Advertisement

Measurement of distance objective visual acuity with the computerized optokinetic nystagmus test in patients with ocular diseases

  • Sang Beom Han
  • Eun Ryung Han
  • Joon Young Hyon
  • Jong-Mo Seo
  • Jin Hak Lee
  • Jeong-Min HwangEmail author
Neuro-ophthalmology

Abstract

Backgrounds

To evaluate the efficacy of a computerized optokinetic nystagmus (OKN) test for determination of objective visual acuity (VA) at distance in patients with various ocular diseases.

Methods

This is a prospective, non-interventional study that included 85 eyes of 71 patients with one or more ocular pathologies. Study patients were classified into group C (39 eyes of 30 patients with central visual damage), group P (24 eyes of 20 patients with peripheral visual defect) and group M (22 eyes of 21 patients with media opacity). Objective distance VA was measured with OKN induction and suppression methods, and the correlation between the objective and subjective VA at distance was evaluated using linear regression analysis. Mean subjective VAs were compared among each objective VA step and among the three groups.

Results

Significant correlation was found between subjective distance VA and objective VA determined by both OKN induction and suppression methods in all three groups and in overall patients. In overall patients, the mean subjective VA was significantly different in several objective VA steps (Welch’s ANOVA, p < 0.001 for induction and suppression methods). No significant difference in subjective VA among the three groups was found in any objective VA step.

Conclusions

Our objective VA test using OKN induction and suppression methods can be useful in estimating distance VA in patients with various ocular diseases.

Keywords

Objective visual acuity Optokinetic nystagmus Visual acuity 

Notes

Acknowledgements

All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. This work was supported by Grant A080299 from the Korea Health 21 R&D Project, Ministry of Health, Welfare, and Family Affairs, Republic of Korea.

Financial Disclosure

None.

Conflict of Interest

None.

Supplementary material

417_2011_1705_MOESM1_ESM.doc (29 kb)
ESM 1 (DOC 29 kb)

References

  1. 1.
    Hyon JY, Yeo HE, Seo JM, Lee IB, Lee JH, Hwang JM (2010) Objective measurement of distance visual acuity determined by computerized optokinetic nystagmus test. Invest Ophthalmol Vis Sci 51:752–757PubMedCrossRefGoogle Scholar
  2. 2.
    Gundogan FC, Sobaci G, Bayer A (2007) Pattern visual evoked potentials in the assessment of visual acuity in malingering. Ophthalmology 114:2332–2337PubMedCrossRefGoogle Scholar
  3. 3.
    Nakamura A, Akio T, Matsuda E, Wakami Y (2001) Pattern visual evoked potentials in malingering. J Neuroophthalmol 21:42–45PubMedGoogle Scholar
  4. 4.
    Abadi RV, Howard IP, Ohmi M, Lee EE (2005) The effect of central and peripheral field stimulation on the rise time and gain of human optokinetic nystagmus. Perception 34:1015–1024PubMedGoogle Scholar
  5. 5.
    Cheng M, Outerbridge JS (1975) Optokinetic nystagmus during selective retinal stimulation. Exp Brain Res 23:129–139PubMedCrossRefGoogle Scholar
  6. 6.
    Fukai S, Hayakawa T, Tsutsui J (1990) Objective visual acuity testing by optokinetic nystagmus suppression. Jpn J Ophthalmol 34:239–244PubMedGoogle Scholar
  7. 7.
    Gorman JJ, Cogan DG, Gellis SS (1957) An apparatus for grading the visual acuity of infants on the basis of opticokinetic nystagmus. Pediatrics 19:1088–1092PubMedGoogle Scholar
  8. 8.
    Howard IP, Ohmi M (1984) The efficiency of the central and peripheral retina in driving human optokinetic nystagmus. Vis Res 24:969–976PubMedCrossRefGoogle Scholar
  9. 9.
    Millodot M, Harper P (1969) Measure of visual acuity by means of eye movements. Am J Optom Arch Am Acad Optom 46:938–945PubMedGoogle Scholar
  10. 10.
    Millodot M, Miller D, Jernigan ME (1973) Evaluation of an objective acuity device. Arch Ophthalmol 90:449–452PubMedGoogle Scholar
  11. 11.
    Schor C, Narayan V (1981) The influence of field size upon the spatial frequency response of optokinetic nystagmus. Vis Res 21:985–994PubMedCrossRefGoogle Scholar
  12. 12.
    Thomas BB, Seiler MJ, Sadda SR, Coffey PJ, Aramant RB (2004) Optokinetic test to evaluate visual acuity of each eye independently. J Neurosci Methods 138:7–13PubMedCrossRefGoogle Scholar
  13. 13.
    van Die G, Collewijn H (1982) Optokinetic nystagmus in man. Role of central and peripheral retina and occurrence of asymmetries. Hum Neurobiol 1:111–119PubMedGoogle Scholar
  14. 14.
    Van Die GC, Collewijn H (1986) Control of human optokinetic nystagmus by the central and peripheral retina: effects of partial visual field masking, scotopic vision and central retinal scotomata. Brain Res 383:185–194PubMedCrossRefGoogle Scholar
  15. 15.
    Weder W, Wiegand H (1987) Determination of visual acuity using optokinetic nystagmus. A newly developed instrument based on Gunther's principle. Klin Monbl Augenheilkd 191:149–155PubMedCrossRefGoogle Scholar
  16. 16.
    Wester ST, Rizzo JF 3rd, Balkwill MD, Wall C 3rd (2007) Optokinetic nystagmus as a measure of visual function in severely visually impaired patients. Invest Ophthalmol Vis Sci 48:4542–4548PubMedCrossRefGoogle Scholar
  17. 17.
    Reinecke RD, Cogan DG (1958) Standardization of objective visual acuity measurements; opticokinetic nystagmus vs. Snellen acuity. AMA Arch Ophthalmol 60:418–421PubMedGoogle Scholar
  18. 18.
    Shin YJ, Park KH, Hwang JM, Wee WR, Lee JH, Lee IB (2006) Objective measurement of visual acuity by optokinetic response determination in patients with ocular diseases. Am J Ophthalmol 141:327–332PubMedCrossRefGoogle Scholar
  19. 19.
    Gunther G, Noteboom E, Plotz C (1957) Objective determination of visual acuity. Albrecht Von Graefes Arch Ophthalmol 159:180–190PubMedCrossRefGoogle Scholar
  20. 20.
    Voipio H (1962) Objective measurement of visual acuity. Duodecim 78:285–288PubMedGoogle Scholar
  21. 21.
    Makabe R (1984) Objective estimation of visual acuity by means of optokinetic nystagmus. Dev Ophthalmol 9:130–132PubMedGoogle Scholar
  22. 22.
    Graf M, Kaufmann H (1999) Clinical application of a new method for the objective estimation of minimum visual acuity. Klin Monbl Augenheilkd 214:395–400PubMedCrossRefGoogle Scholar
  23. 23.
    Dell'Osso LF, Jacobs JB (2002) An expanded nystagmus acuity function: intra- and intersubject prediction of best-corrected visual acuity. Doc Ophthalmol 104:249–276PubMedCrossRefGoogle Scholar
  24. 24.
    Jacobs JB, Dell'Osso LF, Wang ZI, Acland GM, Bennett J (2009) Using the NAFX to measure the effectiveness over time of gene therapy in canine LCA. Invest Ophthalmol Vis Sci 50:4685–4692PubMedCrossRefGoogle Scholar
  25. 25.
    Wang Z, Dell'Osso LF, Jacobs JB, Burnstine RA, Tomsak RL (2006) Effects of tenotomy on patients with infantile nystagmus syndrome: foveation improvement over a broadened visual field. J AAPOS 10:552–560PubMedCrossRefGoogle Scholar
  26. 26.
    Wang ZI, Dell'Osso LF (2009) Eye-movement-based assessment of visual function in patients with infantile nystagmus syndrome. Optom Vis Sci 86:988–995PubMedCrossRefGoogle Scholar
  27. 27.
    Sloan LL (1951) Measurement of visual acuity; a critical review. AMA Arch Ophthalmol 45:704–725PubMedGoogle Scholar
  28. 28.
    Wolffsohn JS, Eperjesi F (2005) The effect of relative distance enlargement on visual acuity in the visually impaired. Clin Exp Optom 88:97–102PubMedCrossRefGoogle Scholar
  29. 29.
    van den Berg AV, Collewijn H (1988) Directional asymmetries of human optokinetic nystagmus. Exp Brain Res 70:597–604PubMedCrossRefGoogle Scholar
  30. 30.
    Abadi RV, Pascal E (1991) The effects of simultaneous central and peripheral field motion on the optokinetic response. Vis Res 31:2219–2225PubMedCrossRefGoogle Scholar
  31. 31.
    Murasugi CM, Howard IP, Ohmi M (1986) Optokinetic nystagmus: the effects of stationary edges, alone and in combination with central occlusion. Vis Res 26:1155–1162PubMedCrossRefGoogle Scholar
  32. 32.
    Crevits L, van Vliet AG (1986) Optokinetic nystagmus in patients with defects of the central visual field. Eur Neurol 25:454–457PubMedCrossRefGoogle Scholar
  33. 33.
    Valmaggia C, Charlier J, Gottlob I (2001) Optokinetic nystagmus in patients with central scotomas in age related macular degeneration. Br J Ophthalmol 85:169–172PubMedCrossRefGoogle Scholar
  34. 34.
    Valmaggia C, Gottlob I (2002) Optokinetic nystagmus elicited by filling-in in adults with central scotoma. Invest Ophthalmol Vis Sci 43:1804–1808PubMedGoogle Scholar
  35. 35.
    Wang L, Soderberg G (1995) Frequency and amplitude in scotopically stimulated optokinetic nystagmus. Graefes Arch Clin Exp Ophthalmol 233:8–12PubMedCrossRefGoogle Scholar
  36. 36.
    Abadi RV, Pantazidou M (1997) Monocular optokinetic nystagmus in humans with age-related maculopathy. Br J Ophthalmol 81:123–129PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Sang Beom Han
    • 1
  • Eun Ryung Han
    • 1
    • 2
  • Joon Young Hyon
    • 1
  • Jong-Mo Seo
    • 3
  • Jin Hak Lee
    • 1
  • Jeong-Min Hwang
    • 1
    Email author
  1. 1.Department of OphthalmologySeoul National University College of Medicine, Seoul National University Bundang HospitalSeongnamKorea
  2. 2.Myungdong St. Mary’s Eye CenterSeoulKorea
  3. 3.School of Electrical EngineeringSeoul National UniversitySeoulKorea

Personalised recommendations