Vital Domenic, Hegemann Stefan C A, Straumann Dominik, Bergamin Oliver, Bockisch Christopher J, Angehrn Dominik, Schmitt Kai-Uwe, Probst Rudolf
Department of Otorhinolaryngology-Head and Neck Surgery, Zurich University Hospital, Frauenklinikstrasse 24, CH-8091 Zurich, Switzerland.
Arch Otolaryngol Head Neck Surg. 2010 Jul;136(7):686-91. doi: 10.1001/archoto.2010.99.
To evaluate a novel test for dynamic visual acuity (DVA) that uses an adaptive algorithm for changing the size of Landolt rings presented during active or passive head impulses, and to compare the results with search-coil head impulse testing.
Prospective study in healthy individuals and patients with peripheral vestibular deficits.
Tertiary academic center.
One hundred neuro-otologically healthy individuals (age range, 19-80 years) and 15 patients with bilateral (n = 5) or unilateral (n = 10) peripheral vestibular loss (age range, 27-72 years).
Testing of static visual acuity (SVA), DVA during active and passive horizontal head rotations (optotype presentation at head velocities >100 degrees/s and >150 degrees/s), and quantitative horizontal head impulse testing with scleral search coils.
Difference between SVA and DVA, that is, visual acuity loss (VA loss), gain of the high-acceleration vestibulo-ocular reflex.
Passive head impulses and higher velocities were more effective than active impulses and lower velocities. Using passive head impulses and velocities higher than 150 degrees/s, the DVA test discriminated significantly (P < .001) among patients with bilateral vestibulopathy, those with unilateral vestibulopathy, and normal individuals. The DVA test sensitivity was 100%, specificity was 94%, and accuracy was 95%, with search-coil head impulse testing used as a reference. In healthy individuals, VA loss increased significantly with age (P < .001; R(2) = 0.04).
Dynamic visual acuity testing with Landolt rings that are adaptively changed in size enables detection of peripheral vestibular dysfunction in a fast and simple way.
评估一种用于动态视力（DVA）的新型测试方法，该方法使用自适应算法来改变在主动或被动头部冲动期间呈现的Landolt环的大小，并将结果与搜索线圈头部冲动测试进行比较。
对健康个体和外周前庭功能缺陷患者进行的前瞻性研究。
三级学术中心。
100名神经耳科健康个体（年龄范围19 - 80岁）和15名双侧（n = 5）或单侧（n = 10）外周前庭功能丧失患者（年龄范围27 - 72岁）。
测试静视力（SVA）、主动和被动水平头部旋转期间的DVA（在头部速度>100度/秒和>150度/秒时呈现视标）以及使用巩膜搜索线圈进行定量水平头部冲动测试。
SVA和DVA之间的差异，即视力丧失（VA丧失），高加速度前庭眼反射增益。
被动头部冲动和较高速度比主动冲动和较低速度更有效。使用被动头部冲动和高于150度/秒的速度时，DVA测试在双侧前庭病变患者、单侧前庭病变患者和正常个体之间有显著差异（P <.001）。以搜索线圈头部冲动测试为参考，DVA测试的敏感性为100%，特异性为94%，准确性为95%。在健康个体中，VA丧失随年龄显著增加（P <.001；R(2) = 0.04）。
使用大小自适应变化的Landolt环进行动态视力测试能够快速、简便地检测外周前庭功能障碍。
