Zeitschrift für Informatik und Systembiologie

Computer Measurement of Central Visual Acuity under Mesopic and Glare Conditions in Eyes with Nuclear Cataract

Abstract

Walter Gutstein, Stephen H Sinclair, Peter Presti and Rachel V North

Purpose: The CVA is an interactive, automated computer device that rapidly thresholds central acuity under conditions mimicking customary photopic and mesopic activities. In sequence, the CVA may test up to 6 environments, in this series under 3 mesopic environments (98%, 50% MC against 1.6 cd/m2 background, 25% MC against 5 cd/m2), then 3 glare environments (98%, 10% and 8% MC, against 200 cd/m2). This report compares the CVA thresholded acuity with that measured with letter charts, as well as with C-Quant derived glare testing and patient responses to the Activities of Daily Vision Scale (ADVS) in eyes with nuclear cataract. Methods: In 33 eyes with nuclear cataract compared with 69 emmetropic eyes without lens opacity, best refracted acuity was measured under CVA modules and with ETDRS charts presenting similar contrast and luminance. Both groups were also tested with 15% MC charts placed outdoors with sun overhead and with sun at 15° off-axis and compared with the CVA acuty at 10% MC and 8% MC thresholded in a darkened room. In 22 of the eyes with nuclear cataract, C-Quant analysis of straylight glare was also performed along with the ADVS. Results: Acuities thresholded with CVA modules demonstrated high Pearson correlation coefficients, and Bland and Altman statistical similarity with the acuities measured from similar contrast charts. The acuities measured with CVA glare modules correlated significantly with charts placed in sun glare and with C-Quant measurements of straylight. Significant correlations were noted between CVA acuities and near vision as well as distance driving tasks. Conclusions: The CVA demonstrates the ability to accurately threshold the acuity of eyes with nuclear cataract compared with chart acuity under conditions of contrast, luminance and fixation times simulating normal photopic and mesopic activities and to provide the physician with glare evaluation and ability to function under multiple types of activities.