Reliability and variability of visual acuity assessments

视力评估是任何眼科评估的基础，随着新的治疗选择，如视网膜假体和基因治疗，准确监测视力变得越来越重要。然而，测量视力并不像第一眼看上去那么简单。在其他视觉表现领域的研究表明，测量的结果在很大程度上取决于要评估的生理参数之外的因素。这些因素中的许多都与个体受试者在识别视型时的决策过程有关。其他问题包括患者是否愿意进行检查（潜在的装病），以及是否有能力根据具体疾病预测患者的实际表现。我们提出了一系列实验，这些实验将阐明这些问题，目的是理解并最终减少敏锐度评估中可变性的来源。该项目的一个分支将评估在某些情况下（例如弱视）基于vep的敏锐度估计与心理物理敏锐度估计之间的差异。在第二个分支中，我们将评估认知事件相关电位在患者中的应用。第三个分支将关注决定主观敏锐度估计结果的因素，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.