There was moderate correlation between MNREAD and 2SYL SPEED (Reading speed for 2-syllable) (Pearson's rho = 0.589, p < 0.001) and 3SYL SPEED (Reading speed for 3-syllable) (Pearson's rho = 0.617, p < 0.001) for healthy individuals. The mean 2SYL SPEED and 3SYL SPEED for Individuals of the maculopathies group or non-maculopathies group were significantly lower compared to normal individuals adjusted for age and visual acuity [B (95% CI): -93.077 (-104.165, -81.98), p < 0.001] and [B (95% CI): -92.254 (-104.196, -80.312), p < 0.001], respectively. The test-retest analysis showed a good agreement for patients and healthy individuals. CONCLUSION The novel-reading speed application for the Greek-speaking population was found to accurately detect differences between patients with visual impairment and healthy individuals. It was designed and constructed with the intention to ease and improve the ophthalmic examination allowing individuals to self-evaluate reading speed by transmitting the result to their physician.
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Affiliation(s)
- Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios P Athanasopoulos
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni P Papadopoulou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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16
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Altınbay D, Şahlı E, İdil ŞA. Comparison of Reading Test Parameters from the Print and Tablet Application Forms of the Minnesota Low Vision Reading Test. Turk J Ophthalmol 2022; 52:186-192. [PMID: 35770299 PMCID: PMC9249109 DOI: 10.4274/tjo.galenos.2021.33581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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17
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Latham K, Subhi H. Can listening provide a useful clinical estimate of low vision reading parameters? Ophthalmic Physiol Opt 2022; 42:504-513. [PMID: 35243674 DOI: 10.1111/opo.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to determine whether a clinician can assess critical print size (CPS) and/or reading fluency by listening to a visually impaired patient reading aloud across a range of print sizes on an MNREAD chart, rather than needing to plot and analyse reading speed data as a function of print size. METHODS Fifty-six low vision participants were audio-recorded reading an MNREAD chart under standard conditions. Two experienced raters listened to the recordings and made judgments of the CPS (logMAR), and of the level of reading fluency achieved at large print sizes on a 4-point rating scale. Reading times were plotted as a function of print size to determine the CPS as the smallest print size that supported the participant's maximum reading speed (MRS) by inspection, and the MRS as the mean reading speed across print sizes including, and larger than, the CPS. RESULTS Listened CPS judgments made for each rater were slightly larger than the CPS values obtained by inspection (mean differences 0.04logMAR (p = 0.06), 0.08logMAR (p < 0.01); limits of agreement (LoA) ±0.28logMAR, ±0.39logMAR, respectively). CPS judgments were consistent both between raters (mean difference 0.04logMAR [p = 0.18]; LoA ±0.42logMAR) and between two judgments made by each rater (mean differences 0.00logMAR (p = 1.0), 0.03logMAR (p < 0.05); LoA ±0.23logMAR, ±0.17logMAR). Reading fluency could be categorised as 'functional' (MRS > 80 wpm) or 'non-functional' (MRS < 80 wpm) with a sensitivity of 88%-90% and a specificity of 100%. CONCLUSIONS Experienced raters listening to a patient reading an MNREAD chart can determine a clinically useful estimate of critical print size and can discriminate maximum reading speeds that are above and below that likely to provide sustained reading ability. Listening to a patient reading an MNREAD chart is an option for the low vision clinician's armoury of assessments.
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Affiliation(s)
- Keziah Latham
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Hikmat Subhi
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
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18
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Latham K, Macnaughton J. Is patient identification of ‘comfortable’ print size a useful clinical parameter for low vision reading assessment? Ophthalmic Physiol Opt 2022; 42:482-490. [DOI: 10.1111/opo.12946] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Keziah Latham
- Vision and Hearing Sciences Research Centre Anglia Ruskin University Cambridge UK
| | - Jane Macnaughton
- Vision and Hearing Sciences Research Centre Anglia Ruskin University Cambridge UK
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19
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Claessens JLJ, Geuvers JR, Imhof SM, Wisse RPL. Digital Tools for the Self-Assessment of Visual Acuity: A Systematic Review. Ophthalmol Ther 2021; 10:715-730. [PMID: 34169468 PMCID: PMC8225487 DOI: 10.1007/s40123-021-00360-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/05/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Numerous digital tools to self-assess visual acuity have been introduced. The recent COVID-19 pandemic underlined the need for high-quality remote care. This review gives a current overview of digital tools for remotely assessing visual function and reports on their accuracy. METHODS We searched the databases of Embase and Pubmed, and systematically reviewed the literature, conforming to PRISMA guidelines. Two preliminary papers were added from medRxiv.org. The main outcome was the agreement of the digital tools with conventional clinical charts, as expressed by mean differences and 95% limits of agreement (95% LoA). RESULTS Seventeen publications included studies reported on 13 different digital tools. Most of the tools focus on distance visual acuity. The mean differences of the digital tools ranged from - 0.08 to 0.10 logMAR, when compared to traditional clinical assessments. The 95% LoA differed considerably between studies: from ± 0.08 logMAR to ± 0.47 logMAR, though the variability was less pronounced for higher visual acuities. CONCLUSION The low mean differences between digital visual acuity assessments and reference charts suggest clinical equivalence, though the wide 95% LoA identify a lower precision of digital self-assessments. This effect diminishes in individuals with better visual acuities, which is a common feature of visual acuity assessments. There is great potential for the digital tools to increase access to eye care and we expect the accuracy of the current tools to improve with every iteration in technology development.
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Affiliation(s)
- Janneau L J Claessens
- Department of Ophthalmology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GX, Utrecht, The Netherlands.
| | - Judith R Geuvers
- Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Saskia M Imhof
- Department of Ophthalmology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GX, Utrecht, The Netherlands
| | - Robert P L Wisse
- Department of Ophthalmology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GX, Utrecht, The Netherlands
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20
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Guo X, Arsiwala LT, Dong Y, Mihailovic A, Ramulu PY, Sharrett AR, Mosley T, Abraham AG. Visual Function, Physical Function, and Activities of Daily Living in Two Aging Communities. Transl Vis Sci Technol 2021; 10:15. [PMID: 34913953 PMCID: PMC8684303 DOI: 10.1167/tvst.10.14.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose We report the distribution of visual acuity impairment (VAI), contrast sensitivity impairment (CSI) and their associations with physical health in an aging population. Methods In this cross-sectional analysis, VAI was categorized as mild (20/40-20/60) and moderate or greater (<20/60) in the better eye for distance and near vision. CSI was categorized as moderate (1.04-1.50 logCS) and severe or profound (<1.04 logCS). Physical outcomes included the short physical performance battery (SPPB) scores, self-reported quality of life (QoL) scores, physical limitations, difficulty with activity of daily living (ADL) and instrumental ADL (IADL). The associations between VAI and CSI with physical outcomes were explored overall and by community. Results There were 494 Black Jackson and 558 White Washington County participants. The mean age was 80 years, 63% were female, and 15% had VAIdistance presenting. Moderate or greater VAInear presenting was associated with higher prevalence of greater physical limitations (prevalence ratio, 1.25; 95% confidence interval, 1.09-1.44) and IADL difficulties (prevalence ratio, 1.77; 95% confidence interval, 1.32-2.38), but not ADL difficulties. Associations of VAIdistance presenting with physical limitations and lower SPPB scores, and CSI with physical limitations, IADL difficulties, lower QoL, and lower SPPB scores were found. A stratified analysis showed stronger associations in Jackson. Conclusions VAI and CSI were associated with poor physical health. These associations should be understood in the context of community differences. Translational Relevance Community-based factors may mitigate the impact of vision loss on physical outcomes. Public health endeavors are needed to address VAI and CSI to optimize physical health in the older adults with poor vision.
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Affiliation(s)
- Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lubaina T. Arsiwala
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yanan Dong
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pradeep Y. Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A. Richey Sharrett
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Alison G. Abraham
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Colorado School of Public Health, University of Colorado, CO, USA
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21
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Labiris G, Panagiotopoulou EK, Duzha E, Tzinava M, Perente A, Konstantinidis A, Delibasis K. Development and Validation of a Web-Based Reading Test for Normal and Low Vision Patients. Clin Ophthalmol 2021; 15:3915-3929. [PMID: 34588763 PMCID: PMC8473574 DOI: 10.2147/opth.s314943] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/21/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To develop and validate a web-based reading test for normal and low vision patients. Methods This is a prospective, comparative trial. The web-based Democritus Digital Acuity Reading Test (wDDART) was developed. wDDART introduces a series of advanced characteristics (advanced text calibration, computer-vision-based estimation of patient’s distance, and automatic calculation of patient’s reading times) that facilitate the overall examination procedure. wDDART’s reading parameters [reading acuity (RA), maximum reading speed (MRS), critical print size (CPS) and reading accessibility index (ACC)] were compared to the corresponding ones of its conventional Windows-based reading test (DDART) in a sample of normal and low vision participants. wDDART’s test–retest reliability for all reading parameters was evaluated in a 15-day time-window. Results One hundred patients (normal vision group-NVG: 70; low vision group-LVG: 30 patients) responded to DDART and wDDART. Non-significant differences between the two reading tests were found for all parameters in NVG and LVG. Intraclass correlation coefficients (ICCs) between the two tests demonstrated good or excellent correlation for RA, MRS, ACC and moderate correlation for CPS. Test–retest reliability was excellent for RA and ACC, while ICCs were 0.715–0.895 for MRS and CPS. Conclusion The wDDART demonstrated sufficient validity and repeatability making it suitable for clinical and research settings. Clinicaltrials.gov Identifier NCT04618224.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68131, Alexandroupolis, Greece
| | | | - Erald Duzha
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, 35131, Greece
| | - Maria Tzinava
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, 35131, Greece
| | - Asli Perente
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68131, Alexandroupolis, Greece
| | - Aristeidis Konstantinidis
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68131, Alexandroupolis, Greece
| | - Konstantinos Delibasis
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, 35131, Greece
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22
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Morrice E, Murphy C, Soldano V, Addona C, Wittich W, Johnson AP. Assessing optimal colour and illumination to facilitate reading: an analysis of print size. Ophthalmic Physiol Opt 2021; 41:1209-1221. [PMID: 34549808 DOI: 10.1111/opo.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE This study examined how optimal colour/illumination conditions and the efficacy of the iPad, LuxIQ and Smart Bulb varied as a function of print size in younger, older and visually impaired adults. METHODS Participants with visual impairments and simulated low vision (SLV) read the MNRead using the iPad, LuxIQ and Smart Bulb. RESULTS In the impairment condition at 1.20 logMAR, the iPad (M = 9.49, 95% CI [3.18, 19.42]) and LuxIQ (M = 15.95, 95% CI [9.54, 24.86]) improved the reading speeds. At 0.80 logMAR (SLV), all devices improved reading speeds of older adults (iPad (M = 28.70, 95% CI [14.65, 42.51]); LuxIQ (M = 49.63, 95% CI [30.04, 69.68]); Smart Bulb (M = 23.11, 95% CI [3.33, 42.11])), but in younger adults only the LuxIQ (M = 13.04, 95% CI [3.21, 21.27]) did so. In the impairment condition, the iPad (M = 5.54, 95% CI [0.31, 12.13]) and LuxIQ (M = 13.90, 95% CI [7.88, 23.49]) improved reading speeds. In the SLV condition, age was a significant predictor of reading speed at 1.20 logMAR (F3,164 = 10.74, p < 0.001, Adj. R2 = 0.16). At 0.80 logMAR, age and luminance, but not colour, were significant predictors (F3,164 = 52.52, p < 0.001, Adj. R2 = 0.49). In the impairment condition, both age and lux were significant predictors of reading speed at 1.20 (F3,85 = 7.14, p < 0.001, Adj. R2 = 0.20) and 0.80 logMAR (F3,85 = 7.97, p < 0.001, Adj. R2 = 0.22), but colour was not. CONCLUSIONS Light source effectiveness and optimal colour/illumination vary as a function of print size. It appears that print size is the most important factor for improving reading speed. As print size decreases, luminance becomes crucial, and only at the smallest print sizes does the effect of colour become useful.
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Affiliation(s)
- Elliott Morrice
- Department of Psychology, Concordia University, Montreal, Quebec, Canada.,Lethbridge-Layton-Mackay Rehabilitation Centre, Integrated Health and Social Services University Network for West-Central Montreal, Montreal, Quebec, Canada
| | - Caitlin Murphy
- Department of Psychology, Concordia University, Montreal, Quebec, Canada.,Lethbridge-Layton-Mackay Rehabilitation Centre, Integrated Health and Social Services University Network for West-Central Montreal, Montreal, Quebec, Canada.,School of Optometry, University of Montreal, Montreal, Quebec, Canada
| | - Vanessa Soldano
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Cynthia Addona
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Walter Wittich
- Department of Psychology, Concordia University, Montreal, Quebec, Canada.,Lethbridge-Layton-Mackay Rehabilitation Centre, Integrated Health and Social Services University Network for West-Central Montreal, Montreal, Quebec, Canada.,School of Optometry, University of Montreal, Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal/The Nazareth and Louis Braille Institute, Integrated Health and Social Services Centre Montérégie-Centre, Longueuil, Quebec, Canada
| | - Aaron P Johnson
- Department of Psychology, Concordia University, Montreal, Quebec, Canada.,Lethbridge-Layton-Mackay Rehabilitation Centre, Integrated Health and Social Services University Network for West-Central Montreal, Montreal, Quebec, Canada
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23
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Kim D, Nam SW, Bang K, Lee B, Lee S, Jeong Y, Seo JM, Lee B. Vision-correcting holographic display: evaluation of aberration correcting hologram. BIOMEDICAL OPTICS EXPRESS 2021; 12:5179-5195. [PMID: 34513250 PMCID: PMC8407804 DOI: 10.1364/boe.433919] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 05/03/2023]
Abstract
Vision-correcting displays are key to achieving physical and physiological comforts to the users with refractive errors. Among such displays are holographic displays, which can provide a high-resolution vision-adaptive solution with complex wavefront modulation. However, none of the existing hologram rendering techniques have considered the optical properties of the human eye nor evaluated the significance of vision correction. Here, we introduce vision-correcting holographic display and hologram acquisition that integrates user-dependent prescriptions and a physical model of the optics, enabling the correction of on-axis and off-axis aberrations. Experimental and empirical evaluations of the vision-correcting holographic displays show the competence of holographic corrections over the conventional vision correction solutions.
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Affiliation(s)
- Dongyeon Kim
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
- These authors contributed equally to this work
| | - Seung-Woo Nam
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
- These authors contributed equally to this work
| | - Kiseung Bang
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
| | - Byounghyo Lee
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
| | - Seungjae Lee
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
| | - Youngmo Jeong
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
| | - Jong-Mo Seo
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
- Biomedical Research Institute, Seoul National University Hospital, Jongno-gu Daehak-ro 101, Seoul 03080, Republic of Korea
| | - Byoungho Lee
- School of Electrical and Computer Engineering, Seoul National University, Gwanak-gu Gwanak-ro 1, Seoul 08826, Republic of Korea
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24
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Xiong YZ, Lei Q, Calabrèse A, Legge GE. Simulating Visibility and Reading Performance in Low Vision. Front Neurosci 2021; 15:671121. [PMID: 34290578 PMCID: PMC8287255 DOI: 10.3389/fnins.2021.671121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Low vision reduces text visibility and causes difficulties in reading. A valid low-vision simulation could be used to evaluate the accessibility of digital text for readers with low vision. We examined the validity of a digital simulation for replicating the text visibility and reading performance of low-vision individuals. METHODS Low-vision visibility was modeled with contrast sensitivity functions (CSFs) with parameters to represent reduced acuity and contrast sensitivity. Digital filtering incorporating these CSFs were applied to digital versions of the Lighthouse Letter Acuity Chart and the Pelli-Robson Contrast Sensitivity Chart. Reading performance (reading acuity, critical print size, and maximum reading speed) was assessed with filtered versions of the MNREAD reading acuity Chart. Thirty-six normally sighted young adults completed chart testing under normal and simulated low-vision conditions. Fifty-eight low-vision subjects (thirty with macular pathology and twenty-eight with non-macular pathology) and fifteen normally sighted older subjects completed chart testing with their habitual viewing. We hypothesized that the performance of the normally sighted young adults under simulated low-vision conditions would match the corresponding performance of actual low-vision subjects. RESULTS When simulating low-vision conditions with visual acuity better than 1.50 logMAR (Snellen 20/630) and contrast sensitivity better than 0.15 log unit, the simulation adequately reduced the acuity and contrast sensitivity in normally sighted young subjects to the desired low-vision levels. When performing the MNREAD test with simulated low vision, the normally sighted young adults had faster maximum reading speed than both the Non-macular and Macular groups, by an average of 0.07 and 0.12 log word per minute, respectively. However, they adequately replicated the reading acuity as well as the critical print size, up to 2.00 logMAR of both low-vision groups. CONCLUSION A low-vision simulation based on clinical measures of visual acuity and contrast sensitivity can provide good estimates of reading performance and the accessibility of digital text for a broad range of low-vision conditions.
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Affiliation(s)
- Ying-Zi Xiong
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Quan Lei
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
- Department of Psychology, Wichita State University, Wichita, KS, United States
| | | | - Gordon E. Legge
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
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Cheung CMG, Pearce E, Fenner B, Sen P, Chong V, Sivaprasad S. Looking Ahead: Visual and Anatomical Endpoints in Future Trials of Diabetic Macular Ischemia. Ophthalmologica 2021; 244:451-464. [PMID: 33626529 DOI: 10.1159/000515406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 02/23/2021] [Indexed: 11/19/2022]
Abstract
Diabetic macular ischemia (DMI) is a common complication of diabetic retinopathy that can lead to progressive and irreversible visual loss. Despite substantial clinical burden, there are no treatments for DMI, no validated clinical trial endpoints, and few clinical trials focusing on DMI. Therefore, generating consensus on validated endpoints that can be used in DMI for the development of effective interventions is vital. In this review, we discuss potential endpoints appropriate for use in clinical trials of DMI, and consider the data required to establish acceptable and meaningful endpoints. A combination of anatomical, functional, and patient-reported outcome measures will provide the most complete picture of changes that occur during the progression of DMI. Potential endpoint measures include change in size of the foveal avascular zone measured by optical coherence tomography angiography and change over time in best-corrected visual acuity. However, these endpoints must be supported by further research. We also recommend studies to investigate the natural history and progression of DMI. In addition to improving understanding of how patient demographics and comorbidities such as diabetic macular edema affect clinical trial endpoints, these studies would help to build the consensus definition of DMI that is currently missing from clinical practice and research.
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Affiliation(s)
- Chui Ming Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
| | - Elizabeth Pearce
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Beau Fenner
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Piyali Sen
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom
| | - Victor Chong
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom
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Morrice E, Murphy C, Soldano V, Addona C, Wittich W, Johnson AP. Assessing optimal colour and illumination to facilitate reading. Ophthalmic Physiol Opt 2021; 41:281-294. [PMID: 33533095 DOI: 10.1111/opo.12785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE This study examined the effectiveness of the LuxIQ, the Apple iPad and a smart bulb in assessing optimal colour and illumination to facilitate reading in younger, older and visually impaired adults. METHODS Participants read standardised texts at baseline (normal lighting/no device), then using the Apple iPad, LuxIQ and smart bulb, with their normal vision (20/20 condition) and using a simulated reduction in visual acuity/contrast sensitivity (20/80 condition). Visually impaired participants followed the same procedure used in the 20/80 condition. RESULTS There was a significant interaction between condition and device in younger, F(1.5, 43.51) = 30.41, p < 0.001, ω2 = 0.34 and older, F(1.5, 4.51) = 4.51, p = 0.03, ω2 = 0.05 adults with normal vision, and there was a significant effect of device, F(2, 58) = 5.95, p = 0.004, ω2 = 0.12 in visually impaired adults. In the 20/20 condition, age and colour predicted reading speed, F(3, 176) = 36.25, p < 0.001, Adj. R2 = 0.37, whereas age, lighting and colour predicted reading speed, F(3, 176) = 36.25, p < 0.001, Adj. R2 = 0.37 in the 20/80 condition. In the visual impairment condition, lighting, colour and impairment severity predicted reading speed, F(3, 85) = 10.10, p < 0.001, Adj. R2 = 0.24. CONCLUSIONS The clinical implications of this study are that reading speeds improve in individuals with low vision under improved lighting conditions, specifically, with higher levels of luminance and colour temperature. The effectiveness of the devices varied across groups; however, the LuxIQ was the only device to improve reading speeds from baseline in older adults with visual impairments.
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Affiliation(s)
- Elliott Morrice
- Department of Psychology, Concordia University, Montréal, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay Réhabilitation Centre du Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) Centre ouest de l'ile de Montréal, Montréal, Canada
| | - Caitlin Murphy
- Department of Psychology, Concordia University, Montréal, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay Réhabilitation Centre du Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) Centre ouest de l'ile de Montréal, Montréal, Canada.,École d'optométrie, Université de Montréal, Montréal, Canada
| | - Vanessa Soldano
- Department of Psychology, Concordia University, Montréal, Canada
| | - Cynthia Addona
- Department of Psychology, Concordia University, Montréal, Canada
| | - Walter Wittich
- Department of Psychology, Concordia University, Montréal, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay Réhabilitation Centre du Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) Centre ouest de l'ile de Montréal, Montréal, Canada.,École d'optométrie, Université de Montréal, Montréal, Canada.,CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Canada
| | - Aaron P Johnson
- Department of Psychology, Concordia University, Montréal, Canada.,CRIR/Centre de réadaptation Lethbridge-Layton-Mackay Réhabilitation Centre du Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) Centre ouest de l'ile de Montréal, Montréal, Canada
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Semenov EP, Sheplock R, Roman AJ, McGuigan DB, Swider M, Cideciyan AV, Jacobson SG. Reading Performance in Blue Cone Monochromacy: Defining an Outcome Measure for a Clinical Trial. Transl Vis Sci Technol 2020; 9:13. [PMID: 33344057 PMCID: PMC7726588 DOI: 10.1167/tvst.9.13.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Blue cone monochromacy (BCM), a congenital X-linked retinal disease caused by mutations in the OPN1LW/OPN1MW gene cluster, is under consideration for intravitreal gene therapy. Difficulties with near vision tasks experienced by these patients prompted this study of reading performance as a potential outcome measure for a future clinical trial. Methods Clinically and molecularly diagnosed patients with BCM (n = 17; ages 15–63 years) and subjects with normal vision (n = 22; ages 18–72 years) were examined with the MNREAD acuity chart for both uniocular and binocular conditions. Parameters derived from the measurements in patients were compared with normal data and also within the group of patients. Intersession, interocular and between-subject variabilities were determined. The frequent complaint of light sensitivity in BCM was examined by comparing results from black text on a white background (regular polarity) versus white on black (reverse polarity) conditions. Results MNREAD curves of print size versus reading speed were right-shifted compared with normal in all patients with BCM. All parameters in patients with BCM indicated abnormal reading performance. Intersession variability was slightly higher in BCM than in normal, but comparable with results previously reported for other patients with maculopathies. There was a high degree of disease symmetry in reading performance in this BCM cohort. Reverse polarity showed better reading parameters than regular polarity in 82% of the patients. Conclusions MNREAD measures of reading performance in patients with BCM would be a worthy and robust secondary outcome in a clinical trial protocol, given its dual purpose of quantifying macular vision and addressing an important quality of life issue. Translational Relevance Assessment of an outcome for a clinical trial.
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Affiliation(s)
- Evelyn P Semenov
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Sheplock
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - Alejandro J Roman
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - David B McGuigan
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - Malgorzata Swider
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - Artur V Cideciyan
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel G Jacobson
- Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
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Abstract
Two fundamental constraints limit the number of characters in text that can be displayed at one time-print size and display size. These dual constraints conflict in two important situations-when people with normal vision read text on small digital displays, and when people with low vision read magnified text. Here, we describe a unified framework for evaluating the joint impact of these constraints on reading performance. We measured reading speed as a function of print size for three digital formats (laptop, tablet, and cellphone) for 30 normally sighted and 10 low-vision participants. Our results showed that a minimum number of characters per line is required to achieve a criterion of 80% of maximum reading speed: 13 characters for normally sighted and eight characters for low-vision readers. This critical number of characters is nearly constant across font and display format. Possible reasons for this required number of characters are discussed. Combining these character count constraints with the requirements for adequate print size reveals that an individual's use of a small digital display or the need for magnified print can shrink or entirely eliminate the range of print size necessary for achieving maximum reading speed.
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Affiliation(s)
- Nilsu Atilgan
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - Ying-Zi Xiong
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - Gordon E Legge
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455
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Varadaraj V, Assi L, Gajwani P, Wahl M, David J, Swenor BK, Ehrlich JR. Evaluation of Tablet-Based Tests of Visual Acuity and Contrast Sensitivity in Older Adults. Ophthalmic Epidemiol 2020; 28:293-300. [PMID: 33185485 DOI: 10.1080/09286586.2020.1846758] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Purpose: Recent innovations in mobile technology for the measurement of vision present a valuable opportunity to measure visual function in non-clinical settings, such as in the home and in field-based surveys. This study evaluated agreement between a tablet-based measurement of distance and near acuity and contrast sensitivity as compared to gold-standard clinical tests.Methods: Participants aged ≥55 years recruited from a tertiary eye clinic underwent testing with three tablet-based and corresponding gold-standard clinical measures (ETDRS distance acuity, Pelli-Robson contrast sensitivity, and MNRead near acuity). Correlation and agreement between tablet-based and clinical tests were assessed.Results: A total of 82 participants with a mean age of 69.1 (SD = 7.6) years, and majority female (67.1%) and white (64.6%), were enrolled in this study. The mean (SD) difference between the tests (gold-standard - tablet) was -0.04 (0.08) logMAR for distance acuity, -0.11 (0.13) log units for contrast sensitivity, and -0.09 (0.12) logMAR for near acuity. 95% limits of agreement for distance acuity (-0.21, 0.12 logMAR), near acuity (-0.34, 0.14 logMAR), and contrast sensitivity (-0.36, 0.14 logCS) were also determined. The correlation between tablet-based and gold-standard tests was strongest for distance acuity (r = 0.78), followed by contrast sensitivity (r = 0.75), and near acuity (r = 0.67). The agreement between the standard and tablet-based methods did not appear to be dependent on the level of vision.Conclusions: This study demonstrates the agreement of tablet-based and gold-standard tests of visual function in older adults. These findings have important implications for future population vision health surveillance and research.
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Affiliation(s)
- Varshini Varadaraj
- Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Lama Assi
- Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Prateek Gajwani
- Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Madison Wahl
- Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Jenina David
- Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Bonnielin K Swenor
- Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, Center for Eye Policy and Innovation University of Michigan, Ann Arbor, MI, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Labiris G, Panagiotopoulou EK, Chatzimichael E, Tzinava M, Mataftsi A, Delibasis K. Introduction of a digital near-vision reading test for normal and low vision adults: development and validation. EYE AND VISION 2020; 7:51. [PMID: 33102611 PMCID: PMC7579962 DOI: 10.1186/s40662-020-00216-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/15/2020] [Indexed: 11/10/2022]
Abstract
Background MNREAD is an advanced near-vision acuity chart that has already been translated and validated in Greek language. Considering that no validated Greek digital near-vision test exists, our primary objective was to develop and validate a digital near-vision reading test based on the fundamental properties of the Greek printed MNREAD (MNREAD-GR). Methods This is a prospective, comparative study. A digital near-vision chart was developed (Democritus Digital Acuity Reading Test - DDART) with text size calibration, audio recording for automatic reading timing, as well as automatic calculation of reading acuity (RA), maximum reading speed (MRS), critical print size (CPS) and reading accessibility index (ACC). Normal and low vision subjects participated in the validation process, responding to MNREAD-GR and DDART at the same day, at a 40 cm viewing distance. Differences in all parameters between the charts were compared with t-test and intraclass correlation coefficients (ICCs). Within 15 days, all participants responded again to DDART in a different set of sentences to assess its test-retest reliability. Results One hundred patients (normal vision group - NVG: 70 patients; low vision group - LVG: 30 patients) responded to both reading tests. Non-significant differences were detected for all parameters between DDART and MNREAD-GR except for MRS and ACC that were significantly higher in MNREAD-GR in NVG (p < 0.01). NVG participants demonstrated sufficient ICCs that ranged from 0.854 to 0.963, while LVG demonstrated ICCs for RA, ACC, MRS and CPS equal to 0.986, 0.894, 0.794 and 0.723, respectively. All parameters calculated with DDART demonstrated excellent test-retest reliability (ICCs: 0.903 - 0.956). Conclusions The proposed reading test presented comparable validity and repeatability to MNREAD-GR suggesting that it can be used both in normal and low vision Greek patients. Trial registration ClinicalTrials.gov, NCT04242836. Registered 24 January 2020 - Retrospectively registered.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece
| | | | - Eleftherios Chatzimichael
- Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece
| | - Maria Tzinava
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35100, Lamia, Greece
| | - Asimina Mataftsi
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, 56429, Thessaloniki, Greece
| | - Konstantinos Delibasis
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35100, Lamia, Greece
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Curtis R, Hazari H, Eden K, Hopman WM, Irrcher I, Bona MD. Validation of a portable, remotely delivered refraction approach compared to standard in-clinic refraction in a low-vision population. J Telemed Telecare 2020; 28:662-669. [PMID: 32985381 DOI: 10.1177/1357633x20960628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION A low-vision assessment (LVA) is critical in developing a vision rehabilitation plan. A remotely delivered LVA that replicates a standard in-clinic assessment may bridge the gap for patients not accessing care due to the limited quantity and distribution of low-vision providers. Within an LVA, an accurate and consistent assessment of refraction error is an essential component. No system has currently been validated for the purposes of a remote LVA. The purpose of this study was to validate a commercially available portable refraction approach in a low-vision population. METHODS Low-vision patients (n = 26) or normally sighted patients (n = 25) underwent a refraction assessment using the Adaptica® 2WIN autorefractor, adaptor scope (Kaleidos) and VisionFit phoropter portable refraction devices, as well as a standard autorefractor (Huvitz) and phoropter (Haag-Streit). Refraction data between systems and populations were compared using intraclass correlations. Bland-Altman plots were used to assess the differences between devices. RESULTS Spherical equivalent values were found to be reproducible between standard and experimental autorefraction devices (intraclass correlation coefficient (ICC) > 0.8) in both low-vision and normally sighted groups. Similarly, manifest refraction was highly consistent (ICC > 0.8) between devices in all groups. The Bland-Altman plots showed clinically acceptable mean differences of 0.701 between autorefraction methods and -0.116 between manifest refraction methods. DISCUSSION The 2WIN/VisionFit system can reliably generate refraction values across a spectrum of errors in normally sighted and visually impaired people, and would be feasible to deliver remotely.
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Affiliation(s)
- Rachel Curtis
- Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada
| | - Hassan Hazari
- Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada
| | - Karen Eden
- Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada
| | - Wilma M Hopman
- Kingston Health Sciences Centre, Kingston General Hospital Research Institute, Kingston, Ontario, Canada
| | - Isabella Irrcher
- Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada
| | - Mark D Bona
- Department of Ophthalmology, Queen's University and Hotel Dieu Hospital, Kingston, Ontario, Canada
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Arango T, Yu D, Lu ZL, Bex PJ. Effects of Task on Reading Performance Estimates. Front Psychol 2020; 11:2005. [PMID: 32903762 PMCID: PMC7438847 DOI: 10.3389/fpsyg.2020.02005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/20/2020] [Indexed: 11/21/2022] Open
Abstract
Reading is a primary problem for low vision patients and a common functional endpoint for eye disease. However, there is limited agreement on reading assessment methods for clinical outcomes. Many clinical reading tests lack standardized materials for repeated testing and cannot be self-administered, which limit their use for vision rehabilitation monitoring and remote assessment. We compared three different reading assessment methods to address these limitations. Normally sighted participants (N = 12) completed MNREAD, and two forced-choice reading tests at multiple font sizes in counterbalanced order. In a word identification task, participants indicated whether 5-letter pentagrams, syntactically matched to English, were words or non-words. In a true/false reading task, participants indicated whether four-word sentences presented in RSVP were logically true or false. The reading speed vs. print size data from each experiment were fit by an exponential function with parameters for reading acuity, critical print size and maximum reading speed. In all cases, reading speed increased quickly as an exponential function of text size. Reading speed and critical print size significantly differed across tasks, but not reading acuity. Reading speeds were faster for word/non-word and true/false reading tasks, consistent with the elimination of eye movement load in RSVP but required larger text sizes to achieve those faster reading speeds. These different reading tasks quantify distinct aspects of reading behavior and the preferred assessment method may depend on the goal of intervention. Reading performance is an important clinical endpoint and a key quality of life indicator, however, differences across methods complicate direct comparisons across studies.
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Affiliation(s)
- Tiffany Arango
- Department of Psychology, Northeastern University, Boston, MA, United States
| | - Deyue Yu
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Zhong-Lin Lu
- Division of Arts and Sciences, NYU Shanghai, Shanghai, China.,Center for Neural Science, Department of Psychology, New York University, New York, NY, United States.,NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China
| | - Peter J Bex
- Department of Psychology, Northeastern University, Boston, MA, United States
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Ryan EH, Lam LA, Pulido CM, Bennett SR, Calabrèse A. Reading Speed as an Objective Measure of Improvement Following Vitrectomy for Symptomatic Vitreous Opacities. Ophthalmic Surg Lasers Imaging Retina 2020; 51:456-466. [DOI: 10.3928/23258160-20200804-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/01/2020] [Indexed: 11/20/2022]
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Crossland MD, Starke SD, Imielski P, Wolffsohn JS, Webster AR. Benefit of an electronic head-mounted low vision aid. Ophthalmic Physiol Opt 2020; 39:422-431. [PMID: 31696539 DOI: 10.1111/opo.12646] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/18/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the efficacy of electronic head-mounted low vision aid (e-LVA) SightPlus (GiveVision, UK, givevision.net) and to determine which people with low vision would see themselves likely using an e-LVA like this. METHODS Sixty participants with low vision aged 18 to 93 used SightPlus during an in-clinic study session based on a mixed methods design. Visual acuity (ETDRS), contrast sensitivity (Pelli-Robson) and reading performance (MNREAD) were measured binocularly at baseline (no device), with the device in 'normal' mode (zoom only), and with preferred enhanced mode (zoom and one of four digital image enhancements). At the end of the session, a short questionnaire recorded willingness to use an e-LVA like SightPlus, potential use cases, positive/negative comments and adverse effects. RESULTS Binocular distance visual acuity improved significantly by 0.63 logMAR on average (p < 0.0001) to 0.20 logMAR. Contrast sensitivity improved significantly by 0.22 log units (p < 0.0001) to 1.21 log units with zoom only and by 0.40 log units to 1.37 log units with zoom and preferred image enhancement. Reading performance improved significantly for near visual acuity and critical print size (p < 0.015), although reading speed significantly decreased (p < 0.0001). Nearly half (47%) of the participants indicated they would use an e-LVA like SightPlus, especially for television, reading and entertainment (e.g. theatre). Multivariate logistic regression showed that proportion of lifetime affected by sight loss, baseline contrast sensitivity and use of electronic LVAs explained 41% of the variation in willingness to use. CONCLUSIONS SightPlus improves visual function in people with low vision and would be used in its current form by one half of the people who tried it. Adverse effects were infrequent and resolved when the device was removed. Future work should focus on comparing e-LVAs through repeatable real-world tasks and impact on quality of life.
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Affiliation(s)
- Michael D Crossland
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital, UCL Institute of Ophthalmology, London, UK
| | - Sandra D Starke
- School of Engineering, University of Birmingham, Birmingham, UK.,GiveVision, Birmingham, UK
| | | | | | - Andrew R Webster
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital, UCL Institute of Ophthalmology, London, UK
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Baskaran K, Macedo AF, He Y, Hernandez-Moreno L, Queirós T, Mansfield JS, Calabrèse A. Scoring reading parameters: An inter-rater reliability study using the MNREAD chart. PLoS One 2019; 14:e0216775. [PMID: 31173587 PMCID: PMC6555504 DOI: 10.1371/journal.pone.0216775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/29/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose First, to evaluate inter-rater reliability when human raters estimate the reading performance of visually impaired individuals using the MNREAD acuity chart. Second, to evaluate the agreement between computer-based scoring algorithms and compare them with human rating. Methods Reading performance was measured for 101 individuals with low vision, using the Portuguese version of the MNREAD test. Seven raters estimated the maximum reading speed (MRS) and critical print size (CPS) of each individual MNREAD curve. MRS and CPS were also calculated automatically for each curve using two different algorithms: the original standard deviation method (SDev) and a non-linear mixed effects (NLME) modeling. Intra-class correlation coefficients (ICC) were used to estimate absolute agreement between raters and/or algorithms. Results Absolute agreement between raters was ‘excellent’ for MRS (ICC = 0.97; 95%CI [0.96, 0.98]) and ‘moderate’ to ‘good’ for CPS (ICC = 0.77; 95%CI [0.69, 0.83]). For CPS, inter-rater reliability was poorer among less experienced raters (ICC = 0.70; 95%CI [0.57, 0.80]) when compared to experienced ones (ICC = 0.82; 95%CI [0.76, 0.88]). Absolute agreement between the two algorithms was ‘excellent’ for MRS (ICC = 0.96; 95%CI [0.91, 0.98]). For CPS, the best possible agreement was found for CPS defined as the print size sustaining 80% of MRS (ICC = 0.77; 95%CI [0.68, 0.84]). Absolute agreement between raters and automated methods was ‘excellent’ for MRS (ICC = 0.96; 95% CI [0.88, 0.98] for SDev; ICC = 0.97; 95% CI [0.95, 0.98] for NLME). For CPS, absolute agreement between raters and SDev ranged from ‘poor’ to ‘good’ (ICC = 0.66; 95% CI [0.3, 0.80]), while agreement between raters and NLME was ‘good’ (ICC = 0.83; 95% CI [0.76, 0.88]). Conclusion For MRS, inter-rater reliability is excellent, even considering the possibility of noisy and/or incomplete data collected in low-vision individuals. For CPS, inter-rater reliability is lower. This may be problematic, for instance in the context of multisite investigations or follow-up examinations. The NLME method showed better agreement with the raters than the SDev method for both reading parameters. Setting up consensual guidelines to deal with ambiguous curves may help improve reliability. While the exact definition of CPS should be chosen on a case-by-case basis depending on the clinician or researcher’s motivations, evidence suggests that estimating CPS as the smallest print size sustaining about 80% of MRS would increase inter-rater reliability.
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Affiliation(s)
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
- Low Vision and Visual Rehabilitation Lab, Department and Center of Physics—Optometry and Vision Science, University of Minho Braga, Braga, Portugal
| | - Yingchen He
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, United States of America
| | - Laura Hernandez-Moreno
- Low Vision and Visual Rehabilitation Lab, Department and Center of Physics—Optometry and Vision Science, University of Minho Braga, Braga, Portugal
| | | | - J. Stephen Mansfield
- Department of Psychology, SUNY College at Plattsburgh, Plattsburgh, New York, United States of America
| | - Aurélie Calabrèse
- Aix-Marseille University, Marseille, France
- Laboratoire de Psychologie Cognitive, CNRS, Marseille, France
- * E-mail:
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Xiong YZ, Calabrèse A, Cheong AMY, Legge GE. Reading Acuity as a Predictor of Low-Vision Reading Performance. Invest Ophthalmol Vis Sci 2019; 59:4798-4803. [PMID: 30347073 PMCID: PMC6181187 DOI: 10.1167/iovs.18-24716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Most people with low vision experience difficulty with reading. Reading assessment can provide guidance for prescription of reading aids and strategies for reading rehabilitation. Here we investigate the effectiveness of letter acuity (LA) and reading acuity (RA) as predictors of low-vision reading performance. Methods Low-vision subjects (n = 58), young control subjects (n = 52), and older control subjects (n = 14) participated in this study. The low-vision subjects were separated into a Macular group (n = 30) and a Nonmacular group (n = 28) based on whether the diagnoses primarily affected the macular area. LA was measured with the Lighthouse Distance Visual Acuity Chart and RA with the MNREAD Acuity Chart. Reading speeds were obtained across a range of print sizes from the MNREAD test. The MNREAD data were used to estimate required print sizes for three functionally important types of reading for each subject: spot reading (40 words/min [wpm]), fluent reading (80 wpm), and critical print size (required to achieve maximum reading speed). Results For equal values of LA, the Macular group had significantly worse RA than the Nonmacular group. The differences between vision groups, as well as individual variations within groups, were largely explained by the differences in RA. RA is a better predictor than LA for spot reading size, fluent reading size, and critical print size. Conclusions RA may provide more accurate assessment of reading performance than LA for purposes of low-vision reading rehabilitation.
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Affiliation(s)
- Ying-Zi Xiong
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Aurélie Calabrèse
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States.,Laboratoire de Psychologie Cognitive, Aix-Marseille University, Marseille, France
| | - Allen M Y Cheong
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States.,School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Gordon E Legge
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States
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Mansfield JS, Atilgan N, Lewis AM, Legge GE. Extending the MNREAD sentence corpus: Computer-generated sentences for measuring visual performance in reading. Vision Res 2019; 158:11-18. [PMID: 30731097 DOI: 10.1016/j.visres.2019.01.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/18/2019] [Accepted: 01/30/2019] [Indexed: 01/22/2023]
Abstract
The MNREAD chart consists of standardized sentences printed at 19 sizes in 0.1 logMAR steps. There are 95 sentences distributed across the five English versions of the chart. However, there is a demand for a much larger number of sentences: for clinical research requiring repeated measures, and for new vision tests that use multiple trials at each print size. This paper describes a new sentence generator that has produced over nine million sentences that fit the MNREAD constraints, and demonstrates that reading performance with these new sentences is comparable to that obtained with the original MNREAD sentences. We measured reading performance with the original MNREAD sentences, two sets of our new sentences, and sentences with shuffled word order. Reading-speed versus print-size curves were obtained for each sentence set from 14 readers with normal vision at two levels of blur (intended to simulate acuity loss in low vision) and with unblurred text. We found no significant differences between the new and original sentences in reading acuity and critical print size across all levels of blur. Maximum reading speed was 7% slower with the new sentences than with the original sentences. Shuffled sentences yielded slower maximum reading speeds and larger reading acuities than the other sentences. Overall, measures of reading performance with the new sentences are similar to those obtained with the original MNREAD sentences. Our sentence generator substantially expands the reading materials for clinical research on reading vision using the MNREAD test, and opens up new possibilities for measuring how text parameters affect reading.
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Affiliation(s)
- J S Mansfield
- Department of Psychology, SUNY College at Plattsburgh, Plattsburgh, NY, USA.
| | - N Atilgan
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - A M Lewis
- Department of Psychology, SUNY College at Plattsburgh, Plattsburgh, NY, USA
| | - G E Legge
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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Benefits of low vision aids to reading accessibility. Vision Res 2018; 153:47-52. [PMID: 30292724 DOI: 10.1016/j.visres.2018.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/31/2018] [Accepted: 09/17/2018] [Indexed: 11/24/2022]
Abstract
The Reading Accessibility Index (ACC) has been proposed as a single-value reading parameter that can capture information on both reading speed and print sizes that can be read. It is defined as the average reading speed across a relevant range of print sizes (1.3-0.4logMAR), normalised by typical young-adult reading speed of 200 wpm, and with values typically in the range of 0-1. This study determines the impact of low vision aids (LVAs) on reading by evaluating ACC values for visually impaired observers reading both without and with an optical LVA. A secondary analysis of previously published data obtained from 100 visually impaired observers attending low vision assessments was undertaken. Observers had mixed causes of visual impairment but predominantly macular degeneration. All used an LVA for reading, with 88% using it 'often' or 'very often'. MNREAD reading parameters, including ACC, were determined both for reading without an LVA (clinical function) and with the LVA habitually used for reading (aided function). There was a significant improvement in ACC from clinical (0.31) to aided conditions (0.47). Average improvement in ACC with an LVA was 0.16, but the benefits of LVAs in terms of improvement in ACC could not be predicted from clinical visual function. Even with an LVA reading accessibility is, on average, markedly reduced from normal levels. The ACC is a potentially valuable outcome measure for reading rehabilitation interventions.
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Hou F, Zhao Y, Lesmes LA, Bex P, Yu D, Lu ZL. Bayesian adaptive assessment of the reading function for vision: The qReading method. J Vis 2018; 18:6. [PMID: 30208426 PMCID: PMC6133446 DOI: 10.1167/18.9.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Reading is a fundamental skill that can be significantly affected by visual disabilities. Reading performance, which typically is measured as reading speed with a reading chart, is a key endpoint for quantifying normal or abnormal vision. Despite its importance for clinical vision, existing reading tests for vision are time consuming and difficult to administer. Here, we propose a Bayesian adaptive method, the qReading method, for automated assessment of the reading speed versus print size function. We implemented the qReading method with a word/nonword lexical decision task and validated the method with computer simulations and a psychophysical experiment. Computer simulations showed that both the interrun standard deviation and intrarun half width of the 68.2% credible interval of the estimated reading speeds from the qReading method were less than 0.1 log10 units after 150 trials, with a bias of 0.05 log10 units. In the psychophysical experiment, reading functions measured by the qReading and Psi methods (Kontsevich & Tyler, 1999) in a word/nonword lexical decision task were compared. The estimated reading functions obtained with the qReading and Psi methods were highly correlated (r = 0.966 ± 0.004, p < 0.01). The precision of the qReading method with 225 trials was comparable to that of the Psi method with 450 trials. We conclude that the qReading method can precisely and accurately assess the reading function in much reduced time, with great promise in both basic research and clinical applications.
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Affiliation(s)
- Fang Hou
- School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yukai Zhao
- Center for Cognitive and Brain Sciences, Center for Cognitive and Behavioral Brain Imaging, and Department of Psychology, The Ohio State University, Columbus, OH, USA
| | | | - Peter Bex
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Deyue Yu
- College of Optometry, The Ohio State University, Columbus, OH, USA
| | - Zhong-Lin Lu
- Center for Cognitive and Brain Sciences, Center for Cognitive and Behavioral Brain Imaging, and Department of Psychology, The Ohio State University, Columbus, OH, USA
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Xiong YZ, Lorsung EA, Mansfield JS, Bigelow C, Legge GE. Fonts Designed for Macular Degeneration: Impact on Reading. Invest Ophthalmol Vis Sci 2018; 59:4182-4189. [PMID: 30128489 PMCID: PMC6100668 DOI: 10.1167/iovs.18-24334] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 07/15/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose People with macular degeneration (MD) experience difficulties in reading due to central-field loss. Two new fonts, Eido and Maxular Rx, have been designed specifically for individuals with MD. We have compared reading performance of these new fonts with three mainstream fonts (Times-Roman, Courier, and Helvetica). Methods Subjects with MD (n = 19) and normally sighted subjects (n = 40) were tested with digital versions of the MNREAD test using the five fonts. Maximum reading speed (MRS), critical print size (CPS), and reading acuity (RA) were estimated to characterize reading performance. Physical properties of the fonts were quantified by interletter spacing and perimetric complexity. Results Reading with MD showed font differences in MRS, CPS, and RA. Compared with Helvetica and Times, Maxular Rx permitted both smaller CPS and RA, and Eido permitted smaller RA. However, the two new fonts presented no advantage over Courier. Spacing, but not Complexity, was a significant predictor of reading performance for subjects with MD. Conclusions The two fonts, designed specifically for MD, permit smaller print to be read, but provide no advantage over Courier.
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Affiliation(s)
- Ying-Zi Xiong
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Ethan A. Lorsung
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States
| | - John Stephen Mansfield
- Department of Psychology, State University of New York at Plattsburgh, Plattsburgh, New York, United States
| | - Charles Bigelow
- Rochester Institute of Technology, Rochester, New York, United States
| | - Gordon E. Legge
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States
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