Skip to main content

Advertisement

Log in

Reliability of a standardized reading chart system: variance component analysis, test-retest and inter-chart reliability

  • Clinical Investigation
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to analyze statistically the test-retest and inter-chart reliability of three standardized Radner Reading Charts with respect to reading acuity, maximum reading speed, critical print size and LogRAD/LogMAR ratio and to quantitatively identify the sources of variability.

Methods

At two testing sessions (3 to 4 weeks apart), 36 volunteers read monocularly all three Radner Reading Charts in randomized order (orthogonal Latin square design). The subjects were grouped according to their distance LogMAR visual acuity (group 1, 0.1 or better; group 2, 0.12–0.4; group 3, 0.42–0.8). Based on these 216 reading tests, crude correlations were calculated between the two testing sessions and between the three charts, and “variance component analyses” were performed for all variables.

Results

For all visual acuity groups and variables, the test-retest and the inter-chart reliability was high. The variance component analyses showed that the differences between individuals predominantly influenced the variance, whereas the effect of the test replication was low. The three charts caused minimal variability, indicating equality for clinical examinations.

Conclusion

The standardized Radner Reading Charts provide clinically reliable and reproducible results for individuals with normal eyesight and for patients with visual impairment. These findings indicate that reading test systems, which consider the current international standards for visual acuity measurements (EN ISO 8596, NAS-NRC) and the psychophysical requirements for controlling optical item interactions, can provide reliable measures for clinical and scientific analyses of reading performance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2 a–f
Fig. 3 a–f
Fig. 4 a–f

Similar content being viewed by others

References

  1. Age-Related Eye Disease Study Group (2001) The Age-Related Eye Disease Study system for classifying age-related macular degeneration from stereoscopic color fundus photographs: the Age-Related Eye Disease Study Report Number 6. Am J Ophthalmol 132:668–81

    Article  PubMed  Google Scholar 

  2. Ahn S, Legge G (1995) Psychophysics of reading-XIII. Predictors of magnifier aided reading speed in low vision. Vision Res 35:1931–1937

    PubMed  Google Scholar 

  3. Ahn S, Legge G, Luebker A (1995) Printed cards for measuring low-vision reading speed. Vision Res 35:1939–44

    PubMed  Google Scholar 

  4. Arditi A, Cagenello R (1993) On the statistical reliability of letter-chart visual acuity measurements. Invest Ophthalmol Vis Sci 34:120–9

    CAS  PubMed  Google Scholar 

  5. Bach M, Kommerell G (1998) Sehschärfenbestimmung nach Europäischer Norm: wissenschaftliche Grundlagen und Möglichkeiten der automatischen Messung. Klin Monatsbl Augenheilk 212:190–195

    CAS  PubMed  Google Scholar 

  6. Bailey IL, Lovie JE (1976) New design principles for visual acuity letter charts. Am J Optom Physiol Opt 53:745–753

    Google Scholar 

  7. Bailey IL, Lovie JE (1980) The design and use of a new near-vision chart. Am J Optom Physiol Opt 57:378–87

    PubMed  Google Scholar 

  8. Bland JM, Altmann DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    CAS  PubMed  Google Scholar 

  9. Brown B, Yap MKH (1995) Differences in visual acuity between the eyes: determination of normal limits in a clinical population. Ophthal Physiol Opt 15:163–169

    Article  CAS  Google Scholar 

  10. Bullimore MA, Bailey IL (1995) Reading and eye movements in age-related maculopathy. Optom Vis Sci 72:125–137

    CAS  PubMed  Google Scholar 

  11. Camparini M, Cassinari P, Ferrigno L, Macaluso C (2001) ETDRS-Fast: Implementing psychophysical adaptive methods to standardized visual acuity measurement with ETDRS-Charts. Invest Ophthalmol Vis Sci 42:1226–1231

    CAS  PubMed  Google Scholar 

  12. CEN European Committee of Norms (1996) Europäische Norm Sehschärfenprüfung EN ISO 8596. Beuth-Verlag, Berlin

  13. Chung STL, Mansfield JS, Legge GE (1998) Psychophysics of reading. XVIII. The effect of print size on reading speed in normal peripheral vision. Vision Research 37:2949–2962

    Article  Google Scholar 

  14. Colenbrander A (1988) Consilium Ophthalmologicum Universale Visual Functions Committee, Visual Acuity Measurement Standard. Ital J Ophthalmol 11:5-19

    Google Scholar 

  15. DIN 58220 “Sehschärfenbestimmung” Teil 3, 5 und 6 (1997) Beuth Verlag, Berlin

  16. Elliott D, Patel B, Whitaker D (2001) Development of a reading speed test for potential-vision measurements. Invest Ophthalmol Vis Sci 42:1945–1949

    CAS  PubMed  Google Scholar 

  17. Ergun E, Maar N, Radner W, Barbazetto I, Schmidt-Erfurth U, Stur M (2003) Scotoma Size and reading speed in patients with subfoveal occult choroidal neovascularization in age related macular degeneration. Ophthalmology 110:65–69

    Article  PubMed  Google Scholar 

  18. Ferris F, Kassoff A, Bresnick G, Bailey I (1982) New Visual Acuity Charts for Clinical Research. Am J Ophthalmol 94:91–96

    PubMed  Google Scholar 

  19. Ferris F, Sperduto R (1982) Standardized illumination for visual acuity testing in clinical research. Am J Ophthalmol 94:97–98

    PubMed  Google Scholar 

  20. Friedmann S, Munoz B, Rubin G, West S, Bandeen-Roche K, Fried L (1999) Characteristics of discrepancies between self-reported visual function and measuring reading speed. Salisbury Eye Evaluation Project Team. Invest Ophthalmol Vis Sci 40:858–864

    CAS  PubMed  Google Scholar 

  21. Gass JDM (1988) Idiopathic senile macular hole: Its early stages and pathogenesis. Arch Ophthalmol 106:629–39

    Google Scholar 

  22. Gass JDM (1995) Reappraisal of biomicroscopic classification of stages of development of a macular hole. Am J Ophthalmol 119:752–9

    Google Scholar 

  23. Geer I, Westall CA (1996) A comparison of tests to determine acuity deficits in children with amblyopia. Ophthal Physiol Opt 16:367–374

    Article  CAS  Google Scholar 

  24. Hazel CA, Petre KL, Armstrong RA, Benson MT, Frost NA (2000) Visual function and subjective quality of life compare in subjects with acquired macular disease. Invest Ophthalmol Vis Sci 41:1309–1315

    CAS  PubMed  Google Scholar 

  25. John PWM (1971) Statistical Design and Analysis of Experiments. The Macmillan Company, New York

  26. Legge GE, Rubin GS, Pelli DG, Schleske MM (1985) Psychophysics of reading—II. Low vision. Vision Res 25:253–66

    Article  CAS  PubMed  Google Scholar 

  27. Legge GE, Ross JA, Luebker A, LaMay JM (1989) Psychophysics of reading VIII. The Minnesota Low-Vision Reading Test. Optom Vis Sci 66:843–853

    CAS  PubMed  Google Scholar 

  28. Legge G, Ross J, Isenberg L, LaMay J (1992) Psychophysics of reading—XII: Clinical Predictors of low vision reading speed. Invest Ophthalmol Vis Sci 33:667–72

    Google Scholar 

  29. Lovie-Kitchin JE (1988) Validity and reliability of visual acuity measurements. Ophthal Physiol Opt 8:363–370

    CAS  Google Scholar 

  30. Mackensen G (1962) Die Untersuchung der Lesefähigkeit als klinische Funktionsprüfung. Fortschr Augenheilkd 12:344–379

    Google Scholar 

  31. Macular Photocoagulation Study Group (1982) Argon laser photocoagulation for senile macular degeneration: Results of a randomized clinical trial. Arch Ophthalmol 100:912–918

    PubMed  Google Scholar 

  32. Macular Photocoagulation Study Group (1986) Argon laser photocoagulation for neovascular maculopathy: Three year results from randomized clinical trials. Arch Ophthalmol 104:694–701

    Google Scholar 

  33. Mansfield J, Ahn S, Legge G, Luebker A (1993) A new reading-acuity chart for normal and low vision. Opt Soc Am Techn Digest 3:232–235

    Google Scholar 

  34. Munoz B, West SK, Rubin GS, Schein OD, Quigley HA, Bressler SB, Bandeen-Roche K, and the SEE Study Team (2000) Causes of blindness and visual impairment in a population of older Americans. Arch Ophthalmol 118:819–825

    CAS  PubMed  Google Scholar 

  35. NAS-NRC Committee on Vision (1980) Recommended standard procedures for the clinical measurement and specification of visual acuity. Adv Ophthalmol 41:103–148

    Google Scholar 

  36. Osarovsky-Sasin E, Richter-Mueksch S, Pfleger T, Stifter E, Velikay-Parel M, Radner W (2002) Reduced Reading ability of eyes with anisometropic amblyopia. Invest Ophthalmol Vis Sci 43: Abstract 4691

    Google Scholar 

  37. Patel B, Elliott DB, Whitaker D (2001) Optimal reading speed in simulated cataract: development of a potential vision test. Ophthal Physiol Opt 21:272–276

    Article  CAS  Google Scholar 

  38. Pesudovs K, Patel B, Bradbury JA, Elliott DB (2002) Reading speed test for potential central vision measurement. Clin Experiment Ophthalmol 30:183–186

    Article  PubMed  Google Scholar 

  39. Radner W, Willinger U, Obermayer W, Mudrich C, Velikay-Parel M, Eisenwort B (1998) Eine neue Lesetafel zur gleichzeitigen Bestimmung von Lesevisus und Lesegeschwindigkeit. Klin Monatsbl Augenheilkd 213:174–181

    CAS  PubMed  Google Scholar 

  40. Radner W, Obermayer W, Richter-Mueksch S, Willinger U, Velikay-Parel M, Eisenwort B (2002) The validity and reliability of short German sentences for measuring reading speed. Graefe‘s Arch Clin Exp Ophthalmol 240:461–467

    Google Scholar 

  41. Richter-Mueksch S, Weghaupt H, Skorpik C, Velikay-Parel M, Radner W (2002) Reading performance with a refractive multifocal and a diffractive bifocal intraocular lens. J Cataract Refract Surg 28:1957–1963

    Article  PubMed  Google Scholar 

  42. Richter-Mueksch S, Stur M, Stifter E, Kiss S, Velikay-Parel M, Radner W (2003). Different reading ability but same distance acuity of patients with drusen maculopathy and CNV-scars. Invest Ophthalmol Vis Sci 44: Abstract 971

    Google Scholar 

  43. Rubin G, West S, Munoz B, Bandeen-Roche K, Zeger S, Schein O, Fried L (1997) A comprehensive assessment of visual impairment in a population of older Americans. The SEE Eye Evaluation Project. Invest Ophthalmol Vis Sci 37:557–568

    Google Scholar 

  44. Rubin GS, Munoz B, Bandeen-Roche K, West S (2000) Monocular versus binocular visual acuity as measures of vision impairment and predictors of visual disability. The SEE Project Team. Invest Ophthalmol Vis Sci 41:3327–3334

    CAS  PubMed  Google Scholar 

  45. SAS Institute Inc. (1999) SAS/STAT Users-Guide, Version 8, Cary, North Carolina, USA

  46. Sloan L, Rowland WM, Altmann A (1952) Comparison of three types of test target for the measurement of visual acuity. Q Rev Ophthalmol 8:4-16

    Google Scholar 

  47. Sloan LL (1959) New test charts for the measurement of visual acuity at far and near distances. Am J Ophthalmol 48:807

    CAS  PubMed  Google Scholar 

  48. Stangler-Zuschrott E (1990) Verminderte Lesegeschwindigkeit und rasche Ermüdbarkeit als Zeichen der gestörten Sehfunktion. Klin Monatsbl Augenheilkd 196:150–157

    CAS  PubMed  Google Scholar 

  49. Wesemann W (2002) Sehschärfebestimmung mit Freiburger Visustest, Bailey-Lovie-Tafel und Landoltring-Tafel. Klin Monatsbl Augenheilkd 219:660–667

    Article  PubMed  Google Scholar 

  50. West S, Munoz B, Rubin G, Schein O, Bandeen-Roche K, Zeger S, German S, Fried L (1997) Function and visual impairment in a population-based study of older adults. The SEE Eye Evaluation Project. Invest Ophthalmol Vis Sci 37:72–82

    Google Scholar 

  51. West SK, Rubin GS, Broman AT, Munoz B, Bandeen-Roche K, Turano K (2002) How does visual impairment affect performance on tasks of everyday life. Arch Ophthalmol 120:774–780

    PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by the Medizinisch-Wissenschaftliche Fonds des Bürgermeisters der Bundeshauptstadt Wien.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wolfgang Radner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stifter, E., König, F., Lang, T. et al. Reliability of a standardized reading chart system: variance component analysis, test-retest and inter-chart reliability. Graefe's Arch Clin Exp Ophthalmol 242, 31–39 (2004). https://doi.org/10.1007/s00417-003-0776-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-003-0776-8

Keywords

Navigation