Walter Gutstein, Stephen H Sinclair, Peter Presti and Rachel V North
Purpose: The Central Vision Analyzer (CVA) is an interactive, automated computer device that rapidly thresholds central acuity under conditions mimicking customary photopic and mesopic activities. In sequence, the CVA may test up to 6 environments, and in this series was used to test 3 mesopic environments (98% and 50% MC against 1.6 cd/m2 background, 25% MC against 5 cd/m2), then 3 glare environments (98%, 10% and 8% MC, against 200 cd/m2 background). This report compares the CVA thresholded acuity with that measured utilizing standard letter acuity charts.
Methods: In 481 normal eyes acuity was measured with best spectacle and contact lens refraction using both CVA and 0.1 logMAR ETDRS charts presenting similar contrast and luminance. In addition for 162 emmetropic, eyes, acuity was tested with a 15% MC chart placed outdoors with sun overhead and with sun at 15° off-axis and compared with the CVA thresholded acuity at 10% and 8% MC presented in a darkened room.
Results: All CVA modules demonstrated high Pearson correlation coefficients (r=0.51 to r=0.94, p<0.01), Bland and Altman statistical similarity with the acuity measured from similar contrast charts as well as between the acuity measured with a 15% MC letter chart with the sun overhead and CVA 10% glare module and between acuity with a 15% MC chart viewed with the sun 15° off-axis and that with CVA 8% glare module presented in the darkened room.
Conclusions: The CVA demonstrates the ability to accurately threshold the acuity of normal eyes compared with chart acuity under conditions of contrast, luminance and fixation times simulating normal photopic and mesopic activities and appears to provide the clinician rapidly with a better understanding of visual function under a variety of day and evening tasks.
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