Comparion of the amblyopia treatment tudy hotv and electronic-early treatment of diabetic retinopathy tudy viual acuity protocol in children aged 5 to 12 year

Purpoe To compare two etablihed viual acuity protocol: the Amblyopia Treatment tudy HOTV (AT HOTV) viual acuity protocol and the Electronic-Early Treatment of Diabetic Retinopathy tudy (E-ETDR) protocol, in children aged 5 to 12 year. Deign Propective cohort tudy. Method Crowded HOTV optotype and crowded ETDR optotype were preented to 236 conecutive children aged 5 to 12 year uing an electronic viual acuity teter (Palm handheld, peronal computer, and monitor). Twenty-three percent of the children were claified a amblyopic, 35% a having uncorrected refractive error, 36% a normal, and 6% a other. Viual acuity tet reult were converted to logarithm of minimal angle of reolution (logMAR) unit for analyi. Reult In developmentally normal children (n = 230), tetability wa 100% for HOTV in 5- to 12-year-old and 100% for E-ETDR in 7- to 12-year-old. The E-ETDR teting could be completed in 52% of 5-year-old and in 87% of 6-year-old. Viual acuity performance wa better when meaured by HOTV compared with E-ETDR (median difference 0.06 logMAR [three letter on a chart with five letter/line], P = .0001), and the difference wa found in normal eye, eye with refractive error, and amblyopic eye. Concluion The AT HOTV protocol yield lightly better viual acuity performance compared with E-ETDR in 5- to 12-year-old, but on average by le than a logMAR level. Thi ytematic difference i important when a phyician change teting modality a a child mature and hould be conidered when interpreting the reult of recent and ongoing clinical trial in amblyopia.