A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia

Abstract Current criteria for amblyopia do not account for difference in visual acuity charts. This prospective observational study analyzed 100 children younger than 10 years treated at a tertiary referral center. Visual acuity was separately tested in each eye using Landolt C and tumbling E charts...

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Main Authors: Yu-Hung Lai, Horng-Jiun Wu, Shun-Jen Chang
Format: Article
Language:English
Published: Nature Portfolio 2021-09-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-97875-3
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author Yu-Hung Lai
Horng-Jiun Wu
Shun-Jen Chang
author_facet Yu-Hung Lai
Horng-Jiun Wu
Shun-Jen Chang
author_sort Yu-Hung Lai
collection DOAJ
description Abstract Current criteria for amblyopia do not account for difference in visual acuity charts. This prospective observational study analyzed 100 children younger than 10 years treated at a tertiary referral center. Visual acuity was separately tested in each eye using Landolt C and tumbling E charts in a random order. For each chart, receiver operating characteristic curve analysis was performed to determine the best cutoff for visual acuity score. Main outcome measures included the difference in visual acuity scores between the two charts, the feasibility of repeated testing of visual acuity in each eye, and amblyopia cutoff values for each chart. Mean logMAR visual acuity scores obtained by tumbling E chart were significantly better than those obtained by Landolt C chart. For amblyopia, the best cutoff values were <  + 0.14 (20/27 Snellen equivalent) for tumbling E chart and <  + 0.24 (20/35 Snellen equivalent) for Landolt C chart. For children under 10 years old, visual acuity scores for tumbling E chart were significantly better than those for Landolt C chart. We suggest that amblyopia management in children should account for age and the type of visual acuity chart used.
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spelling doaj.art-387425a86e1a4987bb39d037430c572c2022-12-21T21:21:06ZengNature PortfolioScientific Reports2045-23222021-09-011111710.1038/s41598-021-97875-3A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopiaYu-Hung Lai0Horng-Jiun Wu1Shun-Jen Chang2Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDepartment of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDepartment of Kinesiology, Health and Leisure Studies, National University of KaohsiungAbstract Current criteria for amblyopia do not account for difference in visual acuity charts. This prospective observational study analyzed 100 children younger than 10 years treated at a tertiary referral center. Visual acuity was separately tested in each eye using Landolt C and tumbling E charts in a random order. For each chart, receiver operating characteristic curve analysis was performed to determine the best cutoff for visual acuity score. Main outcome measures included the difference in visual acuity scores between the two charts, the feasibility of repeated testing of visual acuity in each eye, and amblyopia cutoff values for each chart. Mean logMAR visual acuity scores obtained by tumbling E chart were significantly better than those obtained by Landolt C chart. For amblyopia, the best cutoff values were <  + 0.14 (20/27 Snellen equivalent) for tumbling E chart and <  + 0.24 (20/35 Snellen equivalent) for Landolt C chart. For children under 10 years old, visual acuity scores for tumbling E chart were significantly better than those for Landolt C chart. We suggest that amblyopia management in children should account for age and the type of visual acuity chart used.https://doi.org/10.1038/s41598-021-97875-3
spellingShingle Yu-Hung Lai
Horng-Jiun Wu
Shun-Jen Chang
A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia
Scientific Reports
title A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia
title_full A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia
title_fullStr A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia
title_full_unstemmed A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia
title_short A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia
title_sort reassessment and comparison of the landolt c and tumbling e charts in managing amblyopia
url https://doi.org/10.1038/s41598-021-97875-3
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