Micropulse laser for glaucoma in children

摘要： The optokinetic nystagmus (OKN) response (induction/suppression) correlates with subjective visual acuity (VA) in adults but has not been studied extensively in school-aged children. We investigated the correlation between subjective and objective VA as elicited with a new computerized OKN suppression test ("SpeedWheel") in adults and school-aged children. Fifteen children (6-12 years) and 27 adults with refractive errors, amblyopia, cataract, age-related macular degeneration and thyroid associated orbitopathy underwent testing of subjective VA with E- and Landolt C-symbols (Freiburg Acuity and Contrast Test [FrACT]) and objective VA (SpeedWheel) on a LCD screen. Statistical analysis: linear regression, Spearman correlation and Bland-Altman plots. Mean difference against the mean was 0.01 when SpeedWheel was compared to Landolt C, but 0.15 when compared to E-symbols. Overall, SpeedWheel correlated very strongly to FrACT ('E': r = 0.85; P < 0.001; Landolt C: r = 0.81; P < 0.001). This also held true in children ('E': r = 0.74; P < 0.003; Landolt C: r = 0.69; P < 0.005). In ocular disease, SpeedWheel appears to underestimate subjective VA. In 2 patients with loss of vision of unknown origin, subjective VA was lower than SpeedWheel VA. This is in agreement with the findings of Fukai et al. and could indicate aggravation or malingering. C? etinkaya et al found no correlation between OKN induction and subjective VA in 52 children. Thus OKN suppression rather than induction may be a better objective acuity test. SpeedWheel can assess visual acuity in in adults as well as in school aged children.