Developing dynamic defocus curve for evaluating dynamic vision accommodative function

To assess dynamic visual acuity (DVA) under different defocus statuses and explore the assessment of dynamic vision accommodation.

Twenty subjects (6 males and 14 females) aged 18 to 35 were recruited. Nonmydriatic subjective refraction (sphere and cylinder) and accommodative tests including negative relative accommodation (NRA), positive relative accommodation (PRA), binocular cross cylinder (BCC) and accommodative facility using a flipper were performed. Binocular static visual acuity (SVA) and DVA at 40 degrees per second (dps) were measured under different defocus statuses (+1.5D to -4D in -0.5D steps) based on the refractive error fully corrected. Static and dynamic defocus curves were plotted. The area under the curve (AUC) and corrected dynamic vision accommodation (CDVAc) were calculated.

The study showed that the dynamic defocus curve fitted the cubic curve properly (p<0.001). DVA was significantly worse than SVA at all defocused statuses (p<0.001), and the difference was more significant at greater defocus diopters. Single factor analysis indicated that CDVAc was significantly correlated with NRA-PRA (p=0.012) and AUC_dynamic (p<0.001). Significant associations were observed between AUC_dynamic and PRA (p=0.013) as well as NRA-PRA (p=0.021). Meanwhile, DVA was positively correlated with PRA at 0D, -1.0D, -1.5D, -2.5D and -3.0D (p<0.05) and with NRA-PRA at 0D, -1.0D, -1.5D, -2.0D and -2.5D (p<0.05). Multiple factor regression analysis indicated that CDVAc (0D ~ -3.5D) and SVA (+1.5D ~ +1.0D & -2.5D ~ -4.0D) were significant influential factors for defocused DVA (p<0.05).

Our study demonstrated that DVA had a defocus curve similar to that of SVA. CDVAc was feasible for the assessment of dynamic vision accommodative function. The dynamic defocus curve test could efficiently be applied in the evaluation of dynamic visual performance under different defocus statuses.