Objective Visual Acuity Estimates in Amblyopia Are More Accurate With Optotype-Based P300 Than With VEP Measurements.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY Translational Vision Science & Technology Pub Date : 2024-12-02 DOI:10.1167/tvst.13.12.30

Akshara V Gopiswaminathan, Julia Haldina, Khaldoon O Al-Nosairy, Céline Z Duval, Francie H Stolle, Michael B Hoffmann, Sven P Heinrich

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Abstract

Purpose: Traditional visual acuity (VA) measurements depend on subjective responses, which can be unreliable, especially with uncooperative participants. Objective measurements with visual evoked potentials (VEP) address this issue but can overestimate VA in amblyopia. This study aims to establish the P300 component of the event-related potential as an objective VA test for amblyopia and compare its performance to subjective (psychophysical) and VEP-based VA estimates.

Methods: Psychophysical, VEP-based, and P300-based VA estimates were obtained for amblyopic and fellow eyes of 18 participants (aged 19-65) in a bicentric study. VEP-based VA was determined from the spatial frequency threshold derived from occipital cortex pattern-pulse responses to check-sizes ranging from 0.048° to 8.95°. P300 responses were collected using visual oddball sequences with circular optotypes. The threshold was estimated from the sigmoid function of parietal P300 amplitude versus optotype gap size. Mean VA values for amblyopic eyes were compared across methods.

Results: VEP-based VA of the amblyopic eyes overestimated psychophysical VA by 0.18 ± 0.06 logMAR (P = 0.0016). In contrast, P300-based VA showed no significant difference from psychophysical VA (0.00 ± 0.04 logMAR, P > 0.05).

Conclusions: In amblyopia, P300-based optotype VA aligns more closely with psychophysical VA than VEP-based VA, suggesting that P300-based VA is a valid objective alternative for estimating VA in amblyopic eyes.

Translational relevance: This study highlights the potential of P300-based VA testing as a reliable and objective method for assessing VA in amblyopic eyes, offering a promising tool for clinical and research applications where traditional methods fall short.

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目的：传统的视力（VA）测量依赖于主观反应，这可能不可靠，尤其是对于不合作的参与者。使用视觉诱发电位（VEP）进行客观测量可以解决这一问题，但可能会高估弱视患者的视力。本研究旨在将事件相关电位的 P300 分量确定为弱视的客观 VA 测试，并将其性能与主观（心理物理）和基于 VEP 的 VA 估值进行比较：方法：在一项双中心研究中，对 18 名参与者（19-65 岁）的弱视眼和同视眼进行了心理物理、基于 VEP 和基于 P300 的视力评估。基于 VEP 的 VA 是根据枕叶皮层对 0.048° 至 8.95° 的检查大小的模式脉冲响应得出的空间频率阈值确定的。P300 反应是通过带有圆形光型的视觉奇数序列收集的。阈值是根据顶叶 P300 振幅与光型间隙大小的 sigmoid 函数估算得出的。对不同方法下弱视眼的平均视力值进行了比较：结果：基于 VEP 的弱视眼 VA 高估了心理物理 VA 0.18 ± 0.06 logMAR（P = 0.0016）。相比之下，基于 P300 的 VA 与心理物理 VA 没有明显差异（0.00 ± 0.04 logMAR，P > 0.05）：结论：在弱视患者中，与基于 VEP 的视力增值相比，基于 P300 的视力增值与心理物理视力增值更为接近，这表明基于 P300 的视力增值是估算弱视眼视力增值的有效客观替代方法：本研究强调了基于 P300 的视力增值测试作为评估弱视眼视力增值的一种可靠而客观的方法的潜力，为传统方法无法满足的临床和研究应用提供了一种前景广阔的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.