Reliability and variability of visual acuity assessments

视力评估是任何眼科评估的基础，随着视网膜假体和基因治疗等新的治疗选择的出现，准确的视力监测变得越来越重要。然而，敏锐度的测量并不像乍一看那么简单。视觉表现的其他领域的研究表明，测量的结果在很大程度上取决于要评估的生理参数以外的因素。这些因素中的许多都与个别受试者在视力类型识别过程中的决策过程有关。其他问题包括患者进行测试的意愿(潜在的伪装)，以及视力测试根据特定疾病预测患者实际表现的能力。我们提出了一系列实验，以阐明这些问题，目的是了解并最终减少视力评估中的可变性来源。该项目的一个分支将评估在某些情况下发生的基于VEP的和心理物理敏锐度估计之间的差异，例如弱视。在第二个分叉中，我们将评估认知事件相关电位在患者中的应用。第三个分叉将侧重于决定主观视力估计结果的因素，这仍然是黄金标准。

Estimation of visual acuity is fundamental to any ophthalmological assessment, and with new treatment options, such as retinal prostheses and gene therapy, the accurate monitoring of acuity is becoming increasingly important. However, acuity measurements are not as straightforward as the first glance suggests. Studies in other areas of visual performance have demonstrated that the outcome of a measurement depends substantially on factors beyond the physiological parameter to be assessed. Many of these factors are related to the decision process in individual subjects during identification of the optotypes. Other issues include the willingness of the patient to perform a test (potential malingering), and the ability of an acuity test to predict real-life performance of a patient depending on the specific disease. We propose a series of experiments that will shed light on these issues with the aim of understanding and ultimately reducing sources of variability in acuity assessments. One fork of the project will assess discrepancies between VEP-based and psychophysical acuity estimates that occur in certain cases, e.g. in amblyopia. In a second fork we will evaluate applications of cognitive event-related potentials in patients. The third fork will focus on the factors determining the outcome of the subjective acuity estimates, which are still the gold standard.