Longitudinal Assessment of High- and Low-Contrast Visual Acuity in Normally-Sighted Children (P10-9.009)

Abstract

<h3>Objective:</h3> To characterize longitudinal visual changes in healthy children. <h3>Background:</h3> Visual acuity (VA) is often used as an outcome measure in clinical and research investigations, although age-related normative contrast data is lacking. We have previously demonstrated in a cross-sectional cohort (ages 5–20 years, grouped by age) that mean monocular and binocular high-contrast visual acuity (HCVA) and monocular low-contrast letter acuity (LCLA) scores increase with age linearly between 5–14 years in normally-sighted youth; however, improvements in acuity scores have not been validated longitudinally in individual children. <h3>Design/Methods:</h3> Children and young adults without neurologic, systemic, or ocular diseases (except refractive error) enrolled in our research program were eligible for longitudinal vision testing. Binocular HCVA and LCLA were assessed at 2 meters using EDTRS and Sloan charts (2.5% and 1.25% contrast). Linear regression with generalized estimating equations to account for repeated observations were used to calculate mean annual visual acuity change. <h3>Results:</h3> Among 101 subjects enrolled in the cross-sectional study, 27 subjects returned for longitudinal testing at a mean of 2.78 years after initial testing. For subjects ≥13 years of age, the mean annual change in binocular scores in letters was −0.67 (p=0.01), −0.82 (p=0.04), and −1.58 (p=0.01) for HCVA, LCLA 2.5%, and LCLA 1.25%, respectively. For subjects &lt;13 years, the mean annual change in binocular scores was 2.31 (p=0.008), 1.71 (p=0.003), and 2.03 (p=0.04) for HCVA, LCLA 2.5%, and LCLA 1.25%, respectively. For all levels of contrast, subjects &lt;7 years of age demonstrated the greatest mean annual changes. <h3>Conclusions:</h3> While HCVA, LCLA 2.5%, and LCLA 1.25% increase annually in children &lt;13 years, scores are expected to remain constant or slightly decrease thereafter. Given variabilities in normal visual acuity changes across the age span, clinicians should use caution when interpreting treatment response or disease progression based on such measures. <b>Disclosure:</b> Mr. Sollee has nothing to disclose. Amy Lavery has nothing to disclose. An immediate family member of Geraldine Liu has received publishing royalties from a publication relating to health care. Dr. Pistilli has nothing to disclose. Gui-Shuang Ying has nothing to disclose. Dr. Waldman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for SwanBio. An immediate family member of Dr. Waldman has stock in Pfizer. The institution of Dr. Waldman has received research support from Ionis Pharmaceuticals. Dr. Waldman has received publishing royalties from a publication relating to health care.