title: A new dynamic visual acuity test to assess peripheral vestibular function.
abstract: OBJECTIVE
  To evaluate a novel test for dynamic visual acuity (DVA) that uses an adaptive algorithm for changing the size of Landolt rings presented during active or passive head impulses, and to compare the results with search-coil head impulse testing.
  
  
  METHODS
  Prospective study in healthy individuals and patients with peripheral vestibular deficits.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  One hundred neuro-otologically healthy individuals (age range, 19-80 years) and 15 patients with bilateral (n = 5) or unilateral (n = 10) peripheral vestibular loss (age range, 27-72 years).
  
  
  METHODS
  Testing of static visual acuity (SVA), DVA during active and passive horizontal head rotations (optotype presentation at head velocities >100 degrees/s and >150 degrees/s), and quantitative horizontal head impulse testing with scleral search coils.
  
  
  METHODS
  Difference between SVA and DVA, that is, visual acuity loss (VA loss), gain of the high-acceleration vestibulo-ocular reflex.
  
  
  RESULTS
  Passive head impulses and higher velocities were more effective than active impulses and lower velocities. Using passive head impulses and velocities higher than 150 degrees/s, the DVA test discriminated significantly (P < .001) among patients with bilateral vestibulopathy, those with unilateral vestibulopathy, and normal individuals. The DVA test sensitivity was 100%, specificity was 94%, and accuracy was 95%, with search-coil head impulse testing used as a reference. In healthy individuals, VA loss increased significantly with age (P < .001; R(2) = 0.04).
  
  
  CONCLUSIONS
  Dynamic visual acuity testing with Landolt rings that are adaptively changed in size enables detection of peripheral vestibular dysfunction in a fast and simple way.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Zurich University Hospital, Frauenklinikstrasse 24, CH-8091 Zurich, Switzerland.
authors.forename: Domenic
authors.initials: D
authors.lastname: Vital
authors.forename: Stefan C A
authors.initials: SC
authors.lastname: Hegemann
authors.forename: Dominik
authors.initials: D
authors.lastname: Straumann
authors.forename: Oliver
authors.initials: O
authors.lastname: Bergamin
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Bockisch
authors.forename: Dominik
authors.initials: D
authors.lastname: Angehrn
authors.forename: Kai-Uwe
authors.initials: KU
authors.lastname: Schmitt
authors.forename: Rudolf
authors.initials: R
authors.lastname: Probst
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology; D012680:Sensitivity and Specificity; D012737:Sex Factors; D015837:Vestibular Diseases / Q000175:diagnosis*; D014724:Vestibular Function Tests / Q000379:methods; D014787:Vision Tests / Q000379:methods*; D014792:Visual Acuity; D055815:Young Adult