Purpose Several previous studies have demonstrated that for normal adult subjects the optotype acuity measured with charts is better than the acuity determined with the sweep visual evoked potential (sVEP) using gratings or checks. However, there is no difference in psychophysical measures of acuity with optotype or grating charts. Thus, it is unclear whether the acuity discrepancy between optotype charts and the sVEP result from the stimulus design or other methodological differences. The purpose of this experiment is to determine the relationship between acuities extrapolated from a contrast sensitivity function (CSF) that uses optotypes and the sVEP. Methods Normal subjects (N = 10) with acuity of 0.00 logMAR or better (ETDRS chart) were recruited for this study. Two commercially available systems were used to measure CSFs [i.e., the Beethoven System (Ryklin Software, NY) and the qCSF system (Adaptive Sensory Tech, CA)]. The stimuli for the Beethoven were sine wave gratings (0.75-18.50 cpd), and thresholds were determined with a 2-alternative forced choice (2-AFC) procedure combined with a staircase. The stimuli for the qCSF system were spatially filtered letters (10 possible letters, 10-AFC) with the letter sizes and contrasts determined by a Bayesian adaptive procedure. Visual acuity was determined by fitting the data with a double exponential equation and extrapolating the fit to a contrast sensitivity of one. The sVEP was obtained with the PowerDiva (Digital Instrumentation for Visual Assessment, version 3.5, CA). The stimuli were sine wave gratings (80% contrast, 3-36 cpd) counter-phased at 7.5 Hz. The final acuity was the average of two estimates each derived from the average of 10 sweeps. Results The average logMAR chart (acuity converted to cpd), sVEP, Beethoven, and qCSF acuities were 36.6 +/- 4.62 cpd (mean +/- SD), 31.2 +/- 4.59 cpd, 27.3 +/- 7.38 cpd, and 27.6 +/- 6.36 cpd, respectively. The logMAR chart acuity was significantly different from the other acuity estimates (all p values < 0.05). The sVEP, Beethoven, and qCSF acuities were not different from one another (all p values < 0.05). The Beethoven and the qCSF acuities had a good intraclass correlation coefficient (ICC = 0.85). Conclusions Similar to previous publications, the sVEP acuity estimate was less than the optotype chart acuity. The acuity determined with the sVEP and the CSFs with letter and grating stimuli were not statistically different, suggesting that the difference in acuity with the sVEP and optotype charts does not result from stimulus differences. Other with the letter sizes and contrasts determined by a Bayesian adaptive procedure. Visual acuity was determined by fitting the data with a double exponential equation and extrapolating the fit to a contrast sensitivity of one. The sVEP was obtained with the PowerDiva (Digital Instrumentation for Visual Assessment, version 3.5, CA). The stimuli were sine wave gratings (80% contrast, 3-36 cpd) counter-phased at 7.5 Hz. The final acuity was the average of two estimates each derived from the average of 10 sweeps. Results The average logMAR chart (acuity converted to cpd), sVEP, Beethoven, and qCSF acuities were 36.6 +/- 4.62 cpd (mean +/- SD), 31.2 +/- 4.59 cpd, 27.3 +/- 7.38 cpd, and 27.6 +/- 6.36 cpd, respectively. The logMAR chart acuity was significantly different from the other acuity estimates (all p values < 0.05). The sVEP, Beethoven, and qCSF acuities were not different from one another (all p values > 0.05). The Beethoven and the qCSF acuities had a good intraclass correlation coefficient (ICC = 0.85). Conclusions Similar to previous publications, the sVEP acuity estimate was less than the optotype chart acuity. The acuity determined with the sVEP and the CSFs with letter and grating stimuli were not statistically different, suggesting that the difference in acuity with the sVEP and optotype charts does not result from stimulus differences. Other methodological differences must account for the discrepancy in sVEP and optotype chart acuity.
