Abstract: Comparison of an iPAD-Based Visual Assessment and Sloan Letter Acuity Testing in Multiple Sclerosis Patients (2018 Annual Meeting of the Consortium of Multiple Sclerosis Centers)

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Comparison of an iPAD-Based Visual Assessment and Sloan Letter Acuity Testing in Multiple Sclerosis Patients

Thursday, May 31, 2018

Exhibit Hall A (Nashville Music City Center)

Thomas J Shoemaker, MD , Neurology, Johns Hopkins University School of Medicine, Baltimore, MD

Peter A Calabresi, MD , Neurology, Johns Hopkins University, Baltimore, MD

Shiv Saidha, MBBCh , Neurology, Johns Hopkins University, Baltimore, MD

Natalia Gonzalez-Caldito, MD , Neurology, Johns Hopkins Hospital, Baltimore, MD

Sydney Feldman, BS , Neurology, Johns Hopkins University, Baltimore, MD

Andrew Aston, BS , Neurology, Johns Hopkins Hospital, Baltimore, MD

Ohemaa Kwakyi, BS , Neurology, Johns Hopkins Hospital, Baltimore, MD

Hunter Risher, BS , Neurology, Johns Hopkins University, Baltimore, MD

Esther Ogboukiri, BS , Neurology, Johns Hopkins Hospital, Baltimore, MD

Ellen M Mowry, MD, MCR , Neurology, Johns Hopkins School of Medicine, Baltimore, MD

Background: Visual symptoms occur frequently in multiple sclerosis (MS), with over half of patients experiencing optic neuritis during the course of relapsing disease. Office testing with high contrast charts (i.e. Snellen) are insensitive to visual dysfunction in early disease. Studies suggest that measures of low-contrast vision, such as Sloan Low-Contrast letter acuity (SLCLA) charts, are the most sensitive measures of visual dysfunction in patients with MS. Sloan Low-contrast letter acuity correlates with disability and retinal thickness on optical coherence tomography. Despite its advantages, SLCLA testing requires dedicated space and personnel, which has been a barrier to widespread implementation. An automated self-administered iPAD test of letter acuity testing based on standard Sloan LCLA was developed for the MS Partners Advancing Technology and Health Solutions (MS PATHS) multi-site study, which collects standardized data from patients at the time of their MS clinical visits.

Objectives: To evaluate the correlation between SLCLA and self-administered iPAD contrast sensitivity in a subset of MS patients enrolled in MS PATHS at the Johns Hopkins MS Center.

Methods: Patients at the Johns Hopkins MS Center who completed the MS PATHS iPAD contrast sensitivity testing as well as standardized visual acuity testing on the same visit were included. The MS PATHS contrast sensitivity testing is based upon the Sloan Low Contrast Letter Acuity test and assessed binocular acuity with a maximum number correct of 60 at high (100%) and low (2.5%) contrast. The iPAD testing was completed prior to clinical visits. Technician-administered Sloan Letter Acuity charts (Precision Vision, LaSalle, IL) were used to assess binocular visual acuity at high (100%) and low contrast (2.5% and 1.25%) with a maximum number correct of 70.

Results: A total of 80 patients were recruited (mean age 43.8 years; 52 (65%) were female, 63 (79%) were Caucasian, 68 (85%) had relapsing-remitting MS). 45 (56%) had a documented history of optic neuritis. Correlation was high between the two high contrast measurements (r=0.81). The iPAD contrast testing at 2.5% had high correlation with Sloan at both 2.5% (r= 0.84) and 1.25% (r=0.75).

Conclusions: Self-administered iPAD-based contrast sensitivity testing correlates with SLCLA testing in patients in MS and may be an option for clinical adoption. Further studies should evaluate the impact of refractive error and the other relevant conditions on the results.

NB04 Comparison of an iPAD-Based Visual Assessment and Sloan Letter Acuity Testing in Multiple Sclerosis Patients

NB04
Comparison of an iPAD-Based Visual Assessment and Sloan Letter Acuity Testing in Multiple Sclerosis Patients