Evaluation of the SpotChecks contrast sensitivity test in healthy adults

SpotChecks is a new contrast sensitivity (CS) test designed for self-monitoring of vision. This study assessed the test–retest repeatability of take-home SpotChecks, in-office SpotChecks and near Pelli–Robson charts in healthy adults.

One eye of 61 healthy adults with near visual acuity (VA) of 6/9 or better (age range 22–84, mean 49 [18] years) was tested during two office visits (mean 10 [8] days apart). Each visit included high-contrast VA, then 12 randomly ordered CS tests (6 different SpotChecks and 6 different Pelli–Robson) under the same lighting (luminance 110 cd/m²), all at near in the same eye with habitual correction. The same eye was self-tested with take-home SpotChecks once a day on 6 days between the office visits. SpotChecks was scored by the logCS at the highest line with ≥2 errors. Pelli–Robson was scored by [0.05 × number of letters read correctly − 0.15]. Repeatability of logCS was defined as 1.96 \( \sqrt{2} \) S_w, S_w representing within-subject standard deviation. Comparison for repeatability was performed with Bootstrap hypothesis test.

SpotChecks and Pelli–Robson showed similar intra-session or inter-visit repeatability (p = 0.14–0.81). Inter-day repeatability for take-home SpotChecks was 0.18 logCS, the same as that from the first measurements of two office visits with SpotChecks or Pelli–Robson. Inter-visit repeatability improved to 0.15 by using the average of two repeated measurements for SpotChecks (p = 0.02) or three repeated measurements for Pelli–Robson (p = 0.04). Age showed a small effect on logCS (−0.015/decade, p = 0.02) for both SpotChecks and Pelli–Robson. Mean logCS was 0.05 lower in those ≥50 years (SpotChecks 1.84 [0.10] and Pelli–Robson 1.77 [0.10]) compared with those <50 years of age (SpotChecks 1.89 [0.07] and Pelli–Robson 1.83 [0.07]).

SpotChecks showed good repeatability with take-home and in-office testing in healthy adults, making it a promising tool for monitoring disease progression at home.