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Determinants and standardization of mesopic visual acuity.

Rachelle J Lin1, Jason S Ng, Andrew L Nguyen

  • 1*OD, MS, FAAO †OD, PhD, FAAO ‡PhD Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California (all authors); and Department of Mathematics, California State University, Fullerton, California (ALN).

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Summary

Visual acuity (VA) decreases in low light, primarily due to luminance levels, not just eye focusing or aberrations. A recommended mesopic VA testing luminance of 0.75 cd/m ensures repeatable and significant results.

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Area of Science:

  • Ophthalmology
  • Visual Science
  • Optometry

Background:

  • Visual acuity (VA) reduction at lower luminance is known.
  • Factors driving this VA decrease, such as accommodative error, pupil size, and aberrations, require further quantification.
  • Standardized mesopic VA testing is crucial for clinical research.

Purpose of the Study:

  • Quantify how accommodative error, pupil size, and aberrations affect VA decline from photopic to mesopic light.
  • Establish a recommended luminance for standardized mesopic VA testing.
  • Assess the repeatability of VA measurements at various luminance levels.

Main Methods:

  • Monocular VA was measured using E-ETDRS at photopic (94 cd/m) and mesopic (3, 0.75, 0.38 cd/m) levels in 43 subjects.
  • Accommodative error, pupil size, and higher-order aberrations were recorded.
  • VA repeatability was assessed in 20 subjects across two visits.

Main Results:

  • VA decreased significantly with luminance, from -0.08 logMAR at 94 cd/m to 0.27 logMAR at 0.38 cd/m.
  • Luminance level and accommodative error were significant predictors of VA, explaining 75% of the variance.
  • VA measurements showed good repeatability across luminance levels, with coefficients ranging from 0.08 to 0.14 logMAR.

Conclusions:

  • Luminance is the primary factor affecting VA reduction in mesopic conditions.
  • A mesopic VA testing luminance of 0.75 cd/m is recommended for its significant and repeatable VA decrease.
  • This standardized mesopic testing luminance supports future clinical studies and adoption.