Development and Validation of a New Design Selfassessment logMAR Visual Acuity Test (“Chudjane” iPhone- and iPad-based Application) in a Normal Eyes Population

Nuttawut  Rodanant; Comkrit  Mahasith; Somanus  Thoongsuwan; Nopasak  Phasukkijwatana; Supalert  Prakhunhungsit

doi:10.33192/Smj.2022.70

Authors

Nuttawut Rodanant Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University
Comkrit Mahasith Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Somanus Thoongsuwan Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Nopasak Phasukkijwatana Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Supalert Prakhunhungsit Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

DOI:

https://doi.org/10.33192/Smj.2022.70

Keywords:

Self-assessment, visual acuity, mobile application

Abstract

Objective: To validate and further design the “Chudjane” application (app), a new design self- assessment logMAR test for distance visual acuity (VA), by comparing the results against the use of a standard numeric ETDRS chart in normal eye population.
Materials and Methods: In total, 52 volunteers who had a normal eye exam and best-corrected VA score by numeric ETDRS (NE) chart equal to or better than 6/6 (logMAR score 0.00 or less) were included. The “Chudjane” app with 3 patterns of optotypes (Arabic numbers (AN), Tumbling-E (TE) and Landolt-C (LC)) was used twice to assess VA individually.
Results: The mean VA in each test NE, AN, TE, LC from the first round were -0.06, -0.10, -0.08 and -0.04, respectively compared to -0.07, -0.12, -0.09 and -0.05 from the second round respectively. Comparing results from the first and second round revealed that NE and LC had higher test-retest reliability (ICC=0.712, 0.789 respectively) than AN and TE (ICC=0.140, 0.495 respectively). For validity, result from NE was compared to each app test using the second round values. Modified Bland-Altman plot showed the mean differences (95% LOA) for NE-AN, NE-TE and NE-LC of 0.05 (-0.11 to 0.20), 0.02 (-0.11 to 0.15) and -0.03 (-0.19 to 0.13) respectively. Simple linear regression analysis of the difference (i.e. NE-AN, NE-TE and NE-LC) on NE showed that the difference did not depend on the NE value with slope close to zero.
Conclusion: The study demonstrated that by using the «Chudjane» application, LC had higher test-retest reliability and higher validity than TE and AN compared to the standard ETDRS chart.

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