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Медико-биологический
информационный портал
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для специалистов |
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Vol. 26, Art. 20 (pp. 500-516) | 2025
Comparison of subjective and objective control methods for determining visual acuity in case of suspicion of malingering
Kulikov A.N., Koskin S.A., Nikolaenko E.N.
Federal State Budgetary Military Educational Institution of Higher Education " Military Medical Academy of S.M. Kirov" of the Ministry of Defense of Russian Federation
Brief summary
Doctor may suspect malingering if the data of traditional visual acuity examination methods do not correspond to results of the anatomical structures study. In this case, it is recommended to use control methods of visual acuity examination. Various tests, test tables or determination of the contrast sensitivity function characteristic are used as additional subjective control methods. Various options of simple electrophysiological studies or registration of visual evoked potentials (VEP) are used as objective control methods. Objective: to conduct an individual comparative assessment of visual acuity based on the results of frequency-contrast characteristics analysis and an objective research method based on the VEP registration in case of suspected simulation or aggravation of a visual acuity decrease. Materials and methods. A control study of visual acuity was conducted in cases of suspected simulation or aggravation in 8 men aged 20 to 56 years with refraction in the range from H2.0 to M5.0 D and BCVA from 0.03 to 0.2. The upper limit frequency was determined based on the study of frequency-contrast characteristics as a control subjective method. The control objective determination of visual acuity was performed based on registration of VEP to a pattern with an increasing angular size of the cell of 0.4˚, 0.9˚, 1.5˚, 2.5˚, which corresponded to visual acuity of 1.0, 0.8, 0.6, 0.4 according to the Visus intern protocol on the Tomey EP-1000 Multifocal electrophysiological device. Results. In all patients with suspected simulation or aggravation, control methods revealed higher visual acuity. The results of the subjective and objective methods were comparable, correlation coefficient was 0.95. Conclusions. To determine visual acuity when simulation or aggravation is suspected, it is possible to use measurement of upper limit frequency based on the frequency-contrast characteristic data, as well as VEP registration according to Visus intern protocol as control methods. Key words aggravation; contrast sensitivity function; malingering; visual acuity; visual evoked potentials (The article in PDF format. For preview need Adobe Acrobat Reader)  Open article in new window
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