0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Development of a Reading Accessibility Index Using the MNREAD Acuity Chart

Aurélie Calabrèse, PhD1; Cynthia Owsley, MSPH, PhD2; Gerald McGwin, MS, PhD2,3; Gordon E. Legge, PhD1
[+] Author Affiliations
1Department of Psychology, University of Minnesota, Minneapolis
2Department of Ophthalmology, The University of Alabama at Birmingham
3Department of Epidemiology, The University of Alabama at Birmingham
JAMA Ophthalmol. 2016;134(4):398-405. doi:10.1001/jamaophthalmol.2015.6097.
Text Size: A A A
Published online

Importance  We define a Reading Accessibility Index for evaluating reading in individuals with normal and low vision.

Objective  To compare the Reading Accessibility Index with data from the Impact of Cataracts on Mobility (ICOM) study.

Design, Setting, and Participants  This investigation was a secondary data analysis from the ICOM study performed between July 1, 2014, and September 20, 2015, at 12 eye clinics in Alabama from October 1, 1994, through March 31, 1996. Participants were 321 adults with cataract (n = 92), pseudophakia (n = 131), or natural crystalline lenses without cataract (n = 98).

Main Outcomes and Measures  The Reading Accessibility Index (hereafter referred to using the abbreviation ACC for the first 3 letters of Accessibility) is defined as an individual’s mean reading speed measured across the 10 largest print sizes on the MNREAD Acuity Chart (Precision Vision) (0.4-1.3 logarithm of the minimum angle of resolution at 40 cm), normalized by 200 words per minute, which was the mean value for a group of 365 normally sighted young adults. The ACC is a single-value measure that captures an individual’s range of accessible print sizes and reading fluency within this range.

Results  The study cohort comprised 321 participants. Their age range was 55 to 85 years, and 157 (48.9%) were female. The ACCs for the ICOM study participants ranged from 0.19 to 1.33, where 1.00 is the mean value for normally sighted young adults. The ACC for the cataract group (mean [SD], 0.65 [0.18]) was significantly lower than that for the pseudophakia group (mean [SD], 0.77 [0.16]) and the control group (mean [SD], 0.76 [0.19]) (P < .001 for both). The correlation between the ACC and Early Treatment Diabetic Retinopathy Study visual acuity (r = −0.22) and Pelli-Robson contrast sensitivity (r = 0.20) was weaker than that with a reading-related measure of instrumental activities of daily living (r = −0.60) (P < .001 for both).

Conclusions and Relevance  The ACC represents an individual’s access to text across the range of print sizes found in everyday life. Its calculation does not rely on curve fitting and provides a direct comparison with the performance of normally sighted individuals. Changes in an individual’s ACC might be used to evaluate the effect of ophthalmic treatment, rehabilitation programs, or assistive technology on reading accessibility. Data from the ICOM study show that the ACC reflects characteristics of reading performance in everyday life and is sensitive to improved reading accessibility for pseudophakic eyes.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Figures

Place holder to copy figure label and caption
Figure 1.
Typical MNREAD Acuity Chart (Precision Vision) Curves for Normal and Low Vision

Squares show the maximum reading speed; diamonds, the critical print size; and triangles, the reading acuity. logMAR indicates logarithm of the minimum angle of resolution; M, M-unit (1 M-unit subtends a visual angle of 5 minutes of arc at 1 m); and RS, reading speed. Print sizes included in the calculation of the Reading Accessibility Index (shorthand abbreviation ACC) are highlighted in orange. The upper box gives a full definition of the ACC.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Mean Values for the MNREAD Acuity Chart (Precision Vision) Parameters by Lens Status

Bars shows group values with 95% CIs. The print size range included in the calculation of the Reading Accessibility Index (shorthand abbreviation ACC) is highlighted in gray.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.
Distribution of the Reading Accessibility Index (Shorthand Abbreviation ACC) by Lens Status

For the purpose of age comparison, the distribution for a group of normally sighted young adults is given.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 4.
Correlations Between the Reading Accessibility Index (Shorthand Abbreviation ACC) and Visual Measures

Distributions are fitted by linear regressions of the form y as a function of x (A, B, C, E, and F) and y as a function of x + x2 (D). Pearson product moment correlation coefficients are given, and extreme data points are shown as crosses. ETDRS indicates Early Treatment Diabetic Retinopathy Study; logMAR, logarithm of the minimum angle of resolution; and TIADL-R, reading-related timed instrumental activities of daily living.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

340 Views
1 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
Jobs
brightcove.createExperiences();