A Computer-Based Optotype Acuity Test System Suitable for Evaluation of Acuity Charts

Arditi, Aries; Cagenello, Ron

doi:10.1364/navs.1992.mb1

Cited by 1 publication

(2 citation statements)

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“…In ideal conditions, chart-based VA still exhibits considerable variation, with 95% LOA approaching 0.09 logMAR; and in clinical settings LOA broaden to at least ±0.15 logMAR [7,39]. Clinical variation is greater as different examinations may be more or less demanding of patient effort, and may or may not test to majority failure (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…As the requirement for clinical examination limits the usefulness of ophthalmic telehealth services, platforms facilitating further examination without physical attendance will serve as important components of any improved suite for remote consultation [3,6]. Pragmatic trials are essential to demonstrate that remote tests are useful for generating actionable VA data without skilled supervision-artificial environments are expected to inflate accuracy and reliability [7,8]. Validation data generated in unrealistic settings provides weaker justification for subsequent clinical deployment than results generated in real-world conditions [8].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy and reliability of self-administered visual acuity tests: Systematic review of pragmatic trials

et al. 2023

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Background Remote self-administered visual acuity (VA) tests have the potential to allow patients and non-specialists to assess vision without eye health professional input. Validation in pragmatic trials is necessary to demonstrate the accuracy and reliability of tests in relevant settings to justify deployment. Here, published pragmatic trials of these tests were synthesised to summarise the effectiveness of available options and appraise the quality of their supporting evidence. Methods A systematic review was undertaken in accordance with a preregistered protocol (CRD42022385045). The Cochrane Library, Embase, MEDLINE, and Scopus were searched. Screening was conducted according to the following criteria: (1) English language; (2) primary research article; (3) visual acuity test conducted out of eye clinic; (4) no clinical administration of remote test; (5) accuracy or reliability of remote test analysed. There were no restrictions on trial participants. Quality assessment was conducted with QUADAS-2. Results Of 1227 identified reports, 10 studies were ultimately included. One study was at high risk of bias and two studies exhibited concerning features of bias; all studies were applicable. Three trials—of DigiVis, iSight Professional, and Peek Acuity—from two studies suggested that accuracy of the remote tests is comparable to clinical assessment. All other trials exhibited inferior accuracy, including conflicting results from a pooled study of iSight Professional and Peek Acuity. Two studies evaluated test-retest agreement—one trial provided evidence that DigiVis is as reliable as clinical assessment. The three most accurate tests required access to digital devices. Reporting was inconsistent and often incomplete, particularly with regards to describing methods and conducting statistical analysis. Conclusions Remote self-administered VA tests appear promising, but further pragmatic trials are indicated to justify deployment in carefully defined contexts to facilitate patient or non-specialist led assessment. Deployment could augment teleophthalmology, non-specialist eye assessment, pre-consultation triage, and autonomous long-term monitoring of vision.

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Section: Discussionmentioning

confidence: 99%