Repeatability of mesopic visual acuity measurements using high- and low-contrast ETDRS letter charts

Abstract

To determine the repeatability of mesopic high-contrast (HC) and low-contrast (LC) visual acuity (VA) measurements made at distance and near in healthy young individuals. While the repeatability of photopic VA is well-known, there is a lack of information with regard to the repeatability of VA measured under low luminance conditions. In two different sessions 1 week apart, best-corrected monocular VA was determined using HC (96 %) and LC (10 %) ETDRS charts under mesopic luminance conditions (0.75 cd/m(2)) at distance (HCD, LCD) and near (HCN, LCN) in 47 healthy subjects aged 22.9 +/- 6.8 years. Repeatability was estimated by the Bland and Altman method, whereby the mean difference (MD) and the 95 % limits of agreement were determined as the coefficient of repeatability (COR). Mean logMAR VA values were HCD = 0.09, LCD = 0.44, HCN = 0.21, and LCN = 0.57. Mean differences in measurements between sessions 1 and 2 were not significant, and low in clinical terms (a parts per thousand currency sign1 letter). Repeatability was better for the distance measurements at both high and lowcontrast (COR (HCD) +/- 0.11 and COR (LCD) +/- 0.11 logMAR vs COR (HCN) +/- 0.15 and COR (LCN) +/- 0.16 logMAR), and MDs were also slightly closer to zero for the distance measurements. Similar repeatability was observed between HC and LC VA, both at distance and near. In mesopic conditions, ETDRS charts offer repeatable best-corrected monocular VA measurements. The criterion for a significant change in logMAR VA was 1 line at distance and 1.5 lines at near.