A new dynamic visual acuity test to assess peripheral vestibular function.
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.
Vital
Domenic
D
Department of Otorhinolaryngology-Head and Neck Surgery, Zurich University Hospital, Frauenklinikstrasse 24, CH-8091 Zurich, Switzerland.
Hegemann
Stefan C A
SC
Straumann
Dominik
D
Bergamin
Oliver
O
Bockisch
Christopher J
CJ
Angehrn
Dominik
D
Schmitt
Kai-Uwe
KU
Probst
Rudolf
R
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