Karampatakis Vasileios, Almaliotis Diamantis, Papadopoulou Eleni P, Almpanidou Stavroula
Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Greece.
Ann Med Surg (Lond). 2022 Apr 29;77:103699. doi: 10.1016/j.amsu.2022.103699. eCollection 2022 May.
The study aims to present a new smartphone-based photostress recovery time test (K-PSRT test) that measures the stimulus-specific loss of visual sensitivity, as well as the differentiation between normal from abnormal macular function. This novel test defines a new standardized photostress application as an alternative tool for incorporation into clinical practice.
A total of 48 visually impaired eyes and 47 normal sighted age-matched controls eyes were enrolled in the study. The median age in subjects with impairment was 71.0 years, while the median age in normal subjects was 70.0 years. A light produced by the smartphone camera at approximately 5 cm distance, perpendicular to the eye up 10 s filled the pupil. The photostress recovery time was assessed immediately after the exposure by asking the subjects to read correctly at least three successive letters of size corresponding to the previous line of the BCVA line at a distance of 40 cm. The digital photostress testing was performed with the best-corrected visual acuity (BCVA). The patients were examined twice within 2 weeks. Correlations among the recovery times, the visual acuity, and the contrast sensitivity function as well as correlations concerning each specific ocular disease were also performed. Furthermore, correlations among technology, usability, and ease of performance in both groups were analyzed.
The initial median photostress recovery time in patients with impaired eyes was 83.5 (68.5, 126.0), while in the normal individuals was 39.0 (14.0, 43.0). The median visual acuity in individuals with impairment was 0.59 logMAR (0.40, 0.90), whereas in the normal individuals was -0,06 logMAR. Test-retest reliability study was performed on 26 eyes (16 males, 10 females) for visually impaired eyes as well as on 35 normal eyes (19 males, 16 females). Concerning the reliability, the average Intraclass Correlation Coefficients (with 95% confidence intervals) ICC (95% CI) = 0,99 (0,98-1,00), indicating significant correlation between them (p < 0.01). The coefficient of repeatability for eye measurements reaches clinically acceptable levels, which is demonstrated with increased repeatability and consistency. The recovery time in patients with diabetic retinopathy was statistically significantly lower than in those with dry age-related macular degeneration (p = 0.027) and those with wet age-related macular degeneration (p = 0.032). The patient group has lower scores concerning technology, usability, and ease of performance compared to the normal.
This new testing modality (K-Photostress Recovery time test), is designed to be an easily implemented measurement in ophthalmic practice, and it can expand our understanding of macular function. The above findings support the usefulness of a novel reproducible photostress application as an indicator of macular pathology.
本研究旨在提出一种基于智能手机的新型光应激恢复时间测试（K-PSRT测试），该测试可测量特定刺激下视觉敏感度的损失，以及区分正常与异常黄斑功能。这项新颖的测试定义了一种新的标准化光应激应用，作为纳入临床实践的替代工具。
本研究共纳入48只视力受损眼睛和47只年龄匹配的正常视力对照眼睛。视力受损受试者的中位年龄为71.0岁，而正常受试者的中位年龄为70.0岁。智能手机摄像头在距离眼睛约5厘米处产生的光线，垂直于眼睛照射10秒，使瞳孔充满光线。曝光后，立即通过让受试者在40厘米的距离正确读出至少三个与最佳矫正视力（BCVA）上一行大小对应的连续字母，来评估光应激恢复时间。数字光应激测试使用最佳矫正视力进行。患者在2周内接受了两次检查。还进行了恢复时间、视力和对比敏感度函数之间的相关性分析，以及每种特定眼病的相关性分析。此外，还分析了两组在技术、可用性和操作简便性方面的相关性。
视力受损患者的初始中位光应激恢复时间为83.5（68.5，126.0），而正常个体为39.0（14.0，43.0）。视力受损个体的中位视力为0.59 logMAR（0.40，0.90），而正常个体为-0.06 logMAR。对26只视力受损眼睛（16名男性，10名女性）和35只正常眼睛（19名男性，16名女性）进行了重测信度研究。关于信度，平均组内相关系数（95%置信区间）ICC（95%CI）=0.99（0.98 - 1.00），表明它们之间存在显著相关性（p < 0.01）。眼部测量的重复性系数达到了临床可接受水平，这通过更高的重复性和一致性得到了证明。糖尿病视网膜病变患者的恢复时间在统计学上显著低于干性年龄相关性黄斑变性患者（p = 0.027）和湿性年龄相关性黄斑变性患者（p = 0.032）。与正常组相比，患者组在技术、可用性和操作简便性方面得分较低。
这种新的测试方式（K-光应激恢复时间测试）旨在成为眼科实践中易于实施的测量方法，并且可以扩展我们对黄斑功能的理解。上述发现支持了一种新型可重复的光应激应用作为黄斑病变指标的有用性。
