A comparison of visual function tests in eyes with maculopathy.

Area of Science:

• Ophthalmology
• Optometry
• Vision Science

Background:

• Accurate assessment of visual function is crucial for managing macular diseases.
• Several new tests aim to predict visual acuity in the presence of ocular conditions.

Purpose of the Study:

• To compare the diagnostic accuracy of recently developed visual function tests against Snellen acuity in eyes with macular disease.
• To determine the reliability of Potential Acuity Meter (PAM), laser interferometer (LI), white-light interferometer (WLI), blue field entoptic phenomenon, and focal electroretinogram (ERG) for evaluating macular function.

Main Methods:

• Compared visual acuity measurements from PAM, LI, WLI, blue field entoptic phenomenon, and focal ERG with Snellen acuity in 81 eyes with clear media and macular disease.
• Analyzed the agreement between test results and Snellen acuity, noting discrepancies in octaves and categorizing blue field and focal ERG as normal/abnormal.

Main Results:

• PAM, LI, and WLI tended to overestimate visual acuity compared to Snellen acuity.
• LI and WLI showed significant discrepancies (≥1.5 octaves) in ~40% of eyes.
• PAM demonstrated better agreement with Snellen acuity (91% within 1.5 octaves).
• Abnormal blue field and focal ERG results correlated with poor Snellen acuity (<20/40) in 65% and 91% of eyes, respectively.

Conclusions:

• PAM and focal ERG are the most reliable tests for evaluating macular function in the presence of maculopathy, assuming clear ocular media.
• These findings assist clinicians in selecting the most accurate visual function tests for patients with macular disease.