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The Freiburg Visual Acuity Test-variability unchanged by post-hoc re-analysis.

Michael Bach1

  • 1University Augenklinik Freiburg, Killianstr. 6, 79106 Freiburg, Germany. michael.bach@uni-freiburg.de

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie
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Summary

The Freiburg Visual Acuity and Contrast Test (FrACT) offers objective visual acuity testing. Post-hoc analysis of short test runs did not improve reliability, suggesting more trials are needed for higher accuracy.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • The Freiburg Visual Acuity and Contrast Test (FrACT) is a computer-based tool for assessing visual acuity.
  • The current study aimed to decrease test-retest variability in visual acuity measurements using short test runs (18 trials) through post-hoc re-analysis.

Purpose of the Study:

  • To evaluate the effectiveness of post-hoc re-analysis in reducing test-retest variability of visual acuity measurements obtained with the FrACT.
  • To compare the results of the Best-PEST algorithm with a maximum-likelihood fit analysis for threshold and slope estimation.

Main Methods:

  • The FrACT utilizes advanced computer graphics and Landolt Cs for visual acuity testing.
  • An adaptive staircase procedure, the Best-PEST algorithm, was employed for threshold determination over 18 trials.
  • A post-hoc re-analysis estimated both threshold and psychometric function slope using maximum-likelihood fitting.

Main Results:

  • Average testing time per run was 1.7 minutes.
  • Test-retest reproducibility with 18 trials was +/-2 lines (0.2 logMAR) for a 95% confidence band.
  • Post-hoc analysis closely matched Best-PEST results (within 1%), but did not improve test-retest reproducibility.

Conclusions:

  • The FrACT provides objective and reliable visual acuity testing compared to traditional methods.
  • The Best-PEST algorithm's assumption of a constant slope is valid, as post-hoc analysis fitting both slope and threshold yielded similar results.
  • To achieve higher reliability, more than 18 trials per run are recommended for the FrACT.