Evaluating Visual Acuity in the American Academy of Ophthalmology IRIS® Registry

Arthur Brant, MD; Natasha Kolomeyer, MD; Jeffrey L. Goldberg, MD, PhD; Julia Haller, MD; Cecilia S. Lee, MD, MS; Aaron Y. Lee, MD, MSCI; Alice C. Lorch, MD, MPH; Joan W. Miller, MD; Leslie Hyman, PhD; Suzann Pershing, MD, MS

Ophthalmology Science (Jan 2024)

Evaluating Visual Acuity in the American Academy of Ophthalmology IRIS® Registry

Arthur Brant, MD,
Natasha Kolomeyer, MD,
Jeffrey L. Goldberg, MD, PhD,
Julia Haller, MD,
Cecilia S. Lee, MD, MS,
Aaron Y. Lee, MD, MSCI,
Alice C. Lorch, MD, MPH,
Joan W. Miller, MD,
Leslie Hyman, PhD,
Suzann Pershing, MD, MS

Affiliations

Arthur Brant, MD: Spencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California
Natasha Kolomeyer, MD: Wills Eye Hospital, Department of Ophthalmology, Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania
Jeffrey L. Goldberg, MD, PhD: Spencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California; Ophthalmology and Eye Care Services, VA Palo Alto Health Care System, Palo Alto, CA
Julia Haller, MD: Wills Eye Hospital, Department of Ophthalmology, Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania
Cecilia S. Lee, MD, MS: Department of Ophthalmology, University of Washington, Seattle, Washington; Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
Aaron Y. Lee, MD, MSCI: Department of Ophthalmology, University of Washington, Seattle, Washington; Roger and Angie Karalis Johnson Retina Center, Seattle, Washington
Alice C. Lorch, MD, MPH: Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
Joan W. Miller, MD: Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
Leslie Hyman, PhD: Wills Eye Hospital, Department of Ophthalmology, Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania; Vickie and Jack Farber Vision Research Center at Wills Eye Hospital, Philadelphia, Pennsylvania
Suzann Pershing, MD, MS: Spencer Center for Vision Research, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University, Palo Alto, California; Ophthalmology and Eye Care Services, VA Palo Alto Health Care System, Palo Alto, CA; Correspondence: Suzann Pershing, MD, MS, 2452 Watson Court, Palo Alto, CA 94304.

Journal volume & issue: Vol. 4, no. 1
p. 100352

Abstract

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Objective: To describe visual acuity data representation in the American Academy of Ophthalmology Intelligent Research in Sight (IRIS) Registry and present a data-cleaning strategy Design: Reliability and validity study. Participants: Patients with visual acuity records from 2018 in the IRIS Registry. Methods: Visual acuity measurements and metadata were identified and characterized from 2018 IRIS Registry records. Metadata, including laterality, assessment method (distance, near, and unspecified), correction (corrected, uncorrected, and unspecified), and flags for refraction or pinhole assessment were compared between Rome (frozen April 20, 2020) and Chicago (frozen December 24, 2021) versions. We developed a data-cleaning strategy to infer patients’ corrected distance visual acuity in their better-seeing eye. Main Outcome Measures: Visual acuity data characteristics in the IRIS Registry. Results: The IRIS Registry Chicago data set contains 168 920 049 visual acuity records among 23 001 531 unique patients and 49 968 974 unique patient visit dates in 2018. Visual acuity records were associated with refraction in 5.3% of cases, and with pinhole in 11.0%. Mean (standard deviation) of all measurements was 0.26 (0.41) logarithm of the minimum angle of resolution (logMAR), with a range of − 0.3 to 4.0 A plurality of visual acuity records were labeled corrected (corrected visual acuity [CVA], 39.1%), followed by unspecified (37.6%) and uncorrected (uncorrected visual acuity [UCVA], 23.4%). Corrected visual acuity measurements were paradoxically worse than same day UCVA 15% of the time. In aggregate, mean and median values were similar for CVA and unspecified visual acuity. Most visual acuity measurements were at distance (59.8%, vs. 32.1% unspecified and 8.2% near). Rome contained more duplicate visual acuity records than Chicago (10.8% vs. 1.4%). Near visual acuity was classified with Jaeger notation and (in Chicago only) also assigned logMAR values by Verana Health. LogMAR values for hand motion and light perception visual acuity were lower in Chicago than in Rome. The impact of data entry errors or outliers on analyses may be reduced by filtering and averaging visual acuity per eye over time. Conclusions: The IRIS Registry includes similar visual acuity metadata in Rome and Chicago. Although fewer duplicate records were found in Chicago, both versions include duplicate and atypical measurements (i.e., CVA worse than UCVA on the same day). Analyses may benefit from using algorithms to filter outliers and average visual acuity measurements over time. Financial Disclosure(s): Proprietary or commercial disclosure may be found found in the Footnotes and Disclosures at the end of this article.

Published in Ophthalmology Science

ISSN: 2666-9145 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Ophthalmology
Website: https://www.journals.elsevier.com/ophthalmology-science/

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