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Validation of a novel iPhone application for evaluating near functional visual acuity.

ABSTRACT: Monitoring dynamic changes in near vision is important for early detection of presbyopia. This study assessed the accuracy and reliability of a new smartphone-based application, the Smart Vision Check (SVC), compared with those of a conventional device (AS-28; Kowa, Aichi, Japan), for measuring near functional visual acuity (NFVA). We enrolled 115 healthy volunteers aged ≥ 20 years with bilateral best-corrected visual acuity of ≥ 20/25. The SVC was designed for use on an Apple iPhone SE2 to measure NFVA by tapping on the orientation icon manually. Conventional FVA was measured using the AS-28 with - 2.50 D added to the best distance correction at baseline. There was no significant difference in NFVA-related measurements between the AS-28 and SVC (P > 0.05). The Spearman correlation coefficients of NFVA measurements between the two devices were over 0.60 (P < 0.001). The Bland-Altman plot indicated minimal bias with limits of agreements of ± 0.34 logMAR for NFVA with habitual correction when comparing the AS-28 and SVC. The intraclass correlation coefficient of the repeated SVC-measured NFVA was 0.915 (95% CI 0.800-0.969). In summary, the SVC has the potential to evaluate NFVA in a relatively easy manner. Applied clinically, the SVC can be useful for presbyopia screening.

SUBMITTER: Hanyuda A

PROVIDER: S-EPMC9791149 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Validation of a novel iPhone application for evaluating near functional visual acuity.

Hanyuda Akiko A Kubota Miyuki M Kubota Shunsuke S Masui Sachiko S Yuki Kenya K Tsubota Kazuo K Negishi Kazuno K

Scientific reports 20221226 1

Monitoring dynamic changes in near vision is important for early detection of presbyopia. This study assessed the accuracy and reliability of a new smartphone-based application, the Smart Vision Check (SVC), compared with those of a conventional device (AS-28; Kowa, Aichi, Japan), for measuring near functional visual acuity (NFVA). We enrolled 115 healthy volunteers aged ≥ 20 years with bilateral best-corrected visual acuity of ≥ 20/25. The SVC was designed for use on an Apple iPhone SE2 to meas ...[more]

PMID: 36572799

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Project description:PurposeTo validate and assess user satisfaction and usability of the New York University (NYU) Langone Eye Test application, a smartphone-based visual acuity (VA) test.DesignMixed-methods cross-sectional cohort study.ParticipantsTwo hundred forty-four eyes of 125 participants were included. All participants were adults 18 years of age or older. Participants' eyes with a VA of 20/400 (1.3 logarithm of the minimum angle of resolution [logMAR]) or worse were excluded.MethodsPatients were tested using the clinical standard Rosenbaum near card and the NYU Langone Eye Test application on an iPhone and Android device. Each test was performed twice to measure reliability. Ten patients were selected randomly for subsequent semistructured qualitative interviews with thematic analysis.Main outcome measuresVisual acuity was the parameter measured. Bland-Altman analysis was used to measure agreement between the results of the NYU Langone Eye Test application and Rosenbaum card, as well as test-retest reliability of each VA. The correlation between results was calculated using the intraclass correlation coefficient. Satisfaction survey and semistructured interview questions were developed to measure usability and acceptability.ResultsBland-Altman analysis revealed an agreement between the application and the Rosenbaum near card of 0.017 ± 0.28 logMAR (iPhone) and 0.009 ± 0.29 logMAR (Android). The correlation between the application and the Rosenbaum near card was 0.74 for both the iPhone and Android. Test-retest reliability was 0.003 ± 0.22 logMAR (iPhone), 0.01 ± 0.25 logMAR (Android), and 0.01 ± 0.23 logMAR (Rosenbaum card). Of the 125 participants, 97.6% found the application easy to use, and 94.3% were overall satisfied with the application. Thematic analysis yielded 6 key themes: (1) weaknesses of application, (2) benefits of the application, (3) tips for application improvement, (4) difficulties faced while using the application, (5) ideal patient for application, and (6) comparing application with traditional VA testing.ConclusionsThe NYU Langone Eye Test application is a user-friendly, accurate, and reliable measure of near VA. The application's integration with the electronic health record, accessibility, and easy interpretation of results, among other features, make it ideal for telemedicine use.

Project description:PurposeThe recent exponential growth in teleophthalmology has been limited in part by the lack of a validated method to measure visual acuity (VA) remotely. We investigated the validity of a self-administered Early Treatment Diabetic Retinopathy Study (ETDRS) home VA test. We hypothesized that a home VA test with a printout ETDRS chart is equivalent to a standard technician-administered VA test in clinic.DesignProspective cohort study.ParticipantsTwo hundred nine eyes from 108 patients who had a scheduled in-person outpatient ophthalmology clinic visit at an academic medical center.MethodsEnrolled patients were sent a .pdf document consisting of instructions and a printout ETDRS vision chart calibrated for 5 feet. Patients completed the VA test at home before the in-person appointment, where their VA was measured by an ophthalmic technician using a standard ETDRS chart. Survey questions about the ease of testing and barriers to completion were administered. For the bioequivalence test with a 5% nominal level, the 2 1-sided tests procedure was used, and an equivalent 90% confidence interval (CI) was constructed and compared with the prespecified 7-letter equivalence margin.Main outcome measuresThe primary outcome was the mean adjusted letter score difference between the home and clinic tests. Secondary outcomes included the unadjusted letter difference, absolute letter difference, and survey question responses.ResultsThe mean adjusted VA letter score difference was 4.1 letters (90% CI, 3.2-4.9 letters), well within the 7-letter equivalence margin. Average unadjusted VA scores in clinic were 3.9 letters (90% CI, 3.1-4.7 letters) more than scores at home. The absolute difference was 5.2 letters (90% CI, 4.6-5.9 letters). Ninety-eight percent of patients agreed that the home test was easy to perform.ConclusionsAn ETDRS VA test self-administered at home following a standardized protocol was equivalent to a standard technician-administered VA test in clinic in the examined population.

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Validation of a novel iPhone application for evaluating near functional visual acuity.

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Validation of a novel iPhone application for evaluating near functional visual acuity.

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