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(Investigative Ophthalmology and Visual Science. 2002;43:1742-1748.)
© 2002 by The Association for Research in Vision and Ophthalmology, Inc.

Binocular Visual Acuity Summation and Inhibition in an Ocular Epidemiological Study: The Los Angeles Latino Eye Study

Stanley P. Azen1,2, Rohit Varma1,3, Susan Preston-Martin2, Mei Ying-Lai2, Denise Globe4 and Sora Hahn1 for the Los Angeles Latino Eye Study Group5

1 From the Departments of Ophthalmology and 2 Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; the 4 Department of Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles, California; and 3 Doheny Eye Institute, Los Angeles, California. 5 See Appendix for members of the Los Angeles Latino Eye Study Group.

PURPOSE. To characterize binocular visual acuity summation and inhibition in participants of a population-based ocular epidemiologic study.

METHODS. A complete ophthalmic examination of Latinos, aged 40 or more years, measured binocular and monocular distance visual acuities by a standard early-treatment diabetic retinopathy study (ETDRS) protocol. The proportions of participants who demonstrated binocular summation (i.e., binocular visual acuity was better than the better eye visual acuity by five or more letters), binocular inhibition (i.e., binocular visual acuity was worse than the better eye visual acuity by five or more letters), and visual impairment (visual acuity worse than 20/40) were calculated.

RESULTS. In 1831 individuals, on average, binocular visual acuity was better than better eye visual acuity. Prevalence rates of binocular summation and inhibition were 21% and 2%, respectively. Compared with participants less than 65 years old or those with equivalent interocular visual acuity, older participants (>=65 years) and those with interocular differences in visual acuity were more likely to demonstrate binocular inhibition (P < 0.01). The rate of visual impairment was significantly lower, when using binocular visual acuity than when using better eye or the American Medical Association (AMA) algorithm (5.2% vs. 6.9% and 9.5%, respectively P < 0.01). Participants with binocular inhibition had greater self-reported problems with driving activities (P < 0.05).

CONCLUSIONS. The large proportion of individuals demonstrating binocular summation and inhibition suggests that in clinical or research settings, binocular visual acuity should be considered a primary measure of visual impairment, because it better equates the state in which the person usually functions.




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